Your First EMDR Client:Deciding Who to Start With

TL;DR: When choosing your first EMDR client, you do not need to find someone you can immediately take into reprocessing. EMDR is an eight-phase treatment approach, and all eight phases are EMDR, including history taking, treatment planning, and Phase 2 preparation and resourcing.

Consider clients you already know clinically, your ability to begin conceptualizing the case through an AIP lens, the therapeutic relationship, the client's needs, and what you are learning as you start integrating EMDR into your work.

You probably will not feel completely ready before your first EMDR client. At some point, you have to practice what you learned. Use your Basic Training consultation to help you choose where to start, think through your cases, ask questions, and learn from what happens as you begin.

You completed your first portion of EMDR Basic Training. You learned the eight phases, practiced different parts of the protocol, started thinking about your clients through the Adaptive Information Processing (AIP) model, and now comes the part that can feel much less straightforward:

Which client do I actually start with?

This is one of the questions I hear most often from therapists during EMDR Basic Training consultation.

Depending on your training program, you may begin practicing EMDR with clients between different portions of your training. You may also be looking at your caseload and wondering who is “ready,” which case is straightforward enough, or whether you are ready to try any of this without your training manual sitting directly beside you.

There is no formula for identifying the perfect first EMDR client. Instead, I encourage newer EMDR therapists to think about the client, the case, the therapeutic relationship, the treatment goals, what they already know about the client, and where consultation might help them decide how to begin.

And there are two things I want you to remember from the beginning:

All eight phases are EMDR.

And consultation is a great place to help you figure out where to start.

Starting EMDR Does Not Mean Starting Reprocessing

One of the biggest shifts I want newer EMDR therapists to make is separating “doing EMDR” from “doing Phases 3–7.”

Reprocessing is one part of EMDR therapy. It is not the entirety of EMDR therapy.

EMDR is an eight-phase treatment approach. When you are gathering history and beginning to conceptualize a client's experiences through an AIP lens, you are doing EMDR. When you are developing a treatment plan, you are doing EMDR. When you are helping a client understand the process, exploring resources, practicing state shifts, and preparing for future reprocessing, you are doing EMDR.

Phase 2 is not the waiting room for the “real” EMDR.

This can take some pressure off choosing your first client. You do not have to identify the person on your caseload who seems most likely to move neatly through all eight phases and give you a textbook reprocessing session.

You can start by integrating what you are learning into the work you are already doing.

Look at Clients You Already Know

For your first EMDR cases, I often recommend beginning by looking at clients you already know clinically.

You may already understand their history, current stressors, strengths, resources, patterns, treatment goals, and how they tend to respond when they become overwhelmed or shut down. You also already have information about the therapeutic relationship and how the two of you communicate.

That does not mean you skip EMDR-specific history taking or assume that because you have worked with someone for a year, you already know everything you need to know. Instead, you are taking what you already know and beginning to look at it through an EMDR and AIP lens.

Choose Someone You Can Begin to Conceptualize

You do not need a perfectly mapped treatment plan before you begin, but you should be able to start making sense of why you are considering EMDR. What is bringing the client to therapy now? What experiences may be connected to the current concern? What happens in the present? What does the client want to be different in the future?

As you begin thinking through the past, present, and future, you may start identifying themes, memory networks, triggers, potential targets, resources, or places where you simply need more information. That last one matters. Sometimes your case conceptualization leads you directly toward a potential target. Sometimes it tells you that you need to spend more time in history taking or preparation first. Both are useful information.

Phase 2 Is EMDR Too

Newer EMDR therapists can feel pressure to get through preparation so they can finally “do EMDR.” But preparation is one of the eight phases of EMDR.

Phase 2 gives you time to learn more about how this particular client experiences distress and what helps them stay connected to the present. You may explore existing resources, develop additional resources, practice bilateral stimulation, introduce concepts such as the Window of Tolerance, and experiment with different ways of shifting state.

You may use practices such as Calm/Safe State, container, light stream, or other resources that fit the client and your training. Sometimes Phase 2 also gives you new information that changes your treatment plan. The amount and type of preparation will not look identical for every client. The goal is not to create a checklist of coping skills that someone has to master before they are allowed to reprocess.

It is to understand the client, build resources that are useful for that particular person, and gather the information you need to make thoughtful decisions about what comes next.

Consider the Relationship and Communication

EMDR is collaborative. As you think about your first client, consider what communication already looks like between you. Can the client tell you when something does not feel right? Can they tell you they need to slow down or stop? Do they tend to agree with you because they think that is what they are supposed to do? How do the two of you navigate misunderstandings or changes in direction? And consider your side of that relationship too.

Can you stay curious if the client responds differently than you expected? Can you slow down rather than pushing forward because you really want to complete the protocol? Can you notice the client while part of your brain is also remembering what comes next? You are still a therapist while you are learning EMDR. Your existing clinical skills did not disappear when someone handed you an eight-phase protocol.

You Are Probably Not Going to Feel Completely Ready

You can understand the eight phases, practice during training, review your materials, and still feel nervous the first time you start integrating EMDR with an actual client.

That does not necessarily mean you are not ready to begin. It means you are learning something new.

There is a point where learning EMDR requires actually practicing EMDR with clients. You start using what you learned, notice where you feel confident and where you have questions, bring those questions to consultation, and keep building from there.

This is another reason I encourage newer EMDR therapists to start with the foundational model they learned in training rather than immediately trying to master every adaptation or specialized protocol. You do not need to know everything about EMDR before you begin using it.

You do need to practice within your scope of competence, recognize when something is outside of your current training or experience, and have support available when you are unsure what to do next.

And that is exactly what Basic Training consultation is there to help with.

Consultation Can Help You Decide Who to Start With

You do not need to choose your first EMDR client alone and then bring the case to consultation after you get stuck.

Choosing who to start with is something you can bring to consultation.

You might come with two or three clients you are considering and talk through what you know about each one. You can explore case conceptualization, readiness, preparation needs, possible targets, questions about dissociation, or anything else that is making you unsure about where to begin. You can also bring the case back after you start.

Maybe you begin looking at the client's history through an AIP lens and realize you have more questions. Maybe Phase 2 is giving you information you had not considered before. Maybe you are wondering whether to continue preparing, move toward assessment and reprocessing, or rethink part of the treatment plan.

Bring that to consultation too. You are not expected to figure everything out before you practice. Practice and consultation work together. You use what you learned, notice what happens with an actual client, ask questions, make adjustments, and gradually become more comfortable integrating EMDR into your clinical work.

Consultation is not only for troubleshooting when something has gone wrong. It is part of how you learn.