Does EMDR work online?

I decided to write a blog post about my experience of delivering EMDR online, as it’s something I get asked about a lot.

Some people are sceptical about the effectiveness and safety of EMDR online, and that’s understandable. After all, EMDR is a trauma-focused therapy, which can involve working with distress, overwhelm, dissociation, and complex presentations. Many therapists and clients have questioned whether this kind of work can be done safely through a screen.

So, is EMDR safe and effective online?

The answer is: it can be.

I know that may sound frustratingly non-committal, but I think most things in therapy are rarely as simple as “yes or no” or “safe” versus “unsafe.” As much as we might wish for a universal formula, therapy does not work on a one-size-fits-all basis. What matters is context, clinical judgement, the individual client, and the therapist's skill and experience.

EMDR can be safe and effective when done online, sometimes face-to-face would be more optimal, and sometimes EMDR shouldn’t be done online. The same can be said for other types of therapy.

Is counselling or CBT online effective and safe? It can be.

Is mindfulness online effective and safe? It can be.

Is breathwork effective and safe online? It can be.

The more useful question is not whether something is universally safe or unsafe, but under what circumstances it is appropriate, and for whom.

When I trained as a therapist, there were certain therapeutic “rules” often presented as facts: don’t move the chair, don’t offer tissues, don’t drink water in session, don’t text clients, don’t work online. I’m not suggesting these ideas came from nowhere, or that boundaries and structure are unimportant. But over time, I’ve become increasingly curious about which practices are strongly evidence-based, which are rooted in theoretical orientation or tradition, and whether all of them apply equally to every client and every therapeutic relationship.

While the research base for online EMDR is still developing, the same could be said for many therapies. The pandemic provided an opportunity to test whether lots of things can be done online, including therapy. There is now growing evidence that EMDR, as well as other therapies, delivered remotely can be effective for many clients when appropriate assessment, preparation, and safety planning are in place. See this link for one such study from 2024.

For me, the safety and effectiveness of online EMDR depend on some important and fairly standard considerations:

1. Is the EMDR being delivered by a properly trained and experienced therapist?

   Unfortunately, “trauma-informed” has become a broad term that can sometimes mean very little. Completing a short online course is not the same as being trained to safely assess, pace, and manage trauma work with the individual person that is in front of you - particularly when working with dissociation or complex trauma.

   
   

2. Does the client have a safe and confidential space to attend sessions from?

   For example, are other people in the house? Is there privacy? Can the client speak freely without worrying about being overheard or interrupted?

   
   

3. Is the technology reliable enough?

   A stable internet connection matters more than people might think. Trauma processing work can be emotionally intense, and repeated disconnections during difficult moments can feel dysregulating or disruptive.

   
   

4. Has adequate preparation taken place before trauma processing begins?

   In my experience, this is one of the most important factors, online or otherwise. Clients need grounding skills, stabilisation, emotional regulation strategies, and a sense of safety within the therapeutic relationship before moving into deeper trauma work.

   
   

5. Is the client suitable for online trauma work at this point in time?

   Some clients may thrive working remotely and feel safer in their own environment. Others may find online work containing, distancing, or emotionally manageable. But for some people, particularly those experiencing severe dissociation, high levels of risk, or limited emotional stability, online EMDR may not currently be the safest or most effective option.

   
   

There are several reliable and effective EMDR online platforms that therapists use, such as Bilateral Base and remotEMDR. These are designed for bilateral audio and visual stimulation, as you would use in a face-to-face session.

Online EMDR can offer a safe, valid alternative that is more accessible, inclusive and convenient.

Ultimately, I don’t think the question is whether online EMDR is “good” or “bad.” I think the more important question is whether it is appropriate, ethical, and clinically safe for the individual person sitting in front of us. A qualified, trained, and experienced therapist can help you identify this.