Eye Movement Desensitization and Reprocessing (EMDR) is a structured therapy model used to help individuals process distressing memories and symptoms related to trauma. While traditionally conducted in a therapist’s office, EMDR can be successfully adapted for telehealth. This adaptation requires maintaining the core components of the therapy and meeting specific technological and safety prerequisites. The feasibility of remote EMDR depends on the therapist’s ability to successfully implement the bilateral stimulation component that drives the reprocessing phase.
Adapting Bilateral Stimulation for Telehealth
The defining element of EMDR is Bilateral Stimulation (BLS), which involves rhythmic, alternating sensory input to both sides of the body. Traditionally, this involves following the therapist’s hand movements. In a remote setting, BLS is achieved through technological tools or client-administered techniques, with the therapist guiding the pace and duration of the stimulation sets.
One common method is self-administered tapping, often called the “butterfly hug.” The client crosses their arms and alternately taps their shoulders or upper arms, creating left-right sensory input. This technique is easily taught via video and allows the client to control the intensity of the sensation.
Specialized software and apps are used for auditory BLS. The client wears headphones and listens to tones or sounds that alternate between the left and right ears, creating the dual attention stimulus. This method requires a stable internet connection and high-quality headphones to ensure the sounds are clear and synchronized.
The third method involves visual tracking, replicating the traditional eye movements used in person. This is accomplished using screen-sharing features to display a moving object, such as a colored ball or light, moving back and forth across the screen. Dedicated online EMDR platforms allow the therapist to remotely control the speed, direction, and intensity of the visual stimulus, ensuring clinical precision.
Clinical Effectiveness and Professional Consensus
The efficacy of remote EMDR has been extensively studied following the widespread adoption of telehealth. Current research suggests that EMDR delivered via a secure video platform is comparable in effectiveness to in-person sessions. These findings indicate that the remote format leads to significant reductions in trauma-related symptoms, including those associated with Post-Traumatic Stress Disorder (PTSD).
A systematic review in 2022 supported these clinical outcomes, concluding that telehealth EMDR yields similar results to traditional therapy when the client is in a secure environment. Service evaluations have shown online EMDR to be an acceptable, safe, and effective alternative for clients with PTSD, anxiety, and depression. The success of remote EMDR is rooted in its highly structured protocol, which translates well to the virtual environment once the BLS is adapted.
The professional community has embraced this modality, recognizing that it expands access to specialized trauma care for individuals who are geographically isolated or face mobility challenges. The successful application depends less on the physical presence of the therapist and more on the fidelity of the eight-phase EMDR protocol and the successful implementation of the adapted BLS.
Essential Requirements for Successful Remote Sessions
Conducting EMDR effectively via telehealth requires establishing a controlled and technologically sound environment. A successful remote session requires a stable, high-speed internet connection, preferably wired, to prevent interruptions during the reprocessing phase. Clients should use a computer or tablet with a screen large enough to follow visual stimuli, and headphones are necessary for the precise delivery of auditory BLS.
The client must be in a private, quiet, and uninterrupted space where they feel secure expressing intense emotions. This dedicated therapeutic space is important because the EMDR process can bring up significant distress. Eliminating distractions like mobile phone notifications and household noise is necessary for the client to maintain focus.
A comprehensive safety plan must be established before the reprocessing phase begins. This plan includes:
- Obtaining the client’s exact location.
- Contact information for local emergency services.
- The phone number of an identified local support person.
- Agreeing on a backup communication method (Plan B) if the video connection fails.
- Agreeing on an emergency contact plan (Plan C) if the client experiences acute distress and cannot reconnect.