Is online EMDR as effective as in-person?

Current evidence indicates it is. Available research shows that remote EMDR therapy reduces PTSD, anxiety, and depression symptoms comparably to in-person treatment. The only direct comparison in a specialized trauma center found no significant differences between formats.

What do I need at home for online EMDR?

A private space where no one will interrupt you, a stable internet connection (preferably wired or strong wifi), a device with camera and microphone (computer or tablet, preferably with a large screen), and headphones if alternating sounds will be used as bilateral stimulation.

How does bilateral stimulation work on screen?

There are several options: a dot that moves side to side on your screen that you follow with your eyes, self-administered tapping like the Butterfly Hug (alternately touching your shoulders), or alternating tones through headphones. Your therapist will choose the most suitable option for you.

What happens if the internet connection drops during a session?

Your therapist will have agreed on a contingency plan before starting. This typically includes a phone number to reconnect immediately and self-regulation techniques you can use on your own while the connection is restored. This is prepared in the first session.

Can I alternate between online and in-person sessions?

Yes, and it's increasingly common. Many therapists offer a hybrid model where you can choose the format based on your needs each week. What matters is maintaining treatment continuity.

Are there situations where online EMDR is not recommended?

Clinical guidelines recommend caution with online EMDR in cases of severe dissociation, high crisis risk, or when the patient doesn't have a safe and private space. In these situations, the therapist may recommend in-person sessions or an online stabilization approach before processing traumatic memories. If you're unsure which format is best for you, your therapist can guide you in the first session.

Online EMDR vs. in-person: differences, evidence, and how to choose - EMDR Digital

Does online EMDR work as well as in person?

If you've already decided to try EMDR and are considering doing it online, it's normal to have doubts. Maybe you live far from an EMDR therapist, have difficulty traveling, or simply prefer the comfort of your own home. The key question is: does it lose effectiveness?

The short answer is no. A systematic review of 16 studies with 1,231 participants concluded that online EMDR therapy produces similar reductions in PTSD, anxiety, and depression symptoms as in-person EMDR (Kaptan et al., 2024). The only direct comparison in a specialized trauma center in the UK found no significant differences between patients treated online and in person (Strelchuk et al., 2023).

Most importantly: online EMDR uses the same 8-phase protocol as in-person EMDR. It's not a reduced version or a simplified adaptation. What changes is how bilateral stimulation is delivered and some practical adjustments we'll cover below. To learn more about the EMDR protocol, see our guide on what is EMDR.

What changes and what stays the same

What stays the same

The 8 phases of the EMDR protocol are applied exactly the same: history-taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation.
Your therapist still guides the entire process in real time. Nothing is automated or self-administered.
The same distressing memories, negative and positive beliefs are worked on, and your disturbance level during the session is measured the same way.
The preparation phase includes the same regulation techniques: Safe Place, Butterfly Hug, breathing.

What adapts for the online format

Bilateral stimulation: instead of the therapist moving fingers in front of you, alternatives are used such as a dot moving across your screen, self-administered tapping (Butterfly Hug, knee tapping), or alternating sounds through headphones. Your therapist will choose the most suitable option for you.
Shorter sets and more check-ins: therapists typically use shorter stimulation sets and check your state more frequently, as the therapist has less visual access to your physical reactions through the screen.
More detailed preparation: before starting, the therapist ensures you have a private space, stable connection, and a contingency plan in case the connection drops.
No commuting: you can do the session from home, which for many patients means less pre-session stress and more post-session comfort.

When to choose online and when to choose in-person

There is no universally better format. The choice depends on your personal situation:

Online is a good choice when: you live far from an EMDR therapist, have mobility difficulties, prefer the comfort and familiarity of your own space, need schedule flexibility for video call sessions, or have already established a good relationship with your therapist and want to continue remotely.

In-person may be preferable when: you experience intense dissociation (a feeling of disconnecting from your body or surroundings) or have difficulty staying present, you don't have a private and quiet space at home, your internet connection is unstable, or you prefer your therapist's physical presence as a source of regulation.

Many people combine both formats based on what they need at any given time, and this is increasingly common.

In an international survey of 148 patients who had received online EMDR, 88% felt comfortable or very comfortable with the format. Those who had tried both modalities highlighted feeling more in control and safer in their own home (Bursnall et al., 2022).

What matters most is not the format, but finding an EMDR therapist with whom you feel safe. To learn what the process looks like from the start, see our guide on your first EMDR session.