EMDR Online: How It Works & Who It’s Right For

What Is EMDR?

EMDR is a neuroscience-based approach for healing trauma that utilizes an 8-phase protocol. It is different from more traditional talk therapies, in that EMDR focuses on the activation and desensitization of traumatic or upsetting memories.

EMDR works to untangle negative self-beliefs, triggering visuals, and uncomfortable body sensations, like muscle tension. This frees the mind to follow what EMDR calls the Adaptive Information Processing (AIP) model. The mind is able to think more accurately about life events or relationships and to recognize that these triggers are a thing of the past. EMDR allows us to live in our current lives without earlier life traumas affecting our here-and-now.

What Can EMDR Help With?

Research has shown that EMDR can successfully treat PTSD, and is also effective for treating:

• Anxiety
• Depression
• Performance anxiety
• Developmental trauma
• Relationship difficulties

Can EMDR Be Done Virtually?

Yes, EMDR can be done virtually. The primary principles and phases of EMDR do not change when done online. It is essentially the same and even potentially enhanced by the fact that those receiving treatment can utilize various home comforts during treatment. EMDR uses grounding techniques to help the client feel safe during the process. Often with online EMDR, providers will spend more time focusing on these grounding techniques, or “resources,” since the provider is less able to support that process remotely.

Is Online EMDR Effective?

Telehealth has come a long way in the past few years. Currently, online EMDR has become common practice for professionals treating a variety of mental health disorders and trauma-related conditions. Numerous studies published in recent years have revealed that EMDR can be successfully delivered remotely and lend similar outcomes as traditional EMDR. In fact, online EMDR has been found to be just as effective as in-person sessions for PTSD, anxiety, depression, and many other concerns. As ongoing research continues to emerge, it will further solidify its effectiveness and feasibility as a web-based therapeutic medium.^{1,2,3,4,5,6,7}

Similarities Between In-Person & Virtual EMDR Therapy

It isn’t unusual for individuals to question how a specialized intervention like EMDR can be properly delivered remotely. Nevertheless, aside from certain technological adjustments, conventional and virtual EMDR function similarly and share some commonalities.

Here are the similarities of in-person and online EMDR:^3,8

• Both require a designated space that’s private, distraction-free, and where the therapist can provide support and engage the client throughout sessions.
• Both are built upon creating a strong therapeutic alliance based on trust and empathy.
• Both use bilateral activation (although online EMDR uses special software and/or other means to stimulate the brain)
• Both practices abide by the same EMDR protocol with specific stages and phases.

Differences Between In-Person & Online EMDR

One of the primary differences between in-person and online EMDR is the way bi-lateral or dual attention devices are delivered. EMDR relies on the use of dual-attention to facilitate the desensitization and adaptation of negative memories. This is traditionally done through eye movements, auditory sound, or tactile stimulation (like tapping).

When in person, the therapist will utilize their own hands or electronic devices like a light bar. When EMDR is done online, the provider might have the client self-tap or use an online software. EMDR software often incorporates a moving light, similar to a light bar, or sounds through headphones.

Although EMDR is extremely effective, the process requires the activation of negative memory content or triggers, which can be quite uncomfortable or upsetting. Some clients feel more contained and safe if doing so in the therapist’s office. Others prefer to be at home where they are most comfortable, meaning they prefer EMDR online.

Benefits of Remote EMDR

Aside from its efficacy, there are many other reasons why you might opt to do online EMDR, including:^3,5

Freedom 

Video-based remote EMDR therapy can grant people access to treatment from any part of the world as long as there is a secure internet connection. This freedom of accessibility allows clients the possibility to select from a wide range of qualified EMDR mental health practitioners. Furthermore, virtual EMDR permits a high level of security and personal privacy since it is offered on a protected online platform.

Convenience

If you have a busy lifestyle, finding a therapy appointment that aligns with your schedule can be cumbersome. Fortunately, because of various online mediums, virtual EMDR can provide you with the flexibility to partake in a session from the comfort of your home or any place where there’s access to reliable internet. This can make it much easier and convenient to fit your session into your day.

Safe Space

Some people are often hesitant about therapy and avoid it because they dread having to be vulnerable in an unfamiliar setting. For anyone struggling with trauma, this could feel even more intense. But engaging in online EMDR in a space where you feel most safe and comfortable like your couch or your bedroom can help you open up and process traumatic memories that will likely surface during sessions.

Less Effort

Having your therapy appointment just a few steps away is not only convenient but effortless. This can reduce wait times, travel burdens, and the overall stress that you would typically experience for in-person visits. This less complicated process can help you feel more relaxed when it is time for your session while also saving you time and money, especially if your therapist’s office is far.

Availability

Maybe you live in an area where behavioral health care is inaccessible or there aren’t any local providers accepting new patients or your insurance. Perhaps, you’re homebound due to a disability and getting to an in-office visit is difficult. EMDR online can be a great alternative that gives you easier access to a wide range of EMDR professionals that might not have been readily available to you otherwise.

