Your Guide to a Successful Online EMDR Therapy Session: Tips for Clients

Note: To reflect the mental health field’s multiple use of terms regarding providing therapy services remotely, this article will use the terms online, virtual, and telehealth interchangeably.

As more people turn to online therapy, understanding how best to prepare for your online EMDR (Eye Movement Desensitization and Reprocessing) therapy session can make a significant difference in your experience. EMDR therapy is a powerful therapeutic approach for processing trauma and managing emotional distress.

How should you prepare for your online EMDR therapy appointment? Learn how to set yourself up for success with these tips and suggestions from virtual EMDR therapy clients and therapists.

Why try EMDR therapy virtually?

Choosing online EMDR therapy over in-person sessions can offer several advantages. You can attend sessions from a familiar, private space, reducing the stress of commuting and creating a sense of safety in your environment. This can be especially helpful if you have a busy schedule, chronic illness, need childcare to go to therapy, or if mobility is a concern.

Some additional benefits could include:

Fewer distractions from an office setting
Better able to focus on the bilateral stimulation or BLS (back and forth eye movements, tapping, etc.)
Children and adults have access to their own calming lotions, blankets, stuffies, etc.
Weather issues won’t keep you from therapy
Working folks can use lunch hours for therapy

In addition, online therapy opens up access to a wider range of therapists, enabling you to find a professional who specializes in EMDR even if they are not in your local area (make sure they are licensed to work in your state, however). You can search for virtual EMDR therapists in your state by using the EMDR Therapist Directory.

“Online EMDR made it so much easier to fit therapy into my life. I didn’t have to commute, and I could schedule it at times that worked best for me.”

Understanding EMDR therapy

EMDR therapy is designed to help individuals process traumatic memories and reduce their emotional charge. It involves an 8 phase process that typically includes the identification of distressing memories, the use of bilateral stimulation, and the reprocessing of those memories.

What is Bilateral Stimulation?

Bilateral stimulation (BLS) is a part of EMDR therapy. It is a technique that involves alternating sensory stimulation between the left and right sides of the body. BLS methods include back-and-forth eye movements, tactile tappers or buzzers, alternating auditory tones, or physical movement.

BLS during in-person EMDR therapy typically involves a client following the movement of a therapist’s fingers. With online EMDR therapy, the bilateral stimulation is often administered via a screen or instruction through physical tapping. While online EMDR may differ from in-person sessions it can be just as effective for reducing emotional charge.

This video shares clients’ stories who have experienced EMDR therapy.

Technical preparations

Familiarize yourself with the technology

Ask your therapist which platform you will be using for telehealth sessions and familiarize yourself with the software ahead of time if you can. Some phases of EMDR therapy will be just like any other video meeting where you are speaking and listening to your therapist on a screen.

As mentioned above, the bilateral stimulation might differ with online vs. in-person EMDR therapy. Your therapist will collaborate with you on what form of bilateral stimulation they have available and what feels best for you. This might include a specific platform designed with bilateral stimulation functions like following a graphic on the screen with your eyes or listening to audio tones go back and forth in your headset. Some therapists might use other low technology options such as instructing you to set up two sticky notes, one in the right side of the screen and another one in the left part of your computer and follow your eyes from one side to the other one.

Choosing your equipment

It can be helpful to use a computer or larger tablet rather than a phone for bilateral stimulation for online EMDR therapy. If the BLS method you use is eye movements, a larger screen size can allow for a wider distance for your eyes to travel back and forth. A distance of 12-16 inches has been shown to produce a cognitive load effective for the desensitization and reprocessing phases of EMDR therapy (Shapiro, 2018, p. 61; van den Hout, et al., 2011). This larger ‘eye sweep’ may enhance the effectiveness of the desensitization and reprocessing process by requiring a greater cognitive effort (van den Hout, et al., 2011).

However, if you do not have a larger screen size, discuss your options with your EMDR therapist, as they may have modifications for eye movements. Your EMDR therapist may have alternate suggestions for bilateral stimulation options like tapping back and forth or audio tones.

Testing your equipment

Check your camera and microphone to ensure they are functioning well. A stable internet connection is essential for a smooth session, so test your connection and, if possible, connect your device directly to your internet source via an Ethernet cord for the greatest reliability. Be sure other applications or individuals in your household are not using too much of your internet bandwidth during therapy time.

You may wish to use headphones for better sound quality and a more private conversation if conducting your therapy session while others are home or nearby.

Setting up your environment

Find a quiet, comfortable, and private space for your session. Minimize distractions by turning off notifications and letting others know you will be in a session.

Pets can be a comfort to have with you during a session. But be sure their needs are taken care of prior to your session so they will not be a distraction.

