After Utøya – EMDR and recent trauma. 
     Bjørn Aksel Aasen 
     Specialist in Clinical Psychology, NPF
     EMDR Europe Accredited Trainer  
     This presentation is based on elements from three relatively similar EMDR protocols for 
     recent disasters, Francine Shapiro (2009): Recent Traumatic Event Protocol; Elan Shapiro 
     and Bruit Laub (2008): R-TEP and  Jarrero, Artiga & Luber (2011): EMDR Protocol for 
     Recent Critical Incidents. The aim has been to synthesize these into the most simple and 
     pragmatic version that mirrors what experienced EMDR clinicians in this field use in 
     practice.
     What is described below is not interventions immediately following the event. For early 
     EMDR intervention soon after the traumatic event, see Gary Quinn: Emergency Response 
     Procedure.  What is described below are interventions that are appropriate after the dust 
     has settled and one is in a therapeutic setting. See also Artigas, L., & Jarero, I. (2009): 
     The butterfly hug.
     Overview
     1. Less detailed overview of the event.
     2. Narrative of the events with BLS (optional).
     3. Focus on the worst part of the incident with as much of the EMDR protocol as possible.
     4. Go to the next part of the event that stands out, reprocess this and continue in this way 
      until you are through the whole incident.
     5. Run an internal video of the whole event and reprocess the distressing elements until 
      the client can go through the entire event without distress.
     6. Check and process present triggers.
     7. Future Template - possible triggers and worries.
     Phase 1
     Obtain an overview of the event as a series of fragments, moments and experiences.
     Level of detail depending on the client's level of activation.
     Float Back to investigate any similar maladaptive reaction pattern, if needed.
     Phase 2
     Safe Place and possibly other safety and grounding strategies.
     Link to experiences of coping and confidence and maybe strengthen this with BLS.
     Phase 3
     Go through the entire event in detail.
     Identify worst Partial Target. It may be desirable to go through the event while doing 
     continuous BLS, using hand taps or pulsars. This may dampen activation somewhat and 
     make it easier to identify Partial Targets.
     Identify worst Partial Target. Set up standard protocol (NC, PC, VoK, E, SUD and 
     Location). Allow flexibility where needed.
     Phase 4
     Processing the worst Partial Target.
     Consider the appropriateness of EMD vs EMDR. This involves an assessment of the 
     extent to which one must follow longer channels or go back to the worst moment again 
     and again. Consider the process, duration of events, time remaining of the session and 
     level of activation. Be flexible in emphasis in the direction of EMD or EMDR.
     In most cases one does not go directly to phase 5, unless one sees that something near a 
     closure could be achievable and beneficial.
     Phase 3
     Back to Phase 3 and Assessment for other Partial Targets / disturbing moments.
     Each of these are processed as separate Targets with accompanying NC, PC, etc.
     The sequence may be chronological, but one can also follow the patient in a search for 
     which Partial Target is most distressing now, or which moment or situation is coming to the 
     fore now.
     Phase 4
     Processing of each of these Partial Targets.
          Phase 5
          Installation of PC when all Partial Targets is processed. Video of the entire sequence of 
          events along with PC.
          Phase 6
          Body Scan. Video of the entire sequence of events along with PC. Processing of any 
          discomfort that may come up.
          Phase 7
          Security and grounding strategies needed when processing of events is incomplete.
          TS, positive cognitions with BLS, Butterfly Hug, Light Stream Technique mm.
          Phase 8
          Check and process present triggers.
          Future Template - possible triggers and concerns.
          References
          Artigas, L., & Jarero, I. (2009). The butterfly hug. In M. Luber (Ed.) Eye movement desensitisation and reprocessing 
          (EMDR) scripted protocols: Special populations (pp. 5–7). New York: Springer Publishing.Bisson, J., & Andrew, M. 
          (2007). Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews, 
          3, CD003388. doi:10.1002/14651858.CD003388.pub3
          Kutz, I., Resnik, V., & Dekel, R. (2008). The effect of single-session modified EMDR on acute stress syndromes. 
          Journal of EMDR Practice and Research, 2(3), 190–200.
          Maxfield, L. (2008). EMDR treatment of recent events and community disasters. Journal of EMDR Practice & 
          Research, 2(2), 74–78.
          Quinn, G. (2009). Emergency Response Procedure. In M. Luber (Ed.), Eye movement desensitization and repro- 
          cessing (EMDR) scripted protocols: Basic and special situa- tions (pp. 271–276). New York: Springer Publishing.
          Shapiro, E. (2009). EMDR treatment of recent trauma. Jour- nal of EMDR Practice and Research, 3(3), 141–151.
          Shapiro, E., & Laub, B. (2008). Early EMDR intervention (EEI): A summary, a theoretical model, and the recent 
          traumatic episode protocol (R-TEP). Journal of EMDR Practice and Research, 2(2), 79–96.
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          Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd 
          ed.). New York: Guilford Press.