Timely EMDR through systematic formulation of complex cases


EMDR practitioners, having experienced the efficacy of EMDR in alleviating distress in clients, may be tempted to provide EMDR therapy without having done a thorough case formulation for their clients. This presentation will address the need for case formulation, illustrate a systematic way of understanding and formulating treatment plan for complex cases, and be clear about when to use EMDR as part of the treatment. A single case study of a young man diagnosed with Major Depression and Social anxiety, and who presented with dissociative features, is used to illustrate the use of the 4Ps for case formulation to enhance practitioners’ understanding of complex cases, be attuned to clients’ need for adequate support prior to processing trauma, and to understand the role of EMDR and the AIP formulation within the complexity of treatment. By using the 4Ps case formulation, it helps less experienced practitioners be more confident about making clinical decisions especially when clients present unexpected issues from session to session. For more experienced practitioners, the 4Ps case formulation is useful when supervising others. The following points will be covered in the presentation: • Description of the 4Ps Case Formulation • Process and matrix of the 4Ps in different domains • Derivation of pattern identification • Derivation of the client’s theme and problem definition • Development of hypotheses and identifying hypotheses model • Development of overall treatment plan and goal • Identifying the variety of appropriate strategies within the treatment plan • Understanding how the AIP in EMDR fits into the overall treatment plan • Monitoring progress and revisiting case formulation before, during and after EMDR.






Shirley Low

Original Work Citation

Low, S. (2017, April). Timely EMDR through systematic formulation of complex cases.  In EMDR in various cultural contexts & special populations (Matthew Woo, Chair). Presentation at the 3rd EMDR Asia International Conference, Shanghai, China



“Timely EMDR through systematic formulation of complex cases,” Francine Shapiro Library, accessed April 18, 2021, https://emdria.omeka.net/items/show/24396.

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