If you’ve been considering EMDR for trauma, anxiety, or memories that still feel too present, you’ve probably hit a practical question early: can this actually be done through a screen? EMDR has a reputation as a hands-on, in-the-room therapy, with a clinician moving their fingers back and forth in front of your eyes. It’s reasonable to wonder whether any of that survives a video call.
The short answer is yes, many people do EMDR online, and the research so far is encouraging. The longer, more honest answer is that it works best when it’s set up carefully, and it isn’t the right format for everyone. This guide walks through what online EMDR looks like, how it’s adapted for telehealth, what the evidence does and doesn’t show, and how to tell whether it’s a good fit for you.
🪷 The quick answer
Online EMDR follows the same eight-phase protocol as in-person EMDR. Bilateral stimulation is adapted through self-tapping or an EMDR-specific platform that runs on your screen. Research suggests remote EMDR can meaningfully reduce trauma, anxiety, and depression symptoms, though the evidence base is still younger and smaller than for in-person EMDR. For many adults it’s a reasonable option; for some, especially those with severe dissociation or limited grounding skills, in-person may be the better starting point.
🖥️ What an Online EMDR Session Actually Looks Like
From the outside, an online EMDR session looks a lot like any other telehealth appointment: you and your therapist on a secure video platform, talking. What’s different is the structure underneath. EMDR follows the same eight phases whether you’re in an office or at home, and the early phases matter even more when you’re working remotely.
The first sessions: history and preparation
You won’t start by processing your hardest memory. The first few sessions focus on understanding your history, identifying which memories or themes are driving your current symptoms, and building the skills you’ll lean on during reprocessing. This is often called preparation or stabilization, and it typically includes:
- Grounding techniques you can use when you notice yourself getting pulled into the past
- A “calm place” or resource exercise to help your nervous system settle
- Containment strategies for setting difficult material aside between sessions
- Practice with the bilateral stimulation method you’ll use, so it’s familiar before it carries any emotional weight
For online work, preparation also covers logistics: where you’ll be during sessions, what happens if the connection drops, and how your therapist will reach you if needed. We’ll come back to those below.
Reprocessing sessions
Once you’re ready, your therapist guides you to briefly bring up a target memory, along with the negative belief and body sensations attached to it. Then you engage in short sets of bilateral stimulation while noticing whatever comes up: thoughts, images, feelings, physical sensations. Between sets, you check in briefly with your therapist, and the process continues until the memory feels less charged. Each session closes with steps to make sure you’re settled before you log off.
👐 How Bilateral Stimulation Works Over Video
Bilateral stimulation (BLS) is the rhythmic left-right input that’s central to EMDR. In an office, it’s often eye movements following the therapist’s hand. Online, it’s adapted in a few ways.
The methods our clinicians use
The butterfly hug. You cross your arms over your chest, rest your hands near your opposite shoulders or upper arms, and alternate gentle taps, left and right. It’s simple, self-directed, and easy to use between sessions as a grounding tool.
Knee tapping. You rest your hands on your knees and tap alternately. Like the butterfly hug, it needs no equipment and keeps you connected to your body.
EMDR-specific platforms. Some of our clinicians use dedicated remote EMDR software that runs alongside the video call. The therapist controls a moving visual target or alternating tones that appear on your screen or in your headphones, adjusting speed and duration in real time.
With self-tapping, your therapist will typically demonstrate the pace and guide you on when to start and stop each set. Some people actually prefer tapping, because it gives them a felt sense of control over the process. Others find it harder to keep a steady rhythm while emotions are moving, which is one reason a platform-based option can be useful. Your therapist will help you find what works for you during preparation, before any difficult material is involved.
🔬 What the Research Says About Remote EMDR
Here’s where it’s worth being careful, because a lot of what’s written online overstates the evidence.
EMDR itself is well established for PTSD, with decades of controlled research behind it. Online EMDR is newer. Most of the research on it emerged after 2020, when the pandemic pushed therapy onto screens almost overnight.
A 2024 systematic review published in Frontiers in Psychiatry gathered 16 studies of remotely delivered EMDR, covering 1,231 participants in total. The authors concluded that online EMDR shows feasibility and potential efficacy as an accessible option, with studies reporting reductions in symptoms such as PTSD, anxiety, and depression. They also noted that the effectiveness of online EMDR is not yet well established. Many of the included studies were small, several focused specifically on healthcare workers during COVID-19, and some looked at self-administered computerized programs rather than live therapy with a clinician.
