TIRCIA · Professionals
Online EMDR: what the research says
Effectiveness, clinical precautions and criteria for choosing a digital tool
By Marie-Agnès Thulliez · Author · Publishing Director11-minute read
Since the Covid-19 pandemic, many EMDR practitioners have learned to work remotely, and dedicated platforms have multiplied: on-screen bilateral stimulation, tracking of measures, built-in video conferencing. What do we actually know about the effectiveness of online EMDR? What precautions should be taken? And how can you choose the tool best suited to your practice? Here is an overview, designed to help each practitioner ask the right questions.
In brief
- The available studies on online EMDR are encouraging: symptoms decrease markedly, and the practice is feasible.
- They rely mainly on studies without a control group. A real-world comparison in the United Kingdom finds similar results for online and in-person EMDR in PTSD. A first randomised trial, in generalised anxiety disorder, also observes comparable results for the two. Further randomised trials, notably in PTSD, are under way.
- Remote work calls for specific precautions: patient selection, a plan in case of dissociation, local emergency contacts.
- In France, health data are subject to strict rules (GDPR, HDS-certified hosting) that should guide the choice of a tool.
1. How EMDR has adapted to remote work
EMDR relies on dual attention: the patient holds a disturbing memory in mind while following bilateral stimulation, most often eye movements guided by the therapist. In person, the therapist’s hand or a device provides this stimulation. Remotely, several solutions have been used:
- A simple video call, with the therapist moving their hand in front of the camera, or the patient doing alternating taps (the “butterfly hug”) under the therapist’s guidance.
- Online stimulation tools: a dot or ball moving across the screen, controlled by the therapist, sometimes accompanied by alternating sounds through headphones.
- Integrated platforms, which bring together video conferencing, bilateral stimulation, tracking of measures (SUD, VOC), visual aids, and sometimes artificial intelligence features.
These tools were developed mainly from 2020 onwards, when lockdowns made remote consultation necessary. Research followed, with some delay.
2. What the studies show
In 2020, a first systematic review found only one study of online EMDR for PTSD, with no control group; its authors judged the results promising but insufficient to recommend the practice on a large scale (Lenferink et al., 2020). Since then, the body of work has grown:
| Study | What was done | Results | Limitations |
|---|---|---|---|
| McGowan et al., 2021 (United Kingdom and Ireland) | Real-world evaluation: 33 therapists, 93 patients treated online during the pandemic | Significant and clinically meaningful reductions on all four symptom measures; results independent of therapist experience | No control group; volunteer therapists; questionnaires designed by the authors |
| Farrell et al., 2022 | A single session of EMDR by video call, using the “Blind 2 Therapist” protocol adapted for remote work (the patient does not need to disclose the memory), with 24 frontline mental health professionals | Large reduction in disturbance (SUD), maintained at 6 months; no dropouts | No clinical patients and no control group; feasibility study |
| Kaptan et al., 2024 (systematic review) | 16 studies, 1,231 participants: individual sessions, group sessions, computerised protocols | Encouraging results for PTSD, anxiety and depression | Small samples, few control groups, mostly self-reported measures |
| Bongaerts et al., 2022 (Netherlands) | A 4-day intensive programme (EMDR and prolonged exposure) delivered entirely remotely to 73 patients with PTSD, nearly half of them with complex PTSD | 82% no longer met PTSD criteria; effects maintained at 6 months; no dropouts or adverse incidents; results at least equivalent to those of studies of the same programme delivered in person | No control group; indirect comparison with other samples |
| Strelchuk et al., 2023 (Wales) | Comparison, within the same service, of online EMDR (12 months) and in-person EMDR (the previous year), supplemented by interviews with patients and therapists | Comparable completion, dropout and adverse effects; similar end-of-therapy PTSD scores, slightly lower online | Non-randomised groups; a single service |
| Jamshidi et al., 2025 (Iran) | Randomised trial: 65 patients with generalised anxiety disorder, allocated to in-person EMDR, online EMDR (10 sessions) or a waiting list | Both forms of EMDR did markedly better than the waiting list, with comparable results, except on measures of worry; effects maintained at 3 months | Generalised anxiety, not PTSD; no active comparison treatment; small sample |
| Matthijssen and Menses, 2024 | An intensive programme delivered entirely online (prolonged exposure and EMDR 2.0), for a patient with severe chronic PTSD | Full remission, maintained at 6 months | A single case: a proof of concept |
| te Brake et al., 2025 | Protocol for a randomised trial comparing online and in-person delivery of EMDR and of ACT in young people | Trial under way, no results yet | — |
In summary: the evidence converges. Online EMDR is feasible and is accompanied by a marked reduction in symptoms. A comparative study conducted in a British public service observed completion rates, dropout rates and outcomes similar to those of in-person treatment (Strelchuk et al., 2023). In the Netherlands, the Psytrec team delivered its intensive programme (EMDR and prolonged exposure) entirely remotely: its results are at least as good as those obtained in person in its previous studies (Bongaerts et al., 2022). A first randomised trial, in generalised anxiety disorder, observed comparable results for online and in-person EMDR (Jamshidi et al., 2025). In PTSD, equivalence remains to be confirmed by randomised trials, several of which are under way or in preparation. These results concern EMDR delivered online by a trained therapist.
