An EMDR Therapist's Guide to Using the TICES Log with Clients

As an EMDR therapist, you know that many of your clients’ current emotional experiences are hidden and often stem from unprocessed memories from their past – and that these powerful emotional forces continue to influence their reactions to situations in their day-to-day life. When strong emotions arise suddenly and unexpectedly out of life experiences, it can be difficult for clients to connect the dots that the emotions they are currently feeling are related to the EMDR work they are doing in session to address their past. Enter the TICES Log.

The TICES Log, developed by Francine Shapiro, the originator of EMDR, is a useful tool in helping clients track and document the cognitions, emotions, and body sensations that arise when they experience an emotional trigger in between sessions. As clients consistently use this worksheet and review the content in session, they will begin to identify patterns that help connect the past to the present. This process will help  those hidden emotional forces be revealed and understood through a compassionate, trauma-informed lens.

Let’s explore the TICES Log's purpose, application, and insights for both therapists and clients: including its methodology and answers common questions for effective use.

What is the TICES Log?

‍The TICES Log encourages clients to reflect on a Triggering event and the Image,Cognitions, Emotions, and (body) Sensations (TICES) that arose as a result of experiencing the event. The TICES Log also provides space for the client to record the level of emotional disturbance they felt while triggered on a scale of 0 (lowest) to 10 (highest). The log helps clients become more aware of their internal experiences and how these relate to external situations.

With the TICES Log, clients can better understand and observe their reactions to triggers. When used throughout EMDR treatment, it can also aid the client in making connections and recognizing patterns regarding how their past affects their present., This self-awareness can drive personal growth and positive change and promote the use of positive coping skills.

When is the TICES Log Worth Using with Clients?

‍The TICES Log is an EMDR tool that can be used between sessions to support the client in enhancing their mindfulness around their emotional, cognitive, and physical responses to triggering events. It's particularly helpful for EMDR clients in the following ways:

• Identifying Targets for Reprocessing: By tracking triggers and their related thoughts, emotions, and sensations, the log can help pinpoint specific events or memories that are distressing and would benefit from being addressed during EMDR reprocessing sessions.
• Increasing Client Awareness: It encourages clients to become more aware of their internal responses to external situations, helping them recognize patterns of disturbance and their connections to past experiences.
• Enhancing Between-Session Work: Clients can use the log between sessions to capture emerging triggers or experiences, ensuring that important material is not forgotten and can be addressed in therapy.
• Facilitating Cognitive and Emotional Insight: By reflecting on thoughts, emotions, and sensations, clients gain deeper insight into how their current experiences are influenced by maladaptive beliefs or unresolved trauma.

Overall, the TICES Log supports the EMDR process by organizing relevant information for treatment, guiding the therapist in target selection, and empowering clients to actively participate in their healing journey.

As far as frequency of use, how often a client should use the TICES Log depends on individual needs and their treatment plan. Some clients may benefit from daily logging, while others might use it a few times a week between sessions or as needed. 

What Insights Can You and Your Client Gain from Using the TICES Log?

‍The TICES Log provides meaningful insights for both therapists and clients, improving understanding and communication within the therapeutic relationship.

For therapists, a completed TICES Log offers:

• Better understanding of the client's internal experiences: The log reveals the client's triggers outside of session and their accompanying thoughts, emotions, and sensations.
• Recognition of patterns and triggers: Reviewing multiple log entries and comparing them to targets identified in session can help  therapists spot recurring themes in negative cognitions and emotional or trauma triggers, guiding treatment planning and interventions.
• Tracking progress: Comparing logs over time allows therapists to evaluate the client's reactions to potential triggers, assess the effectiveness of EMDR, and adjust the treatment plan as needed.

Clients can also gain valuable insights from using the TICES Log:

• Enhanced self-awareness: The process of completing the log helps clients become more aware of their internal experiences and how they connect to external events.
• Identifying patterns and connections: Clients can notice recurring cognition patterns, emotional responses, and behavioral tendencies and their relationship to past challenging or traumatic experiences.
• Building skills and coping strategies: Following completion of the  TICES Log, the client is encouraged to use a relaxation skill, such as Safe/Calm Place. The recurrent use of these relaxation techniques helps clients practice and reinforce skills learned in session..
• Enhances treatment collaboration: The log facilitates a coordinated therapeutic process by providing a useful structure for clients to share their experiences between sessions with their therapist. Additionally, the information gained from the TICES Log can be used to direct treatment and collaboratively decide what key areas to prioritize and focus on during EMDR sessions.

