Topic · AI EMDR progress notes

AI EMDR progress notes drafted on your Mac — no transcript of trauma processing leaves your device

EMDR session notes are structurally different from standard progress notes, and the difference matters for documentation quality. A well-formed EMDR note tracks the trauma-processing arc across sessions — target memory work, SUDS and VOC scores, phase progression, body scan findings, closure protocols — not just the presenting concern and the clinician's intervention summary. Getting that structure right in a note draft requires a tool that understands EMDR's phase-specific documentation, not a generic AI scribe that outputs a SOAP note regardless of what modality was used. TherapyDraft is built for the EMDR note structure, and it runs entirely on your M-series Mac — because EMDR session audio contains trauma material that was never meant to reach a vendor's server.

TL;DR

TherapyDraft is a local AI note-drafting tool that runs entirely on the clinician's M-series Mac. For EMDR sessions, it drafts phase-aware progress notes tracking SUDS and VOC scores, phase indicators, body scan results, and closure protocols — without uploading session audio to any cloud, AI subprocessor, or third-party server. The audio, transcript, and draft stay on the device where the session happened. There is a 10-session free trial at no cost; paid plans start at $39 per month.

Why EMDR notes need a different template than standard progress notes

EMDR-trained therapists often document in two layers: the formal progress note that goes into the chart, and a separate processing log that tracks target memory, phase progression, and session-to-session continuity. The formal progress note in an EMDR practice typically includes phase-specific markers that do not exist in a standard CBT or insight-oriented note:

Phase indicator. Which of the 8 EMDRIA-recognized phases the session primarily addressed — history-taking and treatment planning, preparation, assessment, desensitization, installation, body scan, closure, or reevaluation. Multi-phase sessions (desensitization + body scan + closure is common) are documented as such.
SUDS score at session start and close. The Subjective Units of Disturbance Scale score (0–10) anchors the processing work quantitatively. At open: where was the disturbance when the clinician began engaging the target? At close: where was it at session end, whether processing completed or not?
VOC score. The Validity of Cognition score (1–7) tracks how strongly the client holds the positive cognition. Recorded at installation phase or at the close of successful desensitization. Not applicable when the session ends before installation.
Body scan result. Location and quality of any residual body sensation after processing. "Clear body scan" or a description of remaining sensation at session close — both are clinically significant and document-worthy.
Closure protocol used. When processing is incomplete — which is the norm rather than the exception in active desensitization work — the note documents which containment or stabilization technique brought the session to a safe close: container exercise, safe-place installation, grounding protocol, affect-regulation exercise, or other.

A generic AI scribe that does not know EMDR's structure will flatten all of this into a Subjective-Objective-Assessment-Plan SOAP note, losing the phase-specific documentation that EMDR-trained supervisors and consultation groups rely on to track a client's processing across sessions. TherapyDraft's EMDR template preserves the structure — the draft gives you a phase-aware note with named fields for each element, editable before signing.

Why EMDR session audio is more privacy-sensitive than most therapy audio

EMDR desensitization sessions contain verbatim trauma accounts. When a client is processing a target memory in active desensitization, they describe specific events: dates, names, locations, sensory details, the internal experience of re-accessing the memory. That verbatim account is precisely what the EMDR model requires — the AIP (Adaptive Information Processing) framework works through the clinician keeping the client activated to the memory while bilateral stimulation is applied. The conversation is not an abstracted discussion of themes; it is a direct account of the traumatic material.

EMDR therapists know this. It is standard practice to document target memory work at a high level in the formal chart — "target: childhood incident, identified in session 4 history-taking; currently in active desensitization" — because the verbatim detail is neither clinically necessary in the progress note nor appropriate in a document that can be subpoenaed, reviewed by an insurance auditor, or released on a signed ROI. The verbatim processing content stays in the session and nowhere else.

Cloud AI scribes break that containment. When session audio is uploaded to a cloud scribe's infrastructure for transcription and note drafting, the vendor retains the verbatim audio independently of what the therapist chose to document. That audio is the vendor's own business record. It is a legally separate custodian of the trauma account, reachable by subpoena directed at the vendor rather than at the therapist. The therapist's professional judgment about documentation granularity does not govern the vendor's records. A subpoena directed at the vendor asks for what the vendor has — not what the therapist wrote.

