Assessment Questions for Virtual EMDR Training - Pretest (v2-old)

1. Question

EMDR (Eye Movement Desensitization and Reprocessing) therapy was first called EMD (Eye Movement Desensitization).

a. True
b. False

2. Question

2. The Adaptive Information Processing (AIP) model posits:

a. That all information is adaptive.
b. That the natural tendency of the brain’s information processing system is to move toward a state of mental health.
c. Healing can go too quickly if we don't slow it down.
d. All of the above
e. None of the above

3. Question

3. In EMDR therapy, pathology is viewed in terms of maladaptive memory networks which have not been fully reprocessed and continue to be held in a state-specific form giving rise to maladaptive perceptions, behaviors, beliefs and attitudes.

a. True
b. False

4. Question

4. Which of the Mechanisms of Action has not been strongly supported as an explanation for EMDR therapy?

a. Taxing Working Memory
b. Exposure to High Levels of Distress
c. REM Processes
d. Orienting Response

5. Question

5. One way in which EMDR therapy differs from Cognitive Behavioral therapy is no homework is required for EMDR to be effective.

a. True
b. False

6. Question

6. The three-pronged protocol refers to which of the following:

a. Fears related to a traumatic event, attachment experiences with primary caregivers, and structural dissociation of the personality
b. Identify, target and process the earlier memories causing the problems, present experiences triggering the disturbance and the behaviors needed for adaptive future functioning.
c. Sensory experiences related to the trauma, unacted urges and impulses related to the trauma, and emotions related to the trauma
d. None of the above

7. Question

7. The positive/future template involves applying bilateral stimulation while a client runs through the sequence of a challenging past experience until there is no longer a disturbance associated with it.

a. True
b. False

8. Question

8. Shapiro states that history-taking should:

a. Identify symptoms, duration, initial cause and additional past occurrences
b. Identify other complaints, present complaints and desired state
c. Use the floatback technique to find targets for reprocessing based on current response patterns
d. All of the above
e. None of the above

9. Question

9. So far, no medications appear to completely block EMDR processing, although benzodiazepines have been reported to reduce treatment efficacy with some clients.

a. True
b. False

10. Question

10. Shapiro (2018) states that because EMDR therapy has been shown to be effective and efficient, it is not necessary to take steps to test whether clients can manage moderate to high levels of emotional disturbance and to practice self-control procedures.

a. True
b. False

11. Question

11. During Phase 1, the clinician:

a. Determines whether the patient is emotionally ready to engage in trauma work.
b. Identifies any safety factors that need to be addressed before proceeding with EMDR therapy.
c. Assesses whether there is sufficient rapport with the patient to attempt a treatment that may be very different and therefore frightening to the client.
d. All of the above
e. None of the above

12. Question

12. Which of the following statements is false about clusters?

a. Generalization usually occurs causing reprocessing of one target to impact an entire cluster of incidents
b. After targeting events from a cluster, the clinician should ask the client to scan through the incidents in a cluster to identify any that have not been resolved.
c. Clusters are generally grouped by events that took place within a year of each other.
d. None of the above

13. Question

13. Shapiro (2018) states that screening for dissociative disorders should be done by all EMDR clinicians before starting reprocessing and that treating individuals who meet criteria for DID requires additional training.

a. True
b. False

14. Question

14. According to Shapiro, The Dissociative Experiences Scale (DES-II) should be administered during Phase One, as an initial screening for dissociation. Further exploration may be warranted.

a. True
b. False

15. Question

15. Shapiro (2018) suggests the Safe/Calm place exercise is recommended as part of the preparation phase before starting reprocessing because:

a. It reassures clients they have a way to recover emotional stability during any disturbance
b. It sets up positive associations with the use of eye movements
c. It can help close down disturbance during incomplete sessions and between sessions
d. All of the above
e. None of the above

16. Question

16. Which of the following is true about Resource Development and Installation?

a. RDI provides access to a range of positive affect that can prepare clients to tolerate or shift out of distress when needed both during and between sessions.
b. RDI increases associations to negative associative memory networks.
c. RDI should never be paired with bilateral stimulation.