What You Need for Virtual EMDR

Before entering virtual EMDR therapy, there are a few things you’ll want to arrange prior to your session:

Private Space Where You Won’t Be Interrupted

An essential aspect of online EMDR is creating a place for your sessions that feels safe and private so you can fully engage in therapy. It’s important to ensure that this personal space is quiet, where you won’t be interrupted or distracted and where others aren’t listening in. Since EMDR often triggers painful memories, being in a confidential and cozy setting can put you at ease as you process your emotions during sessions.

Computer or Laptop With a Camera

The simplest way to start engaging with online EMDR can be through your smartphone. Nonetheless, virtual EMDR is most effective when using a device that has a larger screen—a laptop, iPad, or any other equipment with a larger monitor and a built-in camera is ideal for your tele-visit because it allows more space for the therapist to observe your body language and use different visual bilateral stimulation techniques.

Headphones

Using headphones for your online EMDR therapy is a great tool to enrich your video session experience. First, headphones can allow you to participate in EMDR modalities using auditory bilateral stimulation (BLS). Headphones can also enhance sound quality, minimize distractions by reducing background noise, and provide a greater feeling of confidentiality in a shared space, particularly if you live with others.

How to Find a Remote EMDR Therapist

There are not any current directories specifically for online EMDR therapists; however, people can visit EMDRIA.org to find an EMDR therapist in their area who may have online delivery designated on their provider profile. Alternatively, many online therapist directories have EMDR listed in the provider’s profile as a specialty.

Who Is Able to Practice EMDR Online?

EMDRIA recently released their guidelines for providing EMDR online.⁹ There is not currently a specific designation required for the online delivery of EMDR; however, it is recommended to seek providers who have completed an EMDRIA-approved training and have reached EMDRIA Certified status.

Key Questions to Ask a Therapist When Considering Online EMDR

When considering online EMDR, it would be wise to seek out a provider with a good amount of experience using EMDR both in-person and online.

The following questions would be helpful to ask a prospective online EMDR therapist:

• What do they use for bilateral stimulation (BLS)? Do they use any software?
• How long have they been delivering EMDR online or remotely,  and do they feel confident with this approach?
• Have they been trained by an EMDRIA approved training provider?
• Have they reached Certified status?
• Do they have any particular approaches for grounding and stabilization in a remote setting?

How to Prepare for Your First Online EMDR Appointment

To prepare for your first online EMDR appointment, it will be helpful to have an idea of your therapy goals. These can also be discussed and clarified with the provider if you are not sure. Aside from securing a private space, you may also want to have personal items with you that feel comforting, like a blanket, favorite candle, hand cream, or photograph.

If your provider utilizes software, you will likely want to use a laptop with a larger screen or a desktop computer instead of a phone. This will make your use of the BLS devices more comfortable.

What to Expect at Your First Online EMDR Appointment

Depending on the specific provider, you can expect to participate in a typical intake session where you discuss your reasons for starting treatment, provide a brief personal history, and determine your goals for treatment.

At the end of this session, the provider will let you know if EMDR is a good fit for your goals. Then, during the first phase of EMDR, you and the provider will work together to identify specific, historical memories or current triggers that can be focused on one at a time.

What If I’m Not Comfortable With Online EMDR?

EMDR delivered online and via telehealth can be effective for most people. Like any telehealth visit, it is not ideal for those who cannot obtain privacy while at home or work. Those that struggle to cope with negative feelings may want to opt for an in-person setting where they can get an immediate response from the provider who is in the room. In general, the majority of clients would be fine doing EMDR remotely.

How Much Does Remote EMDR Cost?

The cost of online EMDR is generally equivalent to in-person EMDR treatment. Since it requires the provider to have extensive, specialized training, the fees can often be higher than the cost of traditional psychotherapy. The cost can also vary depending on the length of the session, typically 60 or 90 minutes.

Someone can expect to pay in the range of $150-250 a session for remote EMDR treatment. While that may feel pricey, EMDR is generally not a drawn-out process. Clients can expect to feel the effects and beginnings of relief from EMDR treatment in as early as three sessions.

Will My Insurance Cover Online EMDR?

Private mental health insurance plans will typically cover EMDR treatment because it is so effective. It is important to be aware that many common, online telehealth platforms provided by health insurance companies, like MDLive, prohibit EMDR treatment due to its specialization. If looking to utilize your health insurance, it may be best to make sure your mental and behavioral health benefits do not restrict you to the use of a specific online platform.

In general, the advocacy efforts for insurance plans to cover mental health and behavioral health delivered online have been successful, although there is still work to be done. There are currently several advocacy groups petitioning for parity, meaning they must cover online, remote, and telehealth services the same as in-person. As always, each prospective client must check with their individual plan’s benefits.

Final Thoughts on Online EMDR

EMDR has been shown to significantly reduce PTSD symptoms within a six week period.¹⁰ Online EMDR allows for the same protocol to be delivered in a convenient, remote setting when coming into an office might be difficult. This psychotherapy approach is a good choice for anyone who has experienced mental health issues after negative life events. Reaching out to an online EMDR therapist may be the key to healing that you have been searching for.