Clinician's Corner: When Should You Refer a Client for EMDR (And When Should You Not?)
- Carolyn Morris, LCSW
- May 25
- 2 min read
Let’s just say it plainly: if your client has great insight but nothing is actually changing… that’s not a motivation problem.
It’s a processing problem.
And no, more insight usually isn’t the solution.
When EMDR is likely a good fit
1. They can explain it beautifully… and still feel terrible
You know this client.“I know I’m safe.”“I know it’s not my fault.”
And yet their body is reacting like it absolutely is happening again.
That gap? That’s not stubbornness. That’s unprocessed material.
2. Their reactions don’t match the moment
If a small interaction leads to shutdown, panic, rage, or intense shame, you’re not dealing with “overreacting.”
You’re watching a nervous system hit an old file that hasn’t been resolved.
3. You keep having the same session in slightly different words
If you’re both starting to feel like, “Didn’t we just talk about this last week?”—pay attention.
That’s not failure. That’s a sign you’ve likely reached the edge of what talk therapy alone can do.
4. There’s a clear “this feels familiar” thread
It doesn’t have to be a single big trauma.
Repeated experiences of being dismissed, criticized, unseen, or unsafe?That absolutely counts.
When EMDR is not the next step (yet)
Let’s not skip the part people like to gloss over.
1. No regulation = no processing
If your client cannot come back down once activated, EMDR is not step one.
Stabilization is not a warm-up. It’s the foundation.
2. They’re still in the fire
If the trauma is ongoing, the goal isn’t reprocessing—it’s safety.
You don’t process while the threat is still happening.
3. Dissociation is significant and unaddressed
EMDR can be incredibly effective here—but only if the clinician knows what they’re doing.
Standard protocol is not enough.
A reality check
Referring to EMDR isn’t “leveling up.”
It’s not an admission that something isn’t working.
It’s recognizing that you can’t think your way out of something that isn’t stored in thinking.
How you frame the referral matters
Try this instead of making it sound like a last resort:
“You’ve done a lot of important work already.”
“This might be the next layer—not a replacement.”
“There’s a way to help your brain actually resolve this, not just understand it.”
Because if you frame it like failure, don’t be surprised when it feels like one.
So What Now?
If you've found yourself here, and you think that EMDR therapy is a good idea, don't hesitate to reach out to me! I'd love to chat with you to determine if your client (or you for that matter) would benefit from EMDR therapy and can help you get all the information you need to take the next steps.
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