The EMDR Drawing Protocol with Children
Shanon Claussen, LISW RTP-S AC is an experienced EMDR therapist, experienced supervisor and Approved Consultant whose expertise with EMDR with children is illustrated here with using the Drawing Protocol to process traumatic memories.
Phase One: Client History
This phase involves a standard history-taking approach as outlined in the Adaptive Information Processing model. The therapist should gather comprehensive background information to understand the events contributing to the child’s current symptoms and problems. It’s essential to explore potential triggers and the child’s future needs to ascertain the suitability of EMDR interventions.
With children, especially during preverbal stages, it may be necessary for parents to help construct a timeline of significant events. By discussing the child’s perceptions of remembered or unremembered events, therapists can identify and target the belief schemas associated with negative experiences. Decisions on which target to reprocess first and which EMDR protocol to use are made based on clinical judgment and the client’s preferences.
Phase Two: Preparation
The aim here is to stabilize the child and enhance access to positive affect. This might involve having the child draw their ‘safe place’ or ‘container’ and using Bilateral Stimulation (BLS) to strengthen these images. Techniques to activate a calm state should engage all five senses, asking the child to describe what they see, feel, smell, taste, or hear.
For reinforcing positive characteristics like bravery or intelligence, have the child draw instances demonstrating these traits and connect these to positive body sensations, enhancing them with BLS. The inclusion of a stop sign drawn by the child provides them control over the BLS process, enhancing their comfort and engagement.
Phase Three: Assessment
In this phase, the therapist confirms the child’s willingness to proceed with reprocessing the agreed-upon target. If a child is not ready to tackle a whole event, the therapist may break it down into smaller, manageable parts.
The child can draw aspects of the event they feel capable of handling, and only this segment is focused on initially. During this phase, the therapist helps the child articulate the negative and positive beliefs associated with the trauma, which might be simplistic depending on the child’s age.
Phase Four: Desensitization
This phase involves processing the targeted trauma to shift towards an adaptive resolution. Typically, faster, longer sets of BLS are utilized, with adjustments based on the child’s age and specific needs.
Children are encouraged to draw the traumatic event, which may be used actively during the session for additional tactile or visual BLS methods, such as scribbling across the image to symbolize processing.
Phase Five: Installation
This phase aims to strengthen connections to positive, adaptive neuro networks. The therapist checks if the initially selected positive cognition still applies or needs adjustment.
The validity of the positive belief is enhanced through further BLS until it feels completely true (VOC at level 7), using drawings to visualize and reinforce this change.
Phase Six: Body Scan
Here, any residual bodily disturbances related to the target are addressed. Children may illustrate where they feel tension or discomfort on a drawing of a gingerbread man, which helps externalize and address these sensations.
Techniques like drawing over these sensations with a ‘healing color’ or using BLS to ‘scribble out’ discomfort are employed to clear any lingering disturbances.
Phase Seven: Closure
To ensure the child leaves the session feeling stable, this phase might include revisiting or teaching new stabilization techniques. Techniques such as the butterfly hug or visualizing a calm place are reinforced.
Educating parents on these strategies is also crucial so they can support their child between sessions.
Phase Eight: Reevaluation
This final phase assesses the treatment effects and ensures no residual disturbances remain. The child might redraw the traumatic event to help the therapist assess any remaining disturbance and determine if further processing is necessary.
Conclusion
Shanon’s application of the Drawing Protocol offers a structured yet flexible approach to integrating EMDR in child therapy, allowing therapists to adapt interventions based on the unique needs and responses of each child. This method fosters a deeper, more intuitive engagement with young clients, facilitating significant therapeutic breakthroughs in a supportive, creative environment.
Resources:
- Luber, Marilyn, Ed. (2009) Eye Movement Desensitization and Reprocessing (EMDR) Scripted Protocols,, Chapter 16
- The use of drawing in EMDR is described by other clinicians such as Jarero, Ignaciou Nacho et al (2008) The EMDR Integrative Group Treatment Protocol: Application With Child Victims of a Mass Disaster Journal of EMDR Practice and Research 2(2):97-105
DOI:10.1891/1933-3196.2.2.97
- Dr. Esly Regina Carvalho’s The EMDR Drawing Protocol for Adults.
Bonnie Mikelson LISW