What about EMDR 2.0?
One online platform, WeMind Therapy, developed by the Dutch company Moovd, also offers tools for practising EMDR and EMDR 2.0, a development of the protocol devised in the Netherlands by Suzy Matthijssen and Ad de Jongh. It seeks to make reprocessing more efficient by placing greater demands on working memory, attention and emotional arousal during stimulation. In a laboratory study of 62 adults without a diagnosis, EMDR 2.0 proved as effective as standard EMDR in reducing the emotionality and vividness of memories, with fewer sets of stimulation for a comparable session length (Matthijssen et al., 2021). A first clinical case, treated online with an intensive programme combining prolonged exposure and EMDR 2.0, describes full remission maintained at six months (Matthijssen and Menses, 2024). The ENHANCE randomised trial compares standard EMDR, EMDR 2.0 and the Flash technique in patients with PTSD; its results will clarify what each one contributes (Alting van Geusau et al., 2023).
3. Precautions specific to remote work
The EMDR International Association (EMDRIA), in the United States, published guidelines for online EMDR as early as 2020 (EMDRIA, 2020). They echo what clinical experience teaches:
- Prepare more thoroughly. Build a solid alliance before the reprocessing phases, and assess the patient’s emotional tolerance.
- Anticipate dissociation and abreactions. Agree in advance with the patient on what you will do if the session becomes too intense, allow more time for closure, and plan follow-up between sessions.
- Know the local resources. Before starting, note the emergency numbers and useful contacts in the patient’s town, and a person to contact in a crisis.
- Keep control of the stimulation. Bilateral stimulation should remain therapist-led, in sets. The EMDRIA guidelines specify that stimulation is conducted by the clinician, and the association’s policy excludes self-administered EMDR.
- Have a technical plan B. What to do if the connection drops mid-session: a phone call back, a stabilisation exercise agreed in advance.
- Check the patient’s setting. A room where they will not be disturbed, a screen large enough to follow the movement from edge to edge, headphones if sounds are used.
Some patients are less well suited to remote work: severe dissociation, significant suicide risk, ongoing violence in the home, no confidential space. For them, in-person work remains preferable, at least for the reprocessing phases. We look at preparation in our article Stabilisation before trauma therapy: what the science says.
4. Health data: what the law requires in France
An EMDR session produces health data, among the most sensitive data there are. In France, several rules apply (practitioners elsewhere will check the equivalent rules in their own country):
- The GDPR classifies health data as “special category” data, which call for enhanced protection and clear information for the patient.
- Hosting of health data by an external provider must be entrusted to an HDS-certified host (hébergeur de données de santé, article L.1111-8 of the French Public Health Code). HIPAA compliance, often highlighted by international tools, falls under United States law. In France, HDS certification is what applies, and it is this certification that should be checked.
- Recording, automatic transcription or artificial intelligence analysis of sessions, offered by some platforms, require the patient’s informed consent and careful thought about professional confidentiality: where do these data go, who has access to them, and how long are they kept?
