EMDR sessions can generate a large amount of information: target details, ratings, shifts in affect and body sensation, bilateral stimulation settings, pauses, modality changes and closure decisions. The challenge is not to record every moment. It is to create a clear clinical record that supports continuity of care and explains the reasoning that mattered.
Australian health-record guidance emphasises records that are accurate, current, factual, objective and respectful. For EMDR practitioners, that principle can help distinguish useful documentation from a minute-by-minute equipment log.
Document the treatment, not just the device
Bilateral stimulation is one component within EMDR’s eight-phase approach. A note that records only “lightbar used” or “tappers used” says little about the therapeutic work. Depending on professional obligations, workplace policy and clinical relevance, a useful note may identify:
- the phase of treatment and purpose of the session;
- the target or agreed focus, described with appropriate regard for privacy;
- relevant assessment measures or client-reported ratings;
- the bilateral modality used—visual, tactile, auditory or a clinically relevant combination;
- material changes made in response to comfort, access or presentation;
- the client’s response and significant clinical observations;
- any departure from the planned approach and the reasoning for it;
- how the session was closed and the client’s state on leaving; and
- the plan for re-evaluation or subsequent work.
The purpose is to preserve the clinical thread. Another appropriately authorised practitioner—or the treating clinician returning to the record later—should be able to understand what occurred, why key decisions were made and what needs attention next.
Record settings when they are clinically meaningful
It is rarely helpful to transcribe every speed or intensity adjustment. Settings become worth noting when they influenced comfort, access, engagement or the clinical course. Examples might include changing from visual to tactile stimulation because visual tracking became difficult, reducing audio volume after client feedback, or altering positioning to accommodate pain or mobility.
Use the terminology of the actual system carefully. A number on one controller may not correspond to the same sensation or speed on another. If a setting is recorded, include enough context for it to be meaningful rather than assuming a bare number will explain itself.
Separate observation from interpretation
Objective language improves clarity. “Client looked uncomfortable” is less informative than recording the observable behaviour, the client’s report and the action taken. For example: the client reported visual fatigue and repeatedly lost the tracking point; stimulation was paused and the modality was changed following discussion.
Interpretation still belongs in the clinical record when relevant, but it should be distinguishable from observation and linked to the clinician’s assessment. Notes should remain respectful and avoid unnecessary or judgemental detail.
Protect privacy through relevance
A comprehensive record is not the same as an indiscriminate record. Include the information required for safe, accountable care while avoiding unrelated detail. Follow applicable privacy law, professional standards, organisational requirements and the practice’s policies for access, storage, correction, retention and disposal.
Templates can help with consistency, but they should support rather than replace thinking. A checklist that automatically records “tolerated well” may conceal important variation. The clinician still needs to document what was relevant for this client, in this session.
Use documentation to support re-evaluation
EMDR’s phase-eight re-evaluation depends on understanding what changed and what remains active. A concise record of the target, response, meaningful stimulation adjustments, closure and next-step plan gives the following session a clear starting point.
Good documentation does not make the equipment the story. It shows how the clinician integrated the equipment into an assessed, responsive and ethically accountable treatment process.
Sources: Ahpra: Managing health records, Psychology Board of Australia: Code of conduct, and EMDR International Association: The Eight Phases of EMDR Therapy.
For trained health professionals. This general information does not replace professional, legal, organisational or insurer requirements for clinical records, nor individual supervision or clinical judgement.