What to give your EMDR clients between sessions

Every EMDR therapist has watched it happen. A client arrives for session three genuinely activated — not the productive kind, the dysregulated kind. They spent the week ruminating on the target you worked on together. They didn't do anything wrong. There was just nothing useful for them to do, and an unquiet nervous system filled the gap.

Between-session support is one of the least-discussed clinical challenges in EMDR practice, and it deserves more attention. Not because it's complicated, but because most of what therapists reach for — generic mindfulness apps, printed worksheets, YouTube videos — doesn't actually address what's happening neurologically.

Why the standard options don't quite work

Generic meditation and breathwork apps are valuable for general stress regulation. But they weren't built for trauma. A client sitting with a mindfulness body scan while they're between sessions on grief work or childhood abuse is doing something qualitatively different from a client using it to manage work stress. The intervention needs to meet the nervous system where it is.

Journaling has its place — especially for clients who process verbally and need externalization. But for many trauma clients, unstructured writing between sessions can open more than it closes. Without a protocol and proper closure, journaling can become rumination with better penmanship.

Worksheets work for psychoeducation. They don't work as nervous system tools. Reading about the window of tolerance is not the same as experiencing it.

What the nervous system actually needs between sessions

Think about what you're doing in session: you're helping the client access their window of tolerance, hold distress at a manageable level, and process it through bilateral stimulation. Between sessions, the goal isn't more processing — it's maintenance. Keeping the window open. Building the client's capacity to regulate without you in the room.

The tools that serve this best tend to share a few properties. They're structured enough that a client can't accidentally wander into uncontrolled territory. They engage the nervous system directly rather than just the thinking mind. And they have a built-in closure sequence so the client doesn't end a 10-minute home practice feeling worse than when they started.

Bilateral stimulation, used in a contained way, meets all three criteria. The same mechanism that drives processing in session can be used at lower intensity between sessions for resourcing, stabilization, and safe-place installation reinforcement.

A framework for what to assign when

Not every between-session tool is appropriate for every client or every phase of treatment. Here's a rough clinical framework:

Phase 1 (history-taking, stabilization): Focus on resourcing. Safe/calm place installation, container exercises, resource development and installation. A tool that guides clients through these with light bilateral stimulation is ideal — it pairs the resource with the bilateral element, strengthening the installation.

Active processing phases: More caution here. You want the client to maintain gains from session without re-opening targets unsupported. Short, structured sessions focused on positive resource reinforcement. Not open-ended processing.

Phase 7 and reevaluation: Clients can often tolerate more between-session work here. They've developed capacity. Self-directed bilateral work on lower-distress material is reasonable for many clients at this stage.

The question of client readiness

Before assigning any between-session resource that involves bilateral stimulation, it's worth asking: can this client tolerate mild distress activation without destabilizing? Do they have grounding skills they can access reliably? Are they stable enough that brief nervous system engagement won't open a flood gate?

For most clients in stable EMDR work, the answer is yes. For clients with active dissociation, fragile stabilization, or material that regularly overwhelms them in session — introduce slowly, set clear parameters, and monitor closely through whatever reporting mechanism you have available.

What a good between-session tool looks like in practice

The ideal structure: the client arrives at the tool with some sense of what they're working on. They set an intention. They go through a brief setup that grounds them before anything activating happens. The bilateral element runs for a defined, contained period. There's a closure sequence — body scan, container, return to baseline. The session ends rather than trailing off.

This mirrors the basic structure of an EMDR session for a reason. Clients who know the shape of a session can navigate it. The predictability is itself regulating.

"I stopped telling clients to 'try some mindfulness' between sessions. Now I give them something structured that actually fits where we are in treatment. The difference in how they come back is noticeable."

Tracking progress between appointments

One underrated benefit of structured between-session tools: data. If a client is tracking their distress level before and after each self-directed session, you have real information to work with at the start of your next appointment. Not self-report filtered through memory and the desire to report progress — actual longitudinal data across the week.

SUD scores over time, session frequency, which targets a client is gravitating toward on their own — all of this informs case conceptualization in ways that "how was your week?" simply can't.