EMDR progress notes document a client's movement through the eight phases of Eye Movement Desensitization and Reprocessing, capturing the targets you processed, the measures you tracked, and the client's response within a single session.

Because EMDR uses structured, phase-based protocols and quantifiable measures like SUDS and VOC, the documentation looks different from standard talk-therapy notes.

This guide covers what to record in each phase, the templates that keep it consistent, and an example you can adapt.

Key Takeaways

• EMDR notes should document which phase the session addressed, the specific target processed, and the standardized measures (SUDS and VOC) so progress is quantifiable and defensible.

• A phase-aware template prevents the common gap of recording that "bilateral stimulation was used" without capturing the target, the cognitions, or the client's measurable response.

• Tracking SUDS and VOC across sessions creates a clear, outcome-based record of reprocessing progress that supports both clinical decision-making and payer requirements.

What Makes EMDR Documentation Distinct

EMDR is a structured, eight-phase protocol, and that structure should be visible in your notes. Standard psychotherapy notes describe themes and interventions in narrative form, but EMDR documentation needs to capture where in the protocol you are, what target you're working on, and how the client's distress and beliefs shifted. Without those elements, a note can describe a full reprocessing session yet fail to show the clinical reasoning or measurable change behind it.

The phases give you a built-in framework. History-taking and treatment planning, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation each call for slightly different documentation.

A session might span several phases or focus on just one, so your note should make clear which phase or phases you addressed and why. Anchoring the work to the client's broader EMDR treatment plan keeps each session note connected to the overall arc of treatment rather than reading as an isolated event.

The other distinctive feature is measurement. EMDR relies on two standardized scales that turn subjective distress into trackable numbers, which we'll cover next.

The Measures Every EMDR Note Should Capture

Two scales are central to EMDR and belong in your notes whenever you're in the reprocessing phases.

• SUDS (Subjective Units of Distress Scale) runs from 0 to 10 and measures the client's current distress when focused on the target memory. You record it at the start of desensitization and track it as it decreases.

• VOC (Validity of Cognition Scale) runs from 1 to 7 and measures how true the client's positive cognition feels to them. You record it during assessment and again during installation as it strengthens.

Documenting these numbers gives you an objective record of reprocessing. A note showing SUDS dropping from 8 to 2 and VOC rising from 3 to 6 tells a clear story of progress that a narrative summary can't match. Alongside the scales, capture the negative cognition you targeted and the positive cognition you're installing, since those beliefs are the substance the numbers are measuring. This kind of quantifiable tracking also strengthens how you evaluate client progress across the course of treatment. With the measures defined, the phase-by-phase structure shows where each element lands.

Documenting Each EMDR Phase

You won't document every phase in every note, but knowing what each phase contributes keeps your records complete.

Phases 1 and 2: History-Taking and Preparation

Early sessions focus on history, treatment planning, and building the client's capacity to tolerate processing.

Your notes here document the targets you identified, the client's readiness, and the resourcing or stabilization skills you taught. Because affect tolerance is foundational before reprocessing begins, recording the grounding techniques you've established gives you a documented safety net to return to during closure.

Phase 3: Assessment

In assessment, you and the client identify the target image, the negative cognition, the desired positive cognition, the associated emotions and body sensations, and the baseline SUDS and VOC. This is where you capture the starting numbers that everything afterward will be measured against.

Phases 4 Through 6: Desensitization, Installation, and Body Scan

These are the active reprocessing phases. Your note documents the target, the sets of bilateral stimulation used, how the SUDS decreased through desensitization, how the VOC strengthened during installation, and the results of the body scan. Recording the movement in these numbers is what makes the session's clinical work visible.

Phases 7 and 8: Closure and Reevaluation

Closure documents how you returned the client to stability at the end of the session, including any containment or grounding work, and where you left the processing. Reevaluation at the start of the following session documents what carried over, whether gains held, and what target comes next. With the phases mapped, an example shows how they read together.

An EMDR Progress Note Example

Here's how a desensitization-focused session might read using a structured, phase-aware format.

Phase addressed: Phases 3 through 6 (assessment through body scan).

Target: A motor vehicle accident from two years prior.

Negative cognition: "I am not safe." Positive cognition: "I can keep myself safe now."

