FREE EMDR SUDS and VOC Scale
As EMDR therapists know, EMDR therapy is based on the ability to scale or rate the distress that a client is currently experiencing when processing a target and the validity or extent to which a client believes a positive belief about one’s self. These are referred to as a SUDS score (subjective units of distress) and a VOC (Validity of cognition). 2 scale- sounds easy enough, right?
Well it does get a bit more nuanced. The prompt to check for a SUDS score to gauge the distress of a client includes verbiage “On a scale of 0-10, where 0 is no disturbance or neutral and 10 is the “On a scale from 0-10, where 0 is no disturbance or neutral and 10 is the highest you can imagine, how disturbing does it feel to you now?”
In contrast the prompt to check the VOC is “When you think about that picture or incident, how true do those words (repeat PC) feel to you now on a scale from 1 to 7, where 1 is completely false and 7 is completely true?”
There are a few key differences in these scales. The first is the difference in number range. The SUDS scale ranges from 0 to 10 and of course the VOC scale ranges from 1 to 7.
Additionally, the scales are reversed in that a low score on the suds scale marks indicators of positive progress or decreased distress, whereas in the VOC score, a higher score would indicate improvement as the positive belief about one's self would be more true with a higher VOC score.
Now there is purpose in how the founder and creator of EMDR therapy, Robin Shapiro, ordered these scales; however, it can take some time for both therapist and clients to grasp the scales and report experience without confusion.
As an EMDR consultant the communication of these scales to clients is an aspect of EMDR therapy delivery that is discussed often. Below we have created a tool to help these scales be more accessible and understandable for both client and therapist.
The EMDR SUDS and VOC scale page, a downloadable PDF linked below, features the 0-10 SUDS scale on one side of the PDF with corresponding universal pain scale faces to orient clients to the more distressing and less distressing ends of the scale. On the reverse side of the PDF, a VOC is featured with a 1-7 scale corresponding with the universal pain faces in reverse order indicating the reverser orientation of the VOC scale.
This Free EMDR SUDS and VOC scale can be helpful in orienting clients to reporting their experience throughout the EMDR therapy process. Some clients that you may consider using this Free EMDR SUDS and VOC scale include:
Children or younger teens, where visual stimulators may make EMDR therapy more engaging
Client with greater ability for visual process over auditory processing. (This can include clients who simply learn and retain information visually, or may struggle with auditory processing due to learning disability, traumatic brain injury (TBI), executive processing disorders, etc.)
Clients with developmental delay
Client with language barriers
As an EMDR therapist and consultant, I can also say, I frequently keep this Free EMDR SUDS and VOC scale accessible to most client as they are beginning their EMDR therapy journey and offer it as an additional resource to any client that needs some extra reassurance or confidence in their target set up process.
To access the Free EMDR SUDS and VOC scale PDF. Click below.
