What is online EMDR?
It is EMDR therapy that is delivered virtually through video conferencing or a Telehealth platform by using a computer, laptop, tablet, or smartphone. The online or Virtual EMDR follows the same eight-phase EMDR protocol as in-office EMDR and uses bilateral stimulation (back and forth eye movements, taps, clicks or sounds) to help address unresolved trauma and difficult life experiences.
For those new to EMDR, EMDR stands for Eye Movement Desensitization and Reprocessing therapy. Francine Shapiro pioneered EMDR during the 1980’s. EMDR is an evidence-based therapy that has been proven effective in addressing trauma/PTSD, anxiety, depression, phobias, and other conditions. EMDR is one of the most researched trauma therapies.
How effective is virtual EMDR?
Several preliminary studies have found that online EMDR is compatible with in-office EMDR. A study in Germany (2021) concluded that the subjective units of distress (SUDS), one of the essential measures of treatment progress in EMDR, decreased in online EMDR to a similar level as in-office EMDR. The same study concluded that online eye movements produced a significantly higher SUDS drop than bilateral tapping.
Another study in Italy (2021) during the Covid pandemic compared online EMDR Recent Traumatic Episode Protocol (R-TEP) and TF-CBT. The study revealed that both reduced anxiety by 30% and traumatic and depressive symptoms by 55% in 7 sessions for the patients and professionals dealing with ongoing trauma associated to quarantine or disease.
So far, most online EMDR research was conducted with frontline workers and emergency personnel and not with clinical populations. Virtual EMDR is still an emerging therapy. More research is needed to compare the efficacy of EMDR standard protocol to online EMDR standard protocol with clinical populations.
What do clients say about online EMDR?
In my clinical experience, virtual EMDR has been as effective as in-person EMDR. Many clients say they prefer online EMDR over in-office EMDR because they can telecommute from the safety and comfort of their homes. Also, the computer screen provides some distance, which allows for deeper personal exploration of the trauma material. Other benefits of online therapy are that it saves time and money, it is convenient and accessible, and it is compatible with in-office psychotherapy.
When was online EMDR developed?
Teletherapy has been around since the 1990s, and some therapists were already using online EMDR pre-pandemic. However, the arrival of Covid-19 mainstreamed the integration of online EMDR into a regular therapy practice. During the pandemic lockdown, online EMDR became the only option for delivering EMDR therapy. Since then, online EMDR has become a routine for many therapists and clients.
How are eye movements and other bilateral stimulation facilitated virtually?
Many specialized online programs successfully facilitate the delivery of eye movements. Often, an object (usually a circle) moves across the screen. The therapist can adjust the speed, color, background, and direction of the eye movements.
Online programs can provide other forms of bilateral stimulation like music, sounds, clicks, pops, or taps. The client can also manually tap on their shoulders (butterfly hug), knees, arms, snap fingers, or stomp or tap their feet on the ground to provide bilateral stimulation.
In addition, the client may use their own device like a phone, i-pod, or tablet with headphones to listen to bilateral music during online EMDR sessions. Some clients purchase tapping devices like tera tappers or bi-tapps that they can use as calming devices during online therapy sessions or outside therapy.
Ina Lasmane, MA, LMFT is a Certified EMDR therapist and Certified Telemental Health Provider.
Therapists’ Experiences With the Effectiveness and Feasibility of Videoconference-Based Eye Movement Desensitization and Reprocessing. Mischler C, Hofmann A, Behnke A, Matits L, Lehnung M, Varadarajan S, Rojas R, Kolassa IT, Tumani V.Front Psychol. 2021 Oct 5;12:748712. doi: 10.3389/fpsyg.2021.748712. eCollection 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. Perri RL, Castelli P, La Rosa C, Zucchi T, Onofri A.Brain Sci. 2021 Apr 30;11(5):579. doi: 10.3390/brainsci11050579.