The SUDS scale

The SUDS scale — Subjective Units of Distress — is how EMDR captures the client’s experienced distress at each point in a reprocessing session. It’s the single most important data point in the Phase 4 → Phase 7 work, and Rivet’s Workspace is designed around capturing it cleanly.

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The scale

Wolpe, J. (1969). The Practice of Behavior Therapy. Pergamon Press. (Earlier appearance in Wolpe, 1958, Psychotherapy by Reciprocal Inhibition.)

Wolpe’s original scale ran 0 to 100. EMDR convention is 0 to 10. Rivet uses 0–10 to match EMDR practice and to reduce the perceived precision the client has to commit to in the moment. The Workspace surfaces these anchors:

• 0 — calm — no distress
• 5 — moderate
• 10 — worst imaginable

The narrative interpretation in between (1–4 light, 6–9 high) is clinical judgment territory. Rivet doesn’t surface band labels for the intermediate numbers because the published convention varies and the clinical use depends on the client’s reference frame, not a software label.

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Capturing SUDS between sets

After each BLS set ends — either because the countdown reached zero or you tapped End set — the Workspace automatically transitions to the between-sets card. The card shows:

• “How distressing now?” as the question
• A gradient horizontal scale track with a draggable marker (starts at 5)
• A legend showing the three anchors: 0 · calm, 5 · moderate, 10 · worst
• A sparkline of the session’s SUDS history so far
• A Continue button that advances to the next set

You ask the client for their rating, drag the marker, and tap Continue. The value is captured to the session’s SUDS history.

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Where the SUDS values live

SUDS values are stored in your browser’s session storage. That means:

• The values are on your device only — never sent to a Rivet server, never written to your client’s device, never persisted across sessions.
• The values clear when you close the browser tab or the session ends.
• The values are available to the Workspace for the duration of the session — the sparkline rehydrates if you reload the page mid-session.

If you want to keep a SUDS history beyond the session, use the Copy button on the session arc card at the end. See The session arc.

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The optional note field

The SUDS modal on the practitioner panel surfaces an optional one-line note field where you can capture context — a body sensation the client mentioned, an image they reported, a shift in their narrative (“less heavy in chest”). The note is stored alongside the SUDS value and renders in the Copy session summary. The field is capped at 120 characters. Skip if you don’t want it.

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The session sparkline

Inside the between-sets card, a small sparkline renders the SUDS history so far. After Set 1 it’s a single dot; after Set 4 it’s a 4-point line. The sparkline gives you a quick read on trajectory without having to remember the previous SUDS values. If the line is descending steadily, the reprocessing is doing its work. If the line flatlines or rises, that’s a clinical signal — adjust pace, switch dual-task prompt category, check the target, or close the session early.

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What SUDS isn’t

• Not validated for the practitioner to set. Only the client can rate their own distress. The slider is on your screen because you’re driving the controls, but the value reflects the client’s verbal report.
• Not a forced choice. A client who can’t or won’t rate can skip the capture — the practitioner panel surfaces a Skip button. The skipped set won’t render a dot on the sparkline.
• Not part of the EMDR diagnosis. SUDS is a process measure inside the protocol, not a clinical assessment tool. Pair with a validated PTSD measure (PCL-5) for diagnostic and outcome tracking — see the Clinical templates library.

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Capturing SUDS in Phase 3 vs Phase 4

Strictly speaking, the first SUDS in an EMDR session is captured in Phase 3 (assessment) before any BLS runs — the baseline rating with the target activated. Rivet captures that in your session notes, not in the BLS Workspace; the Workspace’s first sparkline dot is the post-Set-1 reading. If you want the Phase 3 baseline to appear on the session arc curve, write it as Set 0 in your notes and add it manually to the Copy output. Rivet’s arc starts with the first BLS set, by design.

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