As a psychotherapy treatment designed to reduce the distress caused by traumatic memories and address emotional and behavioural concerns, EMDR is the foundational therapeutic model utilized at Dr. Amanda Bell and Associates (DABA). All of our staff are trained EMDR therapists, specialized in using EMDR effectively with all ages. At DABA, my caseload has consistently been balanced between children, teens and young adults. Teenagers always bring a fresh perspective to any therapy caseload. On the one hand, they are often able and willing to try more direct discussion about difficult themes and subjects. On the other hand, there is a fine balance in maintaining clear boundaries around their growing maturity. Teens can handle many adult themes but also deserve the chance to focus on creativity and play in the therapy space.

    Teenagers can be a challenging age group for even seasoned clinicians to work with. Developmentally, teenagers are asserting their independence, exploring who they may want to be and engaging in experimental, and possibly risky, behaviours. These developmental tasks can make for very resistant clients. As a therapist working with teenagers, you need to be conscious not only of the developmental tasks and challenges of the teenager years but also of pop culture, current social media trends and community events. On more than one occasion, a teenage client has started or ended a session with me by talking about current issues, sharing school events or even sharing memes or videos. Showing a genuine interest in their favourite video games or musicians, viewing their art work or taking few minutes to playfully banter back and forth can go a long way in building trust and rapport. A close colleague of mine has even been known to participate in trending Tik Tok dances with their teen clients!

    After building rapport, understanding the reasons why a teenage clients may be resistant to attending therapy is the first step towards engaging them in active therapeutic work related to the presenting concern. Meeting teens where they are at developmentally, socially and emotionally can begin the therapeutic process, opening the dialogue for the therapist to hear the teens perspective on why they are attending therapy. Teens may view attending therapy as being the desire of their parents or caregivers to address problematic behaviours. Unlike children, who may require the support of their caregivers in session, most teenage clients attend therapy sessions independently from their parents. Clear limits around confidentiality need to be established with teens and their parents. Teens may decide that they do not want their therapeutic work shared with their parents. By ensuring that parents understand they may receive only general updates if the teen desires it, and that your patient understands his limits of confidentiality, clarity between all parties can be achieved. Establishing clear and shared expectations for the EMDR therapy process early on builds trust with the teenage client, as does ongoing re-evaluation. If a parent session is required, I often work directly with my teen clients to establish a clear agenda and offer them the chance to be present for the meeting. 

     Many teens describe feeling overwhelmed in trying to navigate both the internal and external pressures of their worlds.  EMDR can offer a safe and supportive way to process negative thoughts, experiences and beliefs, with or without a traumatic component. The teenage years can be a challenging and confusing time as teenagers are constantly in transition – be it physically, emotionally or socially. A flexible and client centred EMDR approach can assist in removing barriers for more resistant teens and support those needing to establish autonomy. The eight phase EMDR approach allows for the development of a strong therapeutic connection through thorough history taking, treatment planning and assessment, all done with the input of the teen client. The early EMDR phases (Phases 1-3) may also focus on resourcing and skill development, expanding the Window of Tolerance and ensuring that teenage clients are supported to begin processing and desensitization work. EMDR allows for teenage clients to actively provide input and feedback on their therapeutic process to allow for an increased sense of control. 

     EMDR can be particularly helpful for teens who may struggle to verbalize their thoughts and feelings as there is less emphasis on narratively sharing their experiences. EMDR can allow teens to process the identified negative experience or belief without becoming overwhelmed or feeling the need to answer difficult questions posed by the therapist. We often frame EMDR to teenagers as being like the chapters of a book – as we explore and process together using Standard Protocol, we are looking for the titles or headlines vs. the entire chapter. Shy, quiet teens can be encouraged to draw simple, quick pictures to assist with expressing their thoughts and feelings. Many teens are able to strengthen their ability to verbally express themselves as they begin to process their identified targets with EMDR. 

     The teenage years consist of immense growth and development alongside confusion and pressures. Therapeutically, EMDR offers a very structured approach, with the set Standard Protocol being highly effective with teenagers. The simple scaling around the Validity of Cognition Scale (VOC) and Subjective Unit of Disturbance Scale (SUD) allows teenagers to clearly rate their Positive and Negative Cognitions.  An informed, patient and attuned EMDR therapist will engage these potentially resistant teen clients and assess risk while supporting the processing of traumatic events, difficult emotions and challenging behaviours. The EMDR therapist also needs to recognize that teen clients may not always stick to the therapy agenda. Issues at home, difficulties with friends, or a bad day at school are just some of the common reasons a teen client may need to put EMDR on hold in order to express themselves. When working with teens, it is important to always have a back-up plan. Sometimes they may just need a safe space to vent, unrelated to selected EMDR targets. Just like child and adult EMDR clients, teens are unable to process trauma when their lives are unstable. Ongoing assessment of safety and security are key, as well as understanding that what teenagers may view as ‘life-altering’ events are often very different from what we as adults might classify the same event as. 

     Teens are unique and challenging client population. They are some of my most engaging and most exasperating clients but offer a high sense of achievement when therapeutic change is made. EMDR with teenagers often requires quick thinking, flexibility and snack breaks. Having fidgets, easy access to art supplies and a willingness to understand that risky behaviour is part and parcel of the teenage years can go far in engaging resistant teens. A clear, easily accessible description of EMDR and its processes will help teens to make an informed choice about its use as a modality. Creating a safe place for teens to express themselves, even whey the declare that “everything sucks,” is crucial. By meeting teenagers where they are, respecting their perspectives and supporting their needs, EMDR and non-EMDR sessions with teens will move forward smoothly.


Bennett, E., Le, K., Lindahl, K., Wharton, S., and Weng, T. (2017) Five Out of the Box Techniques for Encouraging Teenagers to Engage in Counseling

Civilotti, C., Margola, D., Zaccagnino, M. et al. (2021) Eye Movement Desensitization and Reprocessing in Child and Adolescent Psychology: a Narrative Review. Curr Treat Options Psych 8, 95–109.

Gomez, A. M., & Waters, F. S., Ogden, P., Jernberg, E., & Krause, P. K. (Collaborators). (2013). EMDR therapy and adjunct approaches with children: Complex trauma, attachment, and dissociation. Springer Publishing Co.

Monaco, A and Wolasz, N. (2022). EMDR Therapy for Challenging Teenagers. Go with That. 27(3).