“I like to have my dog with me during reprocessing. My therapist and I sometimes use petting her as a form of BLS. She helps me stay grounded and calm during the process.”

Personal preparation

Mental and emotional readiness

Before your appointment, it can be helpful to take a moment to ground yourself. Your therapist can help you discover go-to calming resources, such as deep breathing or mindfulness exercises. Consider setting intentions for what you want to focus on during your session.

Some examples of simple grounding exercises:

The Butterfly Hug: https://www.youtube.com/watch?v=iGGJrqscvtU
Body Scan exercise: https://ggia.berkeley.edu/practice/body_scan_meditation
5 Senses grounding: https://www.youtube.com/watch?v=30VMIEmA114
Leaves on a Stream Meditation: https://www.youtube.com/watch?v=1yQX1y7zMAg

Gathering necessary materials

Have a journal or any relevant notes on hand. Think about specific topics, memories, or feelings you would like to discuss with your therapist.

“I keep a therapy journal where I keep all my notes on sessions and things I want to talk about next time. It’s silly, but I bought myself a cute journal so I find joy in using it. I date the entries and its helpful to look back through them from time to time to see my growth.”

Consider your schedule

When scheduling your EMDR therapy session, choose a time that allows for privacy and minimizes interruptions. Sessions can bring up intense emotions that require a quiet, safe environment.

Many clients also feel tired after an EMDR therapy session, so it’s wise to avoid scheduling anything too demanding following your session. Instead, allow yourself some buffer time to relax and process. Late afternoon sessions can work well for some, giving you the chance to unwind afterward. Morning sessions might leave the rest of your day open for self-care if needed. Discuss with your therapist what works best for you and your routine.

Communicating with your therapist

Discussing your goals

Reflect on what you hope to achieve in the session. Being clear about your goals can help guide the therapy process. Discuss your expectations for successful EMDR therapy with your EMDR therapist.

Sharing concerns or questions

If you have any questions about EMDR therapy or online therapy, do not hesitate to share them with your therapist. Your therapist will be happy to share with you some things you should know before starting EMDR therapy. Open communication is key to a successful therapeutic relationship.

During the session

Engagement and participation

Be present and attentive during your session. Remember that EMDR therapy is unique from other therapies because it uses eye movements or other forms of bilateral stimulation to help reprocess traumatic memories.

In EMDR, you do not need to share every detail of your memories or experiences for it to be effective. EMDR therapy focuses on reprocessing how distressing memories are stored in your brain rather than retelling every aspect of the event. Your therapist may ask for a brief outline or key aspects of a memory, but the therapy primarily uses bilateral stimulation (such as eye movements or tapping) to help you process the disturbing memory so that at the outcome of successful therapy you have positive or neutral thoughts when you recall it. The process is effective even if you choose to keep certain details private, allowing you to work through trauma at your comfort level.

“Even though it was online, my therapist was able to guide me effectively through each session. I felt just as connected as I did in person.”

Using coping strategies

It is normal to feel anxious at times. Similar to facing the darkness of a tunnel until you get to the light at the end, there are times when it can be helpful to continue through the discomfort. Use the coping strategies, grounding techniques, or deep breathing that you established with your therapist to help manage any discomfort that arises during the session. However, it is also important to remember that you are the one in control of the process. You can stop the process at any time if it feels like it is too much. EMDR therapists can offer you strategies to remain hopeful during the reprocessing phases of EMDR therapy.

After the session

Reflecting on the experience

After your session, take some time to journal about your thoughts and feelings. Reflecting on what you discussed can help you process the experience more deeply.

“There’s something about being at home during EMDR that helped me feel grounded, especially after difficult sessions. I could process in a safe, familiar place.”

Implementing insights

Consider how you can apply the insights gained from the session to your daily life. Taking small steps can reinforce the progress you have made.

Preparation can enhance your experience

Preparing for your online EMDR therapy appointment can enhance your experience and effectiveness.

Remember to follow these steps to get ready for your remote EMDR therapy appointment:

Understand how EMDR differs from other therapies
Set up your environment
Stay engaged during the session
Take time for reflection and self-care following the session

Approach your session with an open mind and remember that every step you take toward healing is significant. Do not be afraid to try online EMDR. If it is not for you, that is ok too.

Find an online EMDR therapist

Use the EMDR Therapist Directory to find EMDRIA members providing EMDR therapy. The directory includes searches by location, name, and other criteria including “Online Appointments Available.” Think about what you are looking for in a therapist and what would make someone a good EMDR therapist for you.

Note: You will need to find a therapist licensed to conduct therapy in the state you reside in, even when doing online therapy. Some therapists are licensed in multiple states.

