Evaluate dissociation risk, medical issues, and stability; confirm suitability for EMDR with informed consent and safety resources in place.

Test eye movements, taps, or tones; verify tolerance, pacing, dual attention; adjust speed, set length, and breaks for efficient processing when needed.

Build trauma timeline; identify events, triggers, and symptoms; select targets linked to the most impairing problems in daily life today.

Prepare prompts for stalled processing—perspective shifts, responsibility reframes, or new information—to restart adaptive learning now.

Set baselines with SUD (0–10) and VOC (1–7); define negative/positive cognitions; record emotions, body sensations, and desired adaptive belief.

Validated scales measuring irritability, impulsivity, or mood swings act as biomarkers for orbitofrontal and limbic system dysfunction post-injury.