Module 6: Decision-Making Points During Closure and Reevaluation Phases

This module provides an in-depth exploration of clinical decision-making during the core trauma processing phases of EMDR therapy (Phases Four to Six) when working with children and adolescents affected by complex and developmental trauma. These phases are often the most dynamic, delicate, and challenging—especially when dissociative structures, rigid defenses, or internalized perpetrator dynamics are present.

Participants will learn how to identify key decision-making markers that indicate when processing is adaptive, when it is blocked, or when it is leading to destabilization. The module introduces a framework for recognizing types of blocked processing and choosing the appropriate interweaves based on the child’s developmental stage, internal organization, and symptom presentation.

A core focus will be on how to apply the EMDR Interweave Systems Model, developed by Ana Gomez, which includes a wide range of interweaves categorized across multiple systems (e.g., attachment, regulatory, structural, trauma-informed, cognitive, affective, and somatic). This model allows clinicians to tailor their interventions with precision, addressing not only what is blocking processing but also what the system needs in order to resume adaptive resolution.

Through clinical examples and experiential exercises, participants will strengthen their ability to navigate stuck points, offer attuned interventions, and preserve the therapeutic relationship even in the face of intense material.

Learning Objectives:

By the end of this module, participants will be able to:

1. Identify clinical markers that indicate whether processing is adaptive, looping, blocked, or leading to dysregulation.
2. Recognize different types of blocked processing (e.g., phobic avoidance, avoidance via dissociation, dominance of perpetrator-imitating parts).
3. Describe the EMDR Interweave Systems Model and how to use it to select interweaves that match the child’s developmental and clinical needs.
4. Differentiate between cognitive, somatic, affective, attachment, regulatory, and trauma-informed interweaves.
5. Implement developmentally sensitive and phase-appropriate interweaves that promote safety, connection, and continuity of processing.
6. Tailor interweaves to support internal cooperation among ego states or parts when fragmentation or conflict arises during processing.
7. Maintain therapeutic attunement and flexibility while navigating the complex terrain of trauma resolution in children with dissociative structures.