EMDR Case Conceptualization Template — Printable Workbook (Free PDF)
A print-ready workbook for building an AIP-informed case conceptualization from intake through Phase 8: formulation, touchstone hypothesis, three-pronged plan, readiness gate, risk flags and a running session plan.
Free PDF for EMDR clinicians. Get it by email.
Template or one-page worksheet?
This is the long-form version. If you want a single page to organise a new client before building the target plan, use the one-page Case Conceptualisation Worksheet. Use this longer workbook when the case is complex, when you are preparing a case presentation for consultation, or when you want one document that follows the client from intake to Phase 8.
What's inside the workbook
- Presenting problem and goals, in the client's own words, with functional impact and a 0–10 readiness rating
- Diagnostic snapshot with a measures table (PCL-5, PHQ-9, GAD-7, DES-II, ACE) and repeat cadence
- AIP formulation across three networks: unprocessed, adaptive (resource) and blocking or feeder beliefs
- Touchstone hypothesis with a float-back and affect-bridge log
- Three-pronged Target Sequence Plan: past touchstones and contributors, present triggers, future templates
- Phase 2 stabilization checklist with an explicit readiness gate before Phase 3
- Risk, dissociation and complexity flags with the adaptation each one calls for
- A session-by-session running plan (focus, target, SUD/VoC outcome, next step)
How the AIP formulation section works
Shapiro's Adaptive Information Processing model treats symptoms as the output of memory networks that were stored without being linked to adaptive information. The template asks you to map three of them. The unprocessed network holds the images, negative cognitions, affect and body sensations that keep intruding; you usually reach it from a recent trigger through the affect bridge. The adaptive network holds times the client felt competent, safe or seen, which become Phase 2 resources. The blocking network holds the beliefs, loyalties or secondary gains that stall reprocessing, found with questions like "what stops the SUD from dropping?"
Writing all three down before Phase 3 makes it much easier to see why a session stalls, and what to bring to consultation.
The readiness gate
The workbook sets a clear line before reprocessing: do not move to Phase 3 until two resources are stably accessible under mild activation, the dissociation screen is in a tolerable range or a modified protocol is documented, and between-session containment has held for at least a full week. The risk table pairs common flags with adaptations: structural dissociation (DES-II of 30 or more) with fraction-focused stabilization, active suicidality with a safety plan and deferred reprocessing, substance use with a sobriety window and DeTUR-style protocols, and complex developmental trauma with extended Phase 2 and titrated reprocessing. For screening detail see the Dissociation Screening & Stabilization Toolkit.
Inside EMDR Assist
EMDR Assist keeps the same structure live for each client: the target plan groups memories by belief, the phase guide follows you through Phases 1 to 8, and SUD and VoC are saved session by session, so the running plan fills itself in.
Related on the EMDR guide
Frequently asked questions
What is an EMDR case conceptualization?
A written formulation of why a client's symptoms persist, using the AIP model: which memory networks are unprocessed, which resources are available, what might block processing, and the order targets will be reprocessed in (past, present, future).
How is this different from the one-page worksheet?
The worksheet fits a new client on one page. This template is a multi-page workbook with room for measures, a float-back log, a full three-pronged plan, a readiness gate, risk flags and a session-by-session plan.
Can I use it for case presentations in consultation?
Yes. It is laid out to be brought to consultation. Remove names and identifying details first.
Is it free?
Yes. Enter your name and email and the PDF is sent to your inbox.