What that means in plain terms
Research suggests online EMDR can help, and there’s no strong signal that it’s less safe when it’s set up properly. What we don’t yet have is a large body of head-to-head trials proving it performs identically to in-person EMDR for every person and every kind of trauma. If someone tells you it’s “proven just as effective,” they’re getting ahead of the data. “Promising and increasingly well supported” is the fairer summary.
⚖️ Online vs. In-Person EMDR
The core therapy is the same in both formats. What changes is the environment and how certain parts of the session are delivered.
| Online EMDR | In-person EMDR | |
|---|---|---|
| Protocol | Same eight phases | Same eight phases |
| Bilateral stimulation | Self-tapping or on-screen platform | Eye movements, tappers, tones, or tapping |
| Environment | Your own space, which you need to make private | A therapy office set up for the work |
| Therapist’s view of you | Face and upper body on camera | Full body language and posture |
| After the session | You’re already home, with no commute | Travel time can act as a buffer, or as a strain |
| Access | Anywhere in Illinois | Requires getting to the office |
Some people find that processing difficult memories from a familiar space feels less exposing. Others find that doing trauma work in the room where they sleep blurs a boundary they’d rather keep. Neither reaction is wrong. It’s worth paying attention to which one sounds more like you.
✅ Who Online EMDR Tends to Fit, and When In-Person May Be Better
Online EMDR is often a reasonable choice for adults who:
- Have a private, reliable space where they won’t be interrupted or overheard
- Have some ability to notice when they’re getting overwhelmed and use grounding skills to come back
- Live too far from an EMDR-trained clinician, or have schedules that make regular office visits hard to sustain
- Feel comfortable on video and have a stable internet connection
In-person EMDR may be the preferred format, at least to start, if you:
- Experience significant dissociation, such as losing time, feeling unreal, or “leaving your body” under stress
- Are working with complex or developmental trauma and haven’t yet built reliable grounding skills
- Don’t have a private space at home, or live with someone connected to the trauma
- Have found in past therapy that you benefit from the steadiness of having someone physically in the room
- Are currently in crisis or at elevated risk of self-harm, where stabilization comes first regardless of format
This isn’t all-or-nothing. Some clients do preparation online and reprocessing in person, or alternate depending on what a given stretch of treatment calls for. A good EMDR therapist will talk this through with you rather than defaulting to whichever format is more convenient.
🛡️ Safety and Setup: Privacy, Your Space, and Getting Activated
This is the part of online EMDR that gets the least attention, and it’s arguably the most important.
Setting up your space
EMDR asks you to let difficult material move through you, which is hard to do if part of your attention is on whether your roommate can hear. Before reprocessing sessions, it helps to have:
- A room with a door that closes, ideally when no one else is home
- Headphones, to keep your therapist’s voice private and support audio-based bilateral stimulation
- A chair where you can sit comfortably with your feet on the floor
- Water, tissues, and anything you use for grounding within reach, such as a blanket or something with a familiar texture
- A device that’s charged and positioned so your therapist can see your face and shoulders
- Some buffer time afterward, rather than jumping straight into a work call
Doing EMDR from a parked car, a shared office, or a coffee shop isn’t recommended. If privacy at home is genuinely hard to come by, that’s useful information when you’re deciding on format.
What happens if you become highly activated during a session
Feeling stirred up during EMDR is normal. It’s part of how processing works. But there’s a difference between productive activation and getting overwhelmed, and a remote session needs a plan for the second one before it ever happens. A well-run online EMDR practice puts these pieces in place during preparation:
- A stop signal. A simple gesture, like raising a hand, that pauses bilateral stimulation immediately.
- Your location and an emergency contact, confirmed at the start of sessions, so your therapist knows where you are.
- A backup channel. If video freezes mid-processing, your therapist calls your phone. Your job in that moment is simply to use the grounding skill you practiced.
- Shifting gears. Your therapist can stop processing, return to resourcing or grounding, and slow the pace. Reprocessing can always be resumed later.
- Closure before you log off. Sessions don’t end with you mid-memory. Your therapist uses the closing phase to make sure you’re settled and knows how you’ll take care of yourself afterward.
If you’re ever in crisis outside of session, call or text 988 to reach the Suicide & Crisis Lifeline, or call 911.
🧩 Is Online EMDR Only for PTSD?
