Module 3: Decision-Making Points During Preparation Phase

This module offers an in-depth examination of Phase Two of EMDR therapy, which lays the foundational infrastructure for therapeutic safety, stabilization, and readiness for trauma processing. Central to this exploration is the Multifactor Model of Preparation (Gomez, 2013; Gomez, in press), a comprehensive framework that informs the strategic sequencing of preparatory interventions within a neurodevelopmental and attachment-informed lens.

Participants will be guided through the intricate clinical decision-making required to optimize Phase Two, with particular attention to the interplay between relational attunement, affective tolerance, and regulatory scaffolding. Rather than a static or protocolized approach, this module promotes a dynamic and individualized conceptualization of preparation based on the evolving clinical presentation and the child’s or adolescent’s adaptive capacities.

Key areas of focus include:

• Application of the Multifactor Model of Preparation to enhance affect regulation, strengthen somatic coherence, develop dual attention, and scaffold ego strength across cognitive, emotional, relational, and neurobiological domains
• Clinical strategies to enhance resilience and increase the window of affect tolerance, utilizing integrative resource development techniques (e.g., symbol-based resourcing, containment, symbolic anchors) grounded in polyvagal-informed, developmentally appropriate delivery
• Management of clinical dilemmas and disruptions, including affective dysregulation, phobic avoidance of internal states, attachment disruptions, and trauma-induced dissociation—alongside flexible adaptations to pacing, titration, and session structure
• Differentiated pathways for clients who require extended or cyclic preparation, including those with complex trauma histories, structural dissociation, and relational trauma—ensuring fidelity to the AIP model while embracing adjunctive and phase-specific interventions
• Integration of relational neurobiology conceptualization to enhance therapeutic attunement and co-regulatory capacity within the therapeutic dyad

This module empowers clinicians to approach Phase Two with clinical intention, theoretical clarity, and attuned responsiveness. Participants will leave with an advanced capacity to formulate individualized preparation plans that are not only grounded in the AIP model but also attuned to the lived developmental, systemic, and neurobiological realities of each child or adolescent.

By mastering the preparation phase as a complex, decision-rich process, clinicians can ensure a solid therapeutic platform from which adaptive resolution can emerge—maximizing both the efficacy and integrity of the EMDR treatment trajectory.