Baseline: SUDS 8 of 10. VOC 2 of 7.

Desensitization: Multiple sets of bilateral stimulation administered. Client initially reported tightness in the chest and intrusive images of the collision. Across sets, distress diminished and the client spontaneously connected the memory to a sense of having survived. SUDS decreased to 2 of 10.

Installation: Positive cognition installed across additional sets. VOC strengthened to 6 of 7.

Body scan: Client reported residual mild tension in the shoulders, which cleared with one additional set. Body scan ended clear.

Closure: Client stabilized using a previously established calm-place exercise. Reported feeling "lighter" and grounded at session end. No incomplete processing noted.

Plan: Reevaluate this target at next session. If gains hold, move to next target on the treatment plan. Continue resourcing as needed.

This note shows the target, the cognitions, the measurable shift in SUDS and VOC, and the clinical reasoning, all of which a generic note would miss. The same discipline carries into how you structure routine documentation, and a solid progress note template gives you a consistent backbone to build the EMDR-specific elements onto.

Common EMDR Documentation Pitfalls to Avoid

A few recurring gaps undermine otherwise good EMDR records, and they're worth naming so you can sidestep them.

• Recording the technique without the target. A note that says bilateral stimulation was used, without naming the memory processed or the cognitions involved, doesn't document the actual clinical work.

• Skipping the measures. Leaving out SUDS and VOC removes the objective evidence of progress and weakens the note for both clinical and payer review.

• Neglecting closure. Failing to document how you returned the client to stability is a safety and risk-management gap, especially when processing is incomplete.

• Disconnecting sessions from the treatment plan. Notes that don't tie back to identified targets and goals read as isolated events rather than a coherent course of treatment.

Avoiding these comes down to using a structure that prompts for each element. Many clinicians find that a SOAP framework adapts well to EMDR, and reviewing SOAP note examples shows how the EMDR-specific content fits within a familiar format. For trauma work that overlaps with anxiety presentations, aligning notes with established treatment goals and objectives for anxiety keeps the documentation goal-directed.

How Berries AI Supports EMDR Documentation

EMDR's structured, measure-heavy format is exactly the kind of documentation that benefits from automation, because the details that make a note defensible are also the easiest to lose track of after an intense reprocessing session.

Berries is a HIPAA-compliant AI scribe built specifically for mental health professionals. It captures your EMDR session and generates a structured note that reflects the phase, target, cognitions, and your clinical observations in the format you prefer, so the SUDS, VOC, and reprocessing details land in the record without you reconstructing them from memory afterward. The platform learns your documentation style, works for in-person and telehealth sessions alike, and integrates with any EMR. Your first 20 sessions are free, with no credit card required, so you can see how it handles a protocol-driven modality before committing.

Frequently Asked Questions

What should an EMDR progress note always include?

At minimum, the phase or phases addressed, the specific target processed, the negative and positive cognitions, the SUDS and VOC measures, the client's response during reprocessing, and the closure work. Tying the session back to the treatment plan and the next target completes the record.

Do I need to record SUDS and VOC in every note?

Record them whenever you're in the assessment and reprocessing phases, since they're the objective measures of progress. Sessions focused entirely on history-taking, preparation, or resourcing won't always involve active reprocessing, but any session that targets a memory should capture the starting and ending numbers.

How do I document an incomplete EMDR session?

Note the SUDS and VOC where processing paused, document the closure and stabilization techniques you used to return the client to a regulated state, and flag the incomplete target for reevaluation at the next session. Documenting closure is essential for safety and risk management.

Which note format works best for EMDR?

EMDR's phase structure adapts well to formats like SOAP or a dedicated phase-based template. The key is that whatever format you use prompts you to capture the target, cognitions, measures, and closure, rather than just describing the session narratively.

Can EMDR notes support insurance billing?

Yes. EMDR sessions are billed under standard psychotherapy codes based on time and service type, and well-structured notes that show the target, measurable progress, and medical necessity support those claims. The quantifiable nature of SUDS and VOC tracking is an asset when documenting progress for payers.

This article is for educational purposes and professional development only. It does not constitute clinical supervision or replace professional judgment in therapeutic practice.