Find an EMDR Therapist

Lisa Huntsha, MA, manages EMDRIA’s library, connecting members with resources to advance their EMDR therapy practice. With 15+ years experience in library science and technology, she is passionate about leveraging digital tools to enhance professional growth and championing diversity, equity, and accessibility in mental health care.

Susanna Kaufman, MA, compiles and edits EMDRIA’s Focal Point Blog while working toward full LPC licensure. She has provided therapy services in agency settings, counseling group practice, and private practice. Susanna works at EMDRIA as a content specialist and believes in promoting an inclusive community with a compassionate focus.

References

Bongaerts, H. Voorendonk, E. M., van Minnen, A., & de Jongh, A. (2021). Safety and effectiveness of intensive treatment for complex PTSD delivered via home-based telehealth. European Journal of Psychotraumatology, 12(1), 1860346. Open access: http://dx.doi.org/10.1080/20008198.2020.1860346

Bongaerts, H., Voorendonk, E. M., van Minnen, A., Rozendaal, L., Telkamp, B. S. D., & de Jongh, A. (2022). Fully remote intensive trauma-focused treatment for PTSD and complex PTSD. European Journal of Psychotraumatology, 13(2): 2103287. Open access: https://doi.org/10.1080/20008066.2022.2103287

Bursnall, M., Thomas, B. D., Berntsson, H., Strong, E., Brayne, M. & Hind, D. (2022). Clinician and patient experience of internet-mediated eye movement desensitisation and reprocessing therapy. Journal of Psychosocial Rehabilitation and Mental Health, 28, 1-12. Open access: https://doi.org/10.1007/s40737-022-00260-0

Farrell, D., & Clifford, C. (2022). Digital eye movement desensitization and reprocessing. In H. Wilson (Ed.), Digital delivery of mental health therapies: A guide to the benefits and challenges, and making it work. (pp. 213-225). Jessica Kingsley Publishers. https://us.jkp.com/products/digital-delivery-of-mental-health-therapies

Fisher, N. (2021). Using EMDR therapy to treat clients remotely. Journal of EMDR Practice and Research, 15(1), 73-84. http://dx.doi.org/10.1891/EMDR-D-20-00041

Kaptan, S. K., Dernedde, C., Dowden, T., & Akan, A. (2023). “Without it, I am not sure I would still be here”: A mixed methods service evaluation for online EMDR trauma therapy in a primary care network in England. Frontiers in Psychiatry, 14. Open access: https://doi.org/10.3389/fpsyt.2023.1301540

Kaptan, S. K., Varese, F., Yilmaz, B., Andriopoulou, P., & Husain, N. (2022). “Online delivery gave me privacy and distance from others”: Feasibility trial and qualitative evaluation of an online intervention for refugees and asylum seekers; LTP + EMDR G-TEP. Counselling & Psychotherapy Research. Open Access: https://doi.org/10.1002/capr.12580

McGowan, I. W., Fisher, N., Havens, J., & Proudlock, S. (2021). An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid-19 pandemic. BMC Psychiatry, 21, 560. Open access: https://doi.org/10.1186/s12888-021-03571-x

Perri, R. L., Castelli, P., La Rosa, C., Zucchi, T., & Onofri, A. (2021). COVID-19, isolation, quarantine: On the efficacy of internet-based eye movement desensitization and reprocessing (EMDR) and cognitive-behavioral therapy (CBT) for ongoing trauma. Brain Sciences, 11(5), 579. Open access: https://doi.org/10.3390/brainsci11050579

Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). The Guilford Press.

Strelchuk, D., Turner, K., Smith, S., Bisson, J., Wiles, N., & Zammit, S. (2023). Provision of online eye movement and desensitization therapy (EMDR) for people with post-traumatic stress disorder (PTSD): A multi-method service evaluation. European Journal of Psychotraumatology, 14(2): 2281182. Open access: https://doi.org/10.1080/20008066.2023.2281182. Additional data table contribution: https://doi.org/10.6084/m9.figshare.24786003.v1

van den Hout, M. A., Engelhard, I. M., Rijkeboer, M. M., Koekebakker, J., Hornsverld, H., Leer, A., Toffolo, M. B. J., & Akse, N. (2011). EMDR: Eye movements superior to beeps in taxing working memory and reducing vividness of recollections. Behavior Research and Therapy, 49(2), 92-98. Open access: https://doi.org/10.1016/j.brat.2010.11.003

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Additional Resources

If you are a therapist interested in the EMDR training:

If you are EMDR trained:

If you are an EMDRIA Member:

Your Guide to a Successful Online EMDR Therapy Session: Tips for Clients