EMDR Therapy Quarterly

Report and reflections on a presentation delivered by Annie Monaco and Ann Beckley-Forest  at the EMDR UK Annual Conference 2025

In true ‘working with children’ fashion, Annie and Ann began their talk by inviting the audience to stand and imagine themselves chopping and lifting wood. This set the tone for an energetic and engaging presentation covering the interplay between play therapy and EMDR. Delegates were asked to consider the power of engagement arising from a child’s initial experience in the therapy room, to ensure they are not reminded of other settings where meetings with adults occur such as the headteacher’s office. The passion and enthusiasm for utilising play in EMDR was clear, along with the important message that:

“Play is what enables us to have a more equal relationship with a child.”

Delegates were shown how materials commonly used in play therapy can be skillfully interwoven into the delivery of EMDR. Play therapy materials were described as providing an opportunity for ‘projection and externalisation,’ allowing the child to explore spontaneously. Examples of materials the therapist may use include sand trays, doll houses, musical instruments and art supplies. 

The speakers encouraged clinicians to consider, at each stage of the eight-phase EMDR protocol, how play materials can make EMDR more accessible to children. In phase 1, the importance of gaining a shared understanding with children was stressed, as well as giving them agency and the ability to opt-out. Practical ideas for history taking were covered, such as storytelling and props. Joyce Mill’s Bowl of Light story was discussed, and delegates were shown a video cartoon of this story enacted in a sand tray. After presenting this story to the child, the therapist can then move on to show them that stones can represent bad things that block some of the light in the bowl of light. This was then combined with a visual SUD scale to talk to them about developing a problem list and rating how much each stone bothers them now. To explore resources, ideas such as creating a rainbow of the best things that have happened in the child’s life were promoted. 

In phase 2, ‘preparation for therapy,’ a range of body movements to encourage soothing and grounding were explored. Exercises, such as pretending to chop wood and laughing yoga, were recommended to help the child and parent ground during the session. These were taught as strategies that families can use at home during times of distress. Integrated colour visualisations with breathing exercises were described, such as asking the child to give colours to different feelings and then to breathe out the colours associated with the distressing feelings.

The audience was once again asked to take part in an experiential activity – this time their favourite superhero pose – and to observe what this felt like.  Delegates were encouraged to think of ways to learn from young people, such as a favourite TikTok dance, as preparation for moving on to processing. Sword fighting was introduced as both a means of positively resourcing an ‘empowering kinesthetic experience’ and as a potential means of later processing. A video example was shown demonstrating the installation of the resource “I can handle it,” where a child was observed to show physical strength while verbalising the resource. Following the excitation of sword fighting the child was then engaged in the down-regulation activity of bowing to a ‘judge’.   

The speakers encouraged creativity in EMDR by adapting materials. They showed an example of a DIY EMDR toy whereby two footballs can be covered in written statements – one for positive cognitions and another for negative. When the ball is thrown back and forth, the child can be asked to tell a time when they have had that thought. Visual scales can be made more accessible by using language more familiar to children, such as a ‘yucky scale’ ranging from ‘little yucky’ to ‘big yucky’ and feeling dials on a card the child can hold and spin to show changes. 

Throughout phases 3-8, the speakers recommended a flexible approach, as processing may begin before all the details are known. Therapists need to ensure they are mindful of the child’s developmental level and to consider their use of language. Delegates were treated to lots of video examples throughout the presentation. These included demonstrations of how short sets enabled a child to stay within their window of tolerance, and the use of breathing exercises, catching a teddy and dancing in between sets of processing using pool noodles.

To support a family where the parents were fearful of upsetting their child by discussing the trauma, the presenters showed a video example of the Movie Method of EMDR narrative. In this approach, the child is the director of the movie, and the sand tray is used as a way to ‘miniaturise’ the trauma narrative. Recording this movie also provides the clinician with further opportunities to desensitise, process and extend to other family members. The use of a sand tray was recommended to explore narrative questions, such as:

“Show me what happened?”

“I wonder what (the character) is thinking? Maybe…” (negative cognition)

“I wonder what (the character) is feeling?” 

Collaboration with parents and carers was highlighted as key for some children, particularly where there is a strong attachment, with parents being involved in interweaving information if appropriate and structured. In the example covered, the parent acknowledging they also felt scared was important to share as a part of the processing. The Loving Eyes protocol was referred to for parents who find it difficult to be with their child during processing. The importance of educating parents prior to processing and involving them so they are aware of the intervention and equipped to support their child was stressed. Parents may observe changes in their child between sessions that are insightful for the therapist and help to understand and evaluate how the child is responding to treatment. 

After the session, there were more questions than time allowed. The presenters were asked:

“How long do you let a child replay the same story over and over?” – They responded by speaking about how play is the initial show of safety, and it may be that there are aspects of the child experiences and beliefs embedded within the story, so consider what the negative cognition may be while building rapport.

“What about obsessive play with things that scare them in the room?” – They recommended creating an opportunity for them to access the early distress to work on, balancing being flexible with directive.

“How do you manage when working at other people’s settings” – The presenters spoke of being prepared (e.g., taking a yoga ball or noodles) and improvising with whatever else is available at the setting to support working.

“Do you work online, and if so, do you use an online sand tray?” –  Delegates were given information on an online resource available from the Oaklander Training www.onlinesandtray.com.