These questions go to the heart of care: for a traumatised patient, knowing that what they share stays confidential is part of therapeutic safety itself.
5. How to choose a tool: a checklist of criteria
Many tools are available today, from simple bilateral stimulation websites to full platforms, such as Bilateral Stimulation, remotEMDR or WeMind Therapy (a non-exhaustive list, in alphabetical order). Rather than a ranking, here are the questions to ask:
| Criterion | Questions to ask |
|---|---|
| Clinical | Is the stimulation controlled by the therapist? Does it allow movements across the full width of the screen? Can the speed be adjusted and modalities alternated (visual, auditory)? |
| Tracking | Can SUD and VOC ratings be recorded, and the session history retrieved? |
| Data | Where are the data hosted? Is the host HDS-certified (in France) or compliant with your country’s rules? Are sessions recorded or transcribed, and can these features be switched off? |
| Security | Is the video call encrypted? Is the patient’s access protected? |
| Reliability | What happens if the connection drops? Does software need to be installed, or is a browser enough? |
| Training | Is the tool designed for EMDR-trained therapists? Does it offer support for getting started? |
| Transparency | Do claims of effectiveness refer to published studies, or only to testimonials? |
6. Clinical vignette
A fictional case, composed from common clinical situations.
An EMDR therapist has been seeing Paul, 45, for three months for PTSD following a road accident. Paul is moving 600 kilometres away and wishes to continue the work remotely. Before the first online session, they devote an entire session to preparing the setting: Paul will set up his computer in a closed room, with headphones; they test the on-screen stimulation together; he notes down the emergency number and the name of a friend who can be reached; they agree on what they will do if the connection drops or if Paul feels overwhelmed.
During the third reprocessing session, the connection freezes just as Paul is reliving the impact. As planned, the therapist calls him back by phone, and together they do the agreed stabilisation exercise before resuming. This incident, having been prepared for, even becomes an opportunity for Paul to see that he can regulate himself. What made the difference was the preparation of the setting.
What is established, and what remains to be confirmed
- Established: online EMDR is feasible, and studies observe a marked reduction in symptoms.
- To be confirmed: effectiveness equivalent to in-person treatment in PTSD, suggested by early comparative studies and by a randomised trial in generalised anxiety disorder, and currently being evaluated in further randomised trials.
- Not established: the superiority of one tool or platform over another; no study compares them.
- Not recommended: use of stimulation tools by the patient alone, without a trained therapist.
Frequently asked questions
Is online EMDR as effective as EMDR in the consulting room?
The available studies are encouraging. A first randomised trial, in generalised anxiety disorder, found comparable results online and in the consulting room; in PTSD, the existing comparisons point the same way, and randomised trials are under way. Until their results are in, online EMDR can be offered when it meets a genuine need, with the precautions described above.
Is a simple video call enough?
It can be, and that is how many therapists began. An on-screen stimulation tool mainly brings comfort and consistency. What matters most is the therapist’s training and the preparation of the setting.
Can the patient use a bilateral stimulation app on their own?
It is preferable always to do this work with a trained therapist. Reprocessing traumatic memories can trigger intense reactions that call for support. Professional guidelines advise against self-administered EMDR.
Should artificial intelligence features be avoided?
They can be useful, with particular care: the patient’s explicit consent, knowledge of where the data are stored and for how long, and the option to switch them off.
In one sentence
In the first comparative studies, online EMDR achieves results close to those of in-person treatment, including in intensive formats; the randomised trials under way will confirm this.
Digital tools lighten the therapist’s workload and support the quality of the session; they give of their best with a trained therapist, a well-prepared setting and protected patient data.
References
- 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. Link
- EMDR International Association, Virtual Training and Therapy Task Group (2020). Guidelines for Virtual EMDR Therapy. Link
- Farrell, D., Fadeeva, A., Zat, Z., Knibbs, L., Miller, P., Barron, I., et al. (2022). A stage 1 pilot cohort exploring the use of EMDR therapy as a videoconference psychotherapy during COVID-19 with frontline mental health workers. Frontiers in Psychology, 13, 901855. Link
- Jamshidi, F., de Jongh, A., Rajabi, S