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This Clinical Q&A section responds to a question about organizing a client's historical information into a targeting sequence within a treatment plan that is consistent with Shapiro's (2001) three-pronged protocol. The procedures for identifying and prioritizing treatment eye movement desensitization and reprocessing (EMDR) targets are reviewed in the context of Shapiro's theoretical model, and various time line models are summarized. The author then presents her EMDR Target Time Line, which provides a practical simple visual tool for documenting past, present, and future aspects of the presenting problem. It allows the therapist to note if disturbing past experiences present around a core theme, such as negative cognitions, physical symptoms, or situations/persons/circumstances. Three clinical cases are used to illustrate the form's application with various types of treatment targets.
Keywords: eye movement desensitization and reprocessing (EMDR); treatment target; time line; core theme; adaptive information processing; clinical application
Question: How can I organize my client's historical information into a targeting sequence consistent with a treatment plan?
ANSWER:
Target tracking is a critical component of comprehensive treatment with eye movement desensitization and reprocessing (EMDR). Effective target tracking rests on the foundation of relevant targets organized in a way that reframes the presenting issue within the context of the client's history. I have developed the EMDR Target Time Line, which is a structured and systematic tool to conceptualize this task and provide a visual illustration of how the presenting issue is related to the client's significant life experiences (see Figure 1). It allows the therapist to note if disturbing past experiences present around a core theme, such as negative cognitions, physical symptoms, or situations/persons/ circumstances. The EMDR Target Time Line organizes the identified dominant symptom with the related life events and illustrates how the past is recreated in the present. In this way, the EMDR Target Time Line adheres to EMDR's three-pronged approach, connecting past incidents, present triggers, and future concerns or templates. It allows the clinician to monitor progress and remain focused on the client's goals, providing efficient and more effective treatment.
Target Selection and the Adaptive Information Processing Model
The structure of EMDR is grounded in Shapiro's (2001) adaptive information processing (AIP) model, which states that most pathologies have their roots in earlier life experiences that are...