17. Question

17. It is essential that the clinician clearly inform the client of the possibility for emotional disturbance during and after EMDR processing sessions.

a. True
b. False

18. Question

18. When selecting an image during Assessment Phase, the clinician should ask:

a. What picture best represents the experience to you?
b. What picture would you like to believe when you think about the experience?
c. What picture represents the worst part of the experience as you think about it now?
d. Both a and c
e. Both b and c

19. Question

19. Which of the following statements is true of the Negative Cognition (NC)?

a. The Negative Cognition is a clear description of the traumatic event.
b. The Negative Cognition is a negative self-statement associated with the event
c. The Negative Cognition is often stated as an emotion such as, “I am afraid”
d. All of the above.
e. None of the above.

20. Question

What is the Validity of Cognition scale range (VoC)?

a. From 1-10
b. From 0-10
c. From 0-7
d. From 1-7

21. Question

21. In the Assessment phase, when identifying the “Emotion” all the following are true except:

a. We are seeking to identify the emotion the person felt at the time of the original experience. Shapiro (p. 130)
b. The patient naming more than one emotion is fine.
c. Only one emotion is fine. There is no need to prompt for more emotions.
d. The named emotion provides baseline information to help assess later possible changes in patient reports.
e. None of the bove.

22. Question

22. The letter “D” in “SUD scale” stands for:

a. Disturbance
b. Depression
c. Duration
d. Distress

23. Question

23. When beginning the Desensitization Phase, clinician should ask the client to notice:

a. The image
b. The negative cognition
c. Where they feel it in their body
d. All of the above
e. None of the above.

24. Question

24. When starting each subsequent set of bilateral dual attention stimulation in the Desensitization Phase, after the first set it is advisable for the clinician to:

a. Remind client of the negative cognition.
b. Ask the client to continue to hold the original image in mind.
c. Refrain from reminding client of the negative cognition.
d. All of the above.
e. None of the above.

25. Question

25. Shapiro states that during the Desensitization Phase the clinician should recheck the SUD level:

a. After each set of dual attention stimulation (bilateral dual attention).
b. When only a few minutes are left in the session, before ending the session.
c. After retargeting the original incident, providing another set of bilateral dual attention and there are no new associations, no new emotions,
d. None of the above.
e. All of the above.

26. Question

26. The cognitive interweave is a strategy that is used during reprocessing:

a. To address more complex and difficult to treat trauma
b. To jump-start blocked processing by introducing certain material rather than depending on the client to provide all of it
c. When the client remains at a high level of disturbance after successive sets of bilateral stimulation.
d. A and C only
e. All of the above

27. Question

27. Three primary themes for interweaves are:

a. Past, present, future
b. Responsibility, Safety, Choices
c. Supportive figures, personal achievements, spiritual figures
d. None of the above

28. Question

28. Which of the following would be an appropriate strategy for assisting a client in maintaining Dual Attention during an intense emotional response:

a. Stop reprocessing and discuss the emotional response
b. Increase non-specific verbal encouragement during the sets of stimulation.
c. Lengthen the sets of stimulation so that more material is accessed
d. All of the above
e. None of the above

29. Question

29. Shapiro (2018) suggests that when reprocessing effects cease for two consecutive sets clinicians should consider:

a. Changing the eye movements and asking the client to focus only on physical sensations.
b. Invite “unspoken words” silently or aloud
c. Ask the client to listen for sounds or dialogue in the memory that remain disturbing.
d. Ask the client to scan for a more disturbing aspect of the memory
e. None of the above
f. All of the above

30. Question

30. Shapiro (2018) states that, when reprocessing is not progressing, after changing the nature or type of bilateral stimulation, the clinician should next consider shifting attention to:

a. Issues of secondary gain
b. Blocking beliefs
c. Feeder memories
d. None of the above
e. All of the above

31. Question

31. Feeder memories are earlier memories that may contribute to dysfunction and block reprocessing of it.

a. True
b. False

32. Question

32. When processing the initial target is unsuccessful, the clinician should consider inquiring about negative beliefs that are blocking progress.

a. True
b. False

33. Question

33. When beginning the Installation Phase, the first question to ask is:

a. "What do you notice now?"
b. “Do the words [repeat the positive cognition] still fit, or is there another positive statement you feel would be more suitable?”
c. “What do you think about the experience now?”
d. “How are you feeling?”
e. “If you could do it over again, what would you do differently?”

