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Phase 1 of 8

History & Treatment Planning

Establish alliance Gather history Assess readiness Identify targets

Intake Assessment

Print Form
1 Client Information
• DOB / Age
• Caregiver's Name & Relation
• Date of Referral
• Date of Intake
Tip: Verify caregiver's legal relationship and authority to consent for treatment.
2 Risk Assessment Critical

Assess before treatment planning to ensure client stability:

Suicidal/homicidal ideation
Self-harm behaviors
Substance use / addiction
Current safety concerns
Important: If active risk factors present, stabilization must occur before EMDR processing begins. Collaboratively create a safety plan with the client/caregiver.
3 Goals & Strengths

Client's Goals

"What do you hope to get out of therapy?"

Client's Strengths

Coping skills, support system, resilience factors

Tip: Strengths identified here become resources in Phase 2. Document coping strategies that have worked. Motivational interviewing techniques are useful in collaborating with treatment plan goals.
4 Trauma History

Document all relevant trauma experiences:

• Type(s) of trauma experienced
• Age at time of trauma
• Duration / frequency
• Perpetrator relationship (if applicable)
Tip: Don't require detailed narrative at intake. General information sufficient for treatment planning. The UCLA PTSD Reaction Index is a useful tool for identifying trauma history and symptoms.
5 Triggers

Identified by client and caregivers at intake:

Environmental

Places, sounds, smells

Relational

People, interactions

Internal

Thoughts, feelings

Tip: Continue identifying triggers throughout treatment. These inform present-prong targets.
Caution: Only identify triggers if client shows readiness to discuss and is able to tolerate distress. Otherwise, focus on building resources first.
6 Attachment Style

Understanding attachment informs therapeutic approach:

Attachment Style Questionnaire – Short Form (ASQ-SF)

Recommended for ages 15+

Access ASQ-SF
Tip: Disorganized attachment may indicate complex trauma requiring extended Phase 2 preparation.

Clinical Assessments

UCLA PTSD Reaction Index

Trauma symptom measure

Dissociation Screening

Essential before processing

Affect Tolerance

Can client manage distress?

Avoidance Types

Identify patterns

Trauma Phobias

Specific fears related to trauma

Target Identification

Trace Back & Affect Scan Techniques

Use these techniques to identify touchstone memories and connect current symptoms to their origins. Detailed scripts and guidance are available in Phase 3.

View Scripts in Phase 3

Three-Pronged Approach

PAST

Trauma memories that set the template

PRESENT

Current symptoms and triggers

FUTURE

Desired future scenarios

Quick Checklist

  1. 1 Complete intake assessment
  2. 2 Assess risk & stability
  3. 3 Administer clinical measures
  4. 4 Identify goals & strengths
  5. 5 Document trauma history
  6. 6 Identify triggers
  7. 7 Create target sequence
  8. 8 Develop treatment plan

Clinical Notes

  • • Allow adequate time for history-taking
  • • Use age-appropriate measures
  • • Document informed consent
  • • Consider cultural factors
  • • Ensure support system exists
  • • Screen for dissociation first