EMDR Blocking Beliefs Questionnaire
Please answer the following questions to help us understand your EMDR-related blocking beliefs and treatment considerations. Your responses will support a more effective and personalized therapy experience.
I believe I am capable of making meaningful changes in therapy.
*
Strongly Disagree
1
2
3
4
5
6
Strongly Agree
7
1 is Strongly Disagree, 7 is Strongly Agree
I am concerned that processing certain memories may be overwhelming.
*
Not at all concerned
1
2
3
4
5
6
Extremely concerned
7
1 is Not at all concerned, 7 is Extremely concerned
What specific beliefs or thoughts do you notice that might block your progress in EMDR?
*
I feel confident in my ability to cope with emotions that may arise during EMDR.
*
Not at all confident
1
2
3
4
5
6
Extremely confident
7
1 is Not at all confident, 7 is Extremely confident
Please describe any fears or hesitations you have about starting or continuing EMDR.
*
I believe EMDR can be a beneficial part of my healing process.
*
Strongly Disagree
1
2
3
4
5
6
Strongly Agree
7
1 is Strongly Disagree, 7 is Strongly Agree
I worry that letting go of old beliefs or patterns may change my sense of identity.
*
Not at all worried
1
2
3
4
5
6
Extremely worried
7
1 is Not at all worried, 7 is Extremely worried
What would help you feel safer or more supported during EMDR sessions?
*
I am open to exploring new perspectives about myself and my experiences.
*
Not at all open
1
2
3
4
5
6
Extremely open
7
1 is Not at all open, 7 is Extremely open
Is there anything else you would like your therapist to know about your beliefs or expectations regarding EMDR?
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