34. Question

34. When checking the VOC during Installation Phase, say:

a. When you think about the original picture, what do you think now?
b. On a scale of 0 to 10 where 0 is no disturbance or neutral and 10 is the highest disturbance you can imagine, how disturbing does it feel to you now?
c. Think about the original incident and those words [selected positive cognition], from 1, completely false, to 7, completely true, how true do they feel?
d. All of the above
e. None of the above

35. Question

35. Regarding the Body Scan Phase, Shapiro (2018) states that:

a. Dysfunctional material may have a noticeable physical resonance
b. That physical sensations can be targeted
c. Focusing on body sensations can open other channels of information that must be processed.
d. All of above
e. None of the above

36. Question

36. An adequate closure procedure should be established prior to a treatment session. Clinicians should help clients construct a safe and/or calm place in their imagination to use during closure.

a. True
b. False

37. Question

37. In the Reevaluation Phase the clinician is paying attention to which of the following:

a. If the individual target has been resolved
b. If associated material has been activated that must be addressed
c. If all necessary targets have been reprocessed to allow the client to feel at peace with the past, empowered in the present and able to make better choices in the future
d. If adequate assimilation has been made within a healthy social system
e. All of the above
f. None of the above

38. Question

38. The following statements are true for the treatment of children, except:

a. Children can create maps, timelines, and storybooks of their lives, through which the clinician can identify potential targets and resources.
b. Young children may use hands to indicate levels of disturbance
c. Clinicians should advise parents to remain in the room and give verbal feedback during desensitization and installation phases
d. Clinician may ask for a “mixed up thought” or a “bad thought” to help elicit the negative cognition.

39. Question

39. Because of the potential of EMDR for rapid destabilization, there are many client factors to consider prior to beginning EMDR. Which of the following is not a factor?

a. If the client has good affect tolerance
b. If the client has a stable life environment
c. If the client has stated they would like to start the EMDR immediately
d. If the client can undergo temporary discomfort for a long term relief
e. If the client has an adequate support system

40. Question

40. Which of the following are true of working with military personnel and veterans:

a. Several modifications need to be made to the standard EMDR therapy protocol
b. It is important to develop cultural competence on the effect of military values and training
c. It is best to avoid the use of interweaves
d. All of the above
e. None of the above

41. Question

41. Looking at addiction through the lens or the AIP, which of the following is not true:

a. Addiction is often referred to as an “affect regulation strategy,” therefore additional preparation procedures are recommended.
b. The clinician’s judgment supersedes the client’s motivation for change when deciding when and how to utilize EMDR therapy.
c. The ACE study may be used to determine specific targets for reprocessing
d. It is believed that addictions assist avoidance of the underlying trauma that threatens to surface in sobriety.

42. Question

42. When addressing current anxiety with EMDR therapy, the clinician asks the client to identify which of the following:

a. The earliest remembered distressing event
b. The current situations that trigger the disturbance
c. The desired outcome
d. Both a and b
e. All of the above

43. Question

43. When targeting a process phobia, the clinician must address all the pertinent aspects of the experience, including decision-making and anticipatory anxiety.

a. True
b. False

44. Question

44. Following the death of a loved one, a person may first experience emotional shock accompanied by numbing. In these cases, psychological first aid, rather than EMDR processing, is recommended at this stage.

a. True
b. False

45. Question

45. Which of the following are appropriate statements regarding the use of EMDR therapy with couples?

a. A goal for the use of EMDR therapy with couples may be for the client’s partner to provide support for the client, who is working on personal past material in EMDR therapy.
b. A goal for the use of EMDR therapy with couples may be to address relationship issues that stem from unresolved historical traumas or relate to current relationship distress
c. In all instances related to couples’ therapy, conjoint EMDR therapy sessions are recommended
d. Both a and b
e. None of the above

46. Question

46. Which of the following is true of EMD?

a. There is no Negative Cognition with EMD
b. There is no Positive Cognition with EMD
c. You return to target after every set of bilateral dual attention

47. Question

47. Which of the following is the first step in the Recent Event Protocol?

a. Target the most disturbing aspect of the memory
b. Obtain a narrative history of the event, noting the most disturbing moments
c. Process present stimuli
d. Incorporate positive future templates for each trigger
e. None of the above.

48. Question

For many clients with complex PTSD, it is preferable to begin processing by first targeting recent, adult-onset traumatic experiences or the present disturbing situations or triggers.

a. True
b. False