EMDR Questions to Ask Clients
Twenty questions for clinicians working through EMDR history taking and preparation. They cover presenting concerns, trauma history, current symptoms, coping resources, support systems, medication, expectations of the protocol, and what the client does not want to touch yet.
The questions
Open any question for the note
What brings you in now, and what would you like to be different?
Why ask it
The word now matters. Something usually changed in the past few weeks, and naming it tells you whether the referral is driven by a new stressor, an anniversary, or pressure from someone else, which affects pacing.
What does a bad week look like for you at the moment?
Why ask it
Concrete description of a week gives you frequency and function in one answer, which a symptom checklist does not. Clients who cannot describe a bad week distinctly from a normal one are often describing a chronic baseline rather than episodic distress.
Which symptoms interfere most day to day: sleep, intrusive memories, avoidance, numbness, something else?
Why ask it
Ranking rather than listing tells you where to aim the first target and what to measure change against. Avoidance ranked first is a caution, since the client may not be able to stay with a memory long enough to process it yet.
When did you first notice these symptoms, and what was going on around then?
Why ask it
Onset dating often surfaces the earliest relevant event without asking for it directly. A gap between the event and the onset of symptoms is common and worth noting rather than treating as a contradiction.
Are there things from your past you think are connected to how you feel now?
Why ask it
Letting the client draw the connection keeps the history collaborative and reveals their own explanatory model. Answers that name only recent events may indicate earlier material has not yet become speakable.
Which memory feels most present, the one that arrives without being invited?
Why ask it
This locates candidate targets more reliably than asking about the worst event, because intrusiveness rather than severity predicts what will surface during processing. Note the image, not just the story.
Are there memories you do not want to go near yet?
Why ask it
Naming the off-limits material early is protective for both of you, and it usually shortens the time before the client is ready to approach it. Treat the list as a boundary to be revisited, not a permanent exclusion.
What happens in your body when you start thinking about any of this?
Why ask it
Body awareness is needed for the protocol, and this question tests whether it is available. A client who reports nothing at all, or who cannot locate sensation anywhere, needs preparation work before target selection.
What do you do when the distress gets too much, and does it work?
Why ask it
The second half is the part that matters. Strategies that reliably reduce distress can be built on, while strategies that only postpone it, including dissociating or drinking, tell you what needs replacing during preparation.
Do you ever lose time, feel detached from your body, or find yourself somewhere without knowing how you got there?
Why ask it
Routine dissociation screening belongs before any target work, and asking plainly gets a plainer answer than a questionnaire. Positive responses call for a fuller assessment and a longer stabilization phase, not a faster start.
How is your sleep, and what happens at night?
Why ask it
Nightmares, hypervigilance at bedtime and early waking each point to different mechanisms. Severe sleep deprivation also limits how much processing a client can tolerate in a session, so it may need addressing first.
Are you using anything to take the edge off, including alcohol or cannabis?
Why ask it
Ask without alarm and ask about amount and timing rather than category. Use immediately before or after sessions is the detail that matters most, since it interferes with the processing you are trying to support.
What medication are you taking, and has anything changed recently?
Why ask it
Recent starts, stops and dose changes matter more than the list itself, because they can be confused with treatment effects. Benzodiazepine use around session times is worth discussing with the prescriber.
Who knows what you are dealing with, and who could you call late at night?
Why ask it
This asks about actual reachable support rather than a family list. A client who names nobody is not necessarily unsuitable, but between-session containment then has to be planned rather than assumed.
What is the steadiest part of your life at the moment?
Why ask it
Housing, work, income and caregiving load determine how much disturbance a client can carry between sessions. Anyone in an ongoing unsafe situation needs that addressed before processing past events.
Have you had therapy before, and what helped or did not?
Why ask it
The unhelpful part is the more useful half of the answer. Clients often describe a specific rupture or a therapist who moved too quickly, which is direct guidance about how to pace this work.
What have you heard about EMDR, and what are you expecting it to be like?
Why ask it
Expectations are frequently shaped by short video clips and range from disbelief to hope for a single-session fix. Correcting both extremes now prevents the client reading normal early sessions as failure.
What worries you about starting this?
Why ask it
The common answers are losing control, being overwhelmed, and being unable to stop once started. Each has a concrete reply available in the protocol, so this question hands you the reassurance the client actually needs.
What signal will you give me if you need to slow down or stop mid-session?
Why ask it
Agreeing a stop signal in advance gives the client control they can use without having to speak. Clients who dismiss the need for one are worth gently persuading, since they are usually the ones who will not interrupt.
What would tell you, months from now, that this had been worth doing?
Why ask it
Answers grounded in daily life, sleeping through the night or going back to a particular place, give you something to measure against. Answers framed as never thinking about it again need adjusting before treatment starts.
History Taking and Preparation
Practical guidance for the conversation itself
Sequencing the intake
Take the history at the client's speed, across sessions if needed
A full trauma history rarely fits one appointment, and pushing to complete it can produce more disturbance than the first processing session. Getting enough to plan targets is sufficient to start preparation.
Ask for the image, not the narrative
Target selection needs a still picture, a belief about the self, an emotion and a body location. A long chronological account tells you the story but may leave you without a workable target.
Establish resources before touching targets
Calm place and container exercises are worth practising to the point where the client can use them unprompted between sessions. Test them under mild distress rather than only in a settled state.
Screen for dissociation before, not after
Standard practice is to screen early and lengthen stabilization where indicated. Discovering significant dissociative symptoms mid-processing is much harder to manage than delaying the start.
What to listen for in the answers
- Absent body sensation, which limits the protocol until awareness is built.
- Coping that works by shutting off feeling rather than reducing it.
- An ongoing unsafe living or working situation, which usually takes priority over past material.
- Expectations of a single-session resolution, which set the client up to read normal progress as failure.
- A previous therapy rupture, which is direct information about pacing and about how to handle a mistake here.
- Any material the client rules out, which should be written down and revisited rather than argued with.
Practicalities to settle before the first processing session
- 1Explain the shape of a session, including that distress often rises before it falls.
- 2Agree the stop signal and demonstrate that you will honor it immediately.
- 3Introduce the distress and belief rating scales so the numbers are familiar before they are needed.
- 4Plan the last ten minutes of every session for closure rather than assuming processing will finish.
- 5Agree what the client will do between sessions if material continues to surface, and what contact is available.
- 6Confirm transport home and the rest of their day, particularly for a first session.