Phase 3 of 8
Assessment
Assessment Components
Target Image
"Bring up the memory and notice the image that represents the worst part of it now. What image or part of this memory stands out for you?"
Negative Cognition (NC)
"As you focus on that part of the memory, what negative belief do you have about yourself now that goes along with it?"
Positive Cognition (PC)
"Now, what would you like to believe about yourself instead? What positive belief would you rather hold?"
Validity of Cognition (VOC)
"On a scale from 1 to 7, with 1 being completely false and 7 being completely true, how true does this positive belief feel to you right now?"
Emotions
"As you think about that memory and the negative belief, what emotions come up for you?"
Subjective Units of Disturbance (SUD)
"On a scale from 0 to 10, with 0 meaning no disturbance at all and 10 being the most disturbance you can imagine, how disturbing does this memory feel right now?"
Body Location
"Scan your body. Where do you feel it the most? It might be tightness, a lump in your throat, or a sensation somewhere else."
Common Cognitions Reference
Responsibility / Defectiveness / Shame
| Negative (NC) | Positive (PC) |
|---|---|
| I am bad | I am a good person |
| I am not good enough | I am good enough |
| I am worthless | I am worthy / I have value |
| I am shameful | I am okay as I am |
| I am not lovable | I am lovable |
| I am permanently damaged | I am whole |
Safety / Vulnerability / Trust
| Negative (NC) | Positive (PC) |
|---|---|
| I am in danger | I am safe now |
| I cannot protect myself | I can protect myself |
| I cannot trust anyone | I can choose whom to trust |
| I have to be perfect | I am enough |
Power / Control / Choice
| Negative (NC) | Positive (PC) |
|---|---|
| I am powerless | I have power now |
| I am helpless | I can help myself |
| I am out of control | I am in control now |
| I have no control | I have choices |
Guilt / Responsibility
| Negative (NC) | Positive (PC) |
|---|---|
| I should have done something | I did the best I could |
| It's my fault | It's not my fault |
| I cannot be forgiven | I can forgive myself |
Target Identification Techniques
A Affect Scan (Floatback)
Used when client has difficulty identifying a specific target memory. The affect scan uses current emotional and somatic experience to bridge back to earlier memories that may be contributing to present distress.
When to use:
- • Client reports strong emotions but can't identify a specific memory
- • Present-day triggers with unclear origin
- • Identifying touchstone memories (earliest related memory)
"Notice the feeling in your body right now. Let your mind float back to an earlier time when you may have felt a similar feeling. It could be from any time in your life. Just let whatever comes up naturally..."
T Trace Back Technique
Similar to affect scan but starts with a current problematic belief or cognition rather than an emotion. Traces the negative cognition back to its origins to find touchstone events.
When to use:
- • Client has strong negative self-beliefs but unclear source
- • Multiple traumas and need to find touchstone
- • When cognition-focused approach fits client better
"When you think about the belief '[NC]', notice where you feel it in your body. Now, let your mind trace back to the earliest time you can remember feeling this way or believing this about yourself..."
Key Difference: Affect Scan starts with emotions/body sensations, while Trace Back starts with negative cognitions/beliefs. Both techniques help identify the underlying memories feeding current symptoms. Choose based on whether your client leads with feelings or thoughts.
Quick Reference
- 1 Image — worst part of incident
- 2 NC — negative self-belief
- 3 PC — desired positive belief
- 4 VOC — how true PC feels (1-7)
- 5 Emotions — current feelings
- 6 SUD — disturbance level (0-10)
- 7 Body — location of sensations
Clinical Notes
- • Don't rush through assessment
- • NC/PC must be self-referencing
- • VOC below 7 is expected at this stage
- • High SUD is normal and expected
- • Body location used later in Phase 6
- • Start with: earliest, worst, most recent
Opening Script
"Now that we've identified a memory to work on, we're going to go through a process to fully assess it. I'll guide you step by step. Just let me know whatever comes to mind—there are no right or wrong answers."