No. EMDR was originally developed for PTSD, and that’s still where the evidence is strongest. But clinicians also use it, online and in person, for concerns rooted in distressing experiences that don’t necessarily meet criteria for a PTSD diagnosis. That can include anxiety and panic tied to specific memories, phobias, painful relationship experiences, workplace trauma, grief that feels stuck, and deep-seated beliefs like “I’m not safe” or “I’m not enough.”
The question isn’t so much “Do I have PTSD?” as “Is there something from my past that my nervous system still reacts to as if it’s happening now?” If so, EMDR may be worth exploring. You can read more about the range of concerns we treat on our trauma therapy page.
📍 Online EMDR in Illinois: What to Know
Under Illinois law, therapy delivered by telehealth takes place where the client is physically located during the session. In practice, that means two things:
- Your therapist must hold an active Illinois license if you’re in Illinois, even if their practice is based elsewhere.
- Your location during each session matters. If you’ll be traveling out of state, raise it with your therapist ahead of time. Whether a session can go ahead depends on the rules where you’ll be and on your clinician’s license type.
Insurance coverage for telehealth varies by plan. It’s worth confirming your benefits before you start rather than assuming virtual sessions are billed the same way as in-person ones.
🪷 How Calm Anxiety Clinic Provides EMDR
At Calm Anxiety CBT Therapy Clinic, our clinicians offer EMDR therapy in person at our Lakeview office and our Andersonville office, and through secure telehealth for adults anywhere in Illinois. Many clients move between formats as treatment evolves, and that flexibility is built in rather than treated as an exception.
Because we’re an anxiety-focused practice, we often pair EMDR with cognitive behavioral therapy. EMDR addresses the memories fueling the anxiety, and CBT gives you tools for the patterns that show up in day-to-day life. Whether online EMDR is right for you is something we’ll talk through together, based on your history, your home setup, and how you tend to respond under stress.
Not sure which format fits?
You don’t have to decide before reaching out. A free consultation is a chance to describe what you’re dealing with and ask questions. Together we’ll figure out whether online EMDR, in-person EMDR, or a different starting point makes the most sense.
❓ Frequently Asked Questions About Online EMDR
Is online EMDR as effective as in-person EMDR?
Research suggests online EMDR can be effective, with studies reporting meaningful reductions in PTSD, anxiety, and depression symptoms. A 2024 systematic review of 16 studies described it as feasible with potential efficacy. However, the research is newer and smaller than the evidence for in-person EMDR, and direct head-to-head comparisons are still limited. For many people it’s a reasonable option, especially when preparation and safety planning are done well.
How does bilateral stimulation work online?
The most common methods are self-tapping, such as the butterfly hug (crossing your arms and alternately tapping your shoulders) or tapping your knees, and EMDR-specific platforms that display a moving visual target or play alternating tones through headphones. Your therapist guides the pace and timing of each set, just as they would in person.
Do I need special software or equipment for online EMDR?
Usually not. You’ll need a computer or tablet with a camera, a stable internet connection, and ideally headphones. Sessions run on a secure, HIPAA-compliant video platform rather than a standard consumer video app. If your therapist uses an EMDR-specific platform for bilateral stimulation, it typically runs in a web browser alongside the video call, with nothing to install.
What if my internet connection drops during processing?
That’s why a backup plan is set up before reprocessing begins. Typically, your therapist will call your phone right away. In the meantime, you use the grounding skill you practiced during preparation. A dropped connection is unsettling, but it’s a manageable interruption when everyone knows the plan.
What happens if I get overwhelmed during a virtual EMDR session?
You can stop at any time with an agreed signal. Your therapist will pause bilateral stimulation, help you ground, and slow things down. Sessions are closed carefully so you aren’t left in the middle of a distressing memory when the call ends.
Can I switch between online and in-person EMDR?
Yes. At Calm Anxiety Clinic, many clients move between telehealth and in-person sessions at our Lakeview or Andersonville offices. Some prefer in-person for the most intense reprocessing and online for preparation or follow-up.
Can I do online EMDR from my office, car, or a public place?
It’s not recommended. EMDR works best when you can fully focus without worrying about being overheard or interrupted. A private room with a closed door is the standard to aim for.
Can I do online EMDR while I’m traveling outside Illinois?
It depends. Therapy is considered to take place where you’re physically located, so your clinician must be authorized to practice there. Talk with your therapist before you travel so you can plan around any gaps.
This article is for informational purposes only and is not a substitute for professional diagnosis or treatment. If you are experiencing a mental health emergency, call or text 988 or call 911.