Methodology Behind the TICES Log

‍The TICES Log is a commonly used tool in EMDR therapy. EMDR is an evidenced-based practice with a strong research backing for its effectiveness in addressing various mental health issues, especially those that are trauma-related. EMDR is a psychosensory modality that supports the client in decreasing emotionality around a past challenging or traumatic event and shifting their belief about themself in relation to that event from negative to something more positive, true, and adaptive. The TICES Log guides clients in identifying and labeling aspects of an emotional experience using the steps of setting up the EMDR standard protocol. Traditionally, in EMDR therapy, these steps are then built upon to lead into trauma reprocessing. However, when using the TICES Log, the client is encouraged to engage in a relaxation exercise following exploring their emotional experience, as it is generally not advised for clients to do trauma reprocessing work on their own.  

There are many benefits of using therapy worksheets, such as the TICES Log, to improve treatment outcomes:

• Increased self-awareness: Worksheets offer a structured way for clients to enhance emotional awareness, gain deeper understanding of their thought patterns, and identify what coping skills tend to work best for them. 
• Enhanced engagement: Worksheets foster active participation both during and outside of therapy sessions, encouraging clients to engage with the therapeutic process, practice skills learned in session, and reflect on their experiences to reinforce learning and promote progress.
• Specific therapeutic applications: Various worksheets, including thought records, behavioral activation worksheets, and exposure and response prevention worksheets, have proven effective in addressing specific challenges like depression, anxiety disorders, and OCD.

While the TICES Log provides many advantages, it's important to be aware of its limitations:

• Not a standalone treatment: The TICES Log serves as a tool within EMDR therapy and should not replace professional treatment.
• Requires client commitment: The success of the TICES Log hinges on the client's willingness to engage in regular self-reflection and consistently complete the worksheet.
• Not for untrained use: Therapists not trained in EMDR should avoid using the TICES Log with clients, as its purpose and application are specific to the EMDR process and require specialized knowledge to ensure client safety and therapeutic effectiveness.

Despite these limitations, the TICES Log remains a valuable resource for EMDR therapists, offering a structured approach to help clients gain insight, participate actively in their treatment, and prepare themselves for future trauma reprocessing work. 

Frequently Asked Questions (FAQ)

What is the purpose of the TICES Log?
The TICES Log serves as a valuable tool for clients to track and document their thoughts, emotions, and physical sensations that emerge in response to emotional triggers between therapy sessions. By consistently completing the log and reviewing its content during sessions, clients can uncover patterns in their experiences, helping them draw meaningful connections between past events and present reactions. This process fosters insight and supports the EMDR therapeutic journey.

When and how often should clients use the TICES Log?
The frequency of using the TICES Log depends on the client's individual needs and treatment plan. Some clients may find daily logging beneficial, while others might use it a few times a week or as needed. It's important to find a balance that supports regular skill-building without overwhelming the client.

Can the TICES Log be used for various mental health conditions?
Yes, the TICES Log is a flexible tool that can support clients with different diagnoses undergoing EMDR treatment, such as anxiety disorders, depressive disorders, trauma-related disorders, personality disorders, and substance use disorders.

How can therapists ensure client engagement with the TICES Log?
To encourage client engagement, therapists should:

• Clearly explain the purpose and benefits of the TICES Log
• Adapt the log to the client's preferences and learning style
• Regularly review completed logs to monitor progress and discuss how, if, and when to incorporate information from the log into EMDR sessions
• Promote consistent use of the log as part of the therapeutic process

Is the TICES Log a standalone treatment?
No, the TICES Log is not a standalone treatment but rather a tool to be used within the framework of EMDR therapy. It should be used under the guidance of a mental health professional trained in EMDR to ensure its effectiveness and provide appropriate support for the client.

Other Assessments Similar to the TICES Log to Consider

‍While the TICES Log is helpful for self-reflection and understanding one's internal experiences, several other assessments serve similar purposes or complement its use:

• Emotion Regulation Worksheets: Derived from dialectical behavior therapy (DBT), these worksheets assist clients in identifying and managing intense emotions. They teach skills like mindfulness, distress tolerance, and self-soothing to help clients cope with difficult feelings and situations.
• Mindfulness Exercises and Logs: Mindfulness practices, such as meditation, body scans, and breathing exercises, can enhance self-awareness and emotional regulation. Incorporating mindfulness worksheets alongside the TICES Log can help clients cultivate a non-judgmental, present-focused perspective on their experiences.

These assessments and exercises can be used with the TICES log to offer a broad approach to self-reflection, skill-building, and symptom management. By providing clients with a range of tools, therapists can tailor treatment to individual needs and preferences, enhancing the benefits of therapy.