For most EMDR-trained therapists, the response to that information is not complicated: if the trauma account shouldn't be in the chart, it also shouldn't be in a cloud vendor's storage. TherapyDraft is the only AI scribe that keeps both properties in the same architecture — the note is drafted from the session audio, and neither the audio nor the transcript ever leaves the Mac.

The EMDR note-drafting workflow on a Mac

Record the session. TherapyDraft captures audio using your Mac's built-in microphone, a USB or Bluetooth external mic, or an audio interface. In-office EMDR sessions (in-person bilateral stimulation) and telehealth sessions (screen-based bilateral stimulation) are both supported — the audio capture path is identical. The recording is stored in TherapyDraft's local Application Support directory. It never leaves that directory.
Select the EMDR template. The format dropdown in TherapyDraft's post-session screen includes SOAP, DAP, BIRP, GIRP, and EMDR. Selecting EMDR activates the phase-aware template with separate fields for phase, SUDS-at-open, SUDS-at-close, VOC, body scan result, and closure protocol. The clinician can configure which fields are required and which are optional based on their own documentation standard.
Draft locally. whisper.cpp transcribes the audio on the Mac (under 1.0× real-time factor on M2 or later). The local language model — Qwen 2.5 14B-Instruct (4-bit MLX) — processes the transcript against the EMDR template and the clinician's own example notes. End-to-end for a 50-minute EMDR session: 90–150 seconds on M2, 60–100 seconds on M3 or M4. No network socket is open for audio, transcript, or inference output. The macOS network-sandbox entitlement on those code paths is set to deny.
Review the draft. The output includes a pre-populated EMDR progress note with extracted phase indicators, SUDS mentions from the transcript, and a closure-protocol summary. Fields that weren't addressed verbally in the session — VOC if the session didn't reach installation, for example — are flagged for manual entry. The clinician reviews, edits, and finalizes before pasting into the EHR chart.
Paste into SimplePractice, TherapyNotes, TheraNest, or your EHR. TherapyDraft's EMDR output includes a plain-text paste mode sized for standard EHR progress-note fields. You sign the note in your EHR as the author of every field.

EMDR note documentation: what the clinical record should show

The EMDRIA (EMDR International Association) does not publish a mandatory progress-note format, but the clinical community has converged on documentation standards that support continuity, supervision, and third-party review without exposing the content of trauma processing. Those standards generally include:

Phase notation — where in the 8-phase protocol the client and therapist are working
Target identification at a general level (phase of processing, type of memory, approximate time period if relevant) without verbatim trauma content
SUDS scores at start and end of desensitization sets — quantifies progress without narrating what was processed
VOC score and positive cognition for installation phase sessions
Body scan result — "clear" or description of residual sensation — as a processing-completeness indicator
Closure technique when processing did not fully complete, and client's affect at session close
Safety plan status for clients with active PTSD — any changes in risk since prior session

TherapyDraft's EMDR template is built around this structure. The draft the model produces for a desensitization session looks different from the draft it produces for a preparation session (which looks more like a standard skills-focused therapy note) because the template is phase-aware, not format-generic. That matters for documentation quality: a preparation-phase session that gets drafted as a desensitization note will have wrong or missing fields, and a desensitization session drafted as a generic SOAP note misses the EMDR-specific documentation entirely.

EMDR-trained therapists and the ICP for a local AI scribe

EMDR-trained therapists in private practice are a strong fit for TherapyDraft's ICP in several ways. EMDRIA Certified Therapists and EMDRIA Approved Consultants are typically in private practice or small group practices, billing at $150–$250+ per session for trauma processing work. They are cash-pay or insurance-billing clinicians, not hospital-employed W-2 therapists, which means they control their own tool choices without procurement overhead. They are disproportionately privacy-aware — the nature of trauma work, and the fact that EMDR specifically involves accessing explicit traumatic material during sessions, makes cloud-AI-scribe trust a live concern in EMDR consultation groups and the EMDRIA community.

The existing blog post on what cloud AI scribes actually send to their servers is the most-cited piece of TherapyDraft content in EMDR-adjacent communities, based on referral traffic, because the architecture concern is sharper in trauma work than in general-population talk therapy. An EMDR session with an adult PTSD client contains trauma content that the therapist and client both assume will be contained within the clinical relationship. A cloud AI scribe breaks that containment as a side effect of its own architecture — not maliciously, but structurally.

TherapyDraft's privacy architecture means the audio of a trauma processing session stays on the clinician's Mac, under the clinician's own custody, in the same document-custody framework as every other piece of the client's clinical record. The vendor-record problem is eliminated at the architectural level, not managed through a BAA that the vendor can be required to produce records from anyway under the right subpoena.

Pricing

TherapyDraft is $39 per month or $349 per year for the Solo plan — unlimited EMDR note drafts, all format options, all EHR paste presets, the inference attestation log, and one-shot template matching from your own example EMDR notes. The 10-session free trial requires no credit card. Full pricing breakdown is on the pricing page.

For comparison: Mentalyc ($19.99+/mo), Upheal ($29+/mo), Freed ($99/mo), Supanote ($39/mo), Blueprint ($0.99/session). None of these run locally — all upload session audio to cloud infrastructure. TherapyDraft is the only scribe in the market that runs the transcription and note-generation on the clinician's own hardware, with no outbound socket for audio or text.

Related questions

What does an EMDR progress note include that a standard therapy note doesn't?

EMDR progress notes typically track phase-specific elements that don't appear in standard CBT or insight-oriented notes: the SUDS (Subjective Units of Disturbance Scale) score at the start and end of each desensitization set, the VOC (Validity of Cognition) score for the installed positive cognition, the body scan result (location and intensity of any residual body sensation), the closure protocol used when processing is incomplete, and a phase indicator — which of the 8 EMDRIA-recognized phases the session was primarily working in. A standard progress note documents presenting concern, intervention modality, and response; an EMDR note tracks the processing arc across sessions, not just within a single session.

Why is EMDR session audio more privacy-sensitive than a standard therapy session?

Because EMDR desensitization sessions contain the verbatim account of traumatic memories — the specific events, dates, names, and sensory details a client describes while actively processing a trauma target. That content is more specific and more sensitive than the clinical summary a therapist writes in the progress note: EMDR notes conventionally describe target memory work at a general level (e.g., "target: childhood incident, age 8, began processing") precisely because the verbatim detail is inappropriate for a chart that may be subpoenaed or reviewed. A cloud AI scribe retains the verbatim audio independently of what the therapist chose to document, creating a vendor-held record that is more detailed than anything in the therapist's own chart. See the subpoena explainer for the legal mechanics.

Can TherapyDraft handle incomplete EMDR sessions — when processing doesn't fully close?

Yes. Incomplete processing is the norm in standard EMDR sessions, especially early in the desensitization phase. TherapyDraft's EMDR note template includes a closure-protocol field — documenting what containment or stabilization technique was used to end the session safely when processing was not complete — and an end-of-session SUDS to indicate the disturbance level at session close rather than at full processing completion. The note also marks whether the session ended with complete processing, partial processing plus closure, or resource installation and stabilization only.

Does TherapyDraft require the therapist to speak the target memory aloud during recording?

No. TherapyDraft drafts notes from whatever audio it captures — it does not require the target memory to be spoken aloud in a structured way. Many EMDR-trained therapists do not verbalize the trauma target verbatim during sessions; the client processes internally while the clinician tracks and responds. TherapyDraft uses the session audio to draft the structural note elements it can infer from the recording, and the clinician fills in or edits the remaining fields. Fields not verbally addressed in the session are left blank for manual entry. The note is always a draft the clinician reviews and edits, not an auto-filed record.

Is EMDR documentation covered by HIPAA the same way as other therapy notes?

Yes, EMDR session notes are protected health information (PHI) under HIPAA and subject to the same privacy and security rules as any other therapy progress note. There is no special federal carve-out for EMDR documentation. The relevant distinction is not the modality but where the documentation is stored and who can access it: audio and transcripts held by a cloud AI scribe vendor are independently subpoenable records in the vendor's custody, separate from the therapist's own chart. See what a BAA does and doesn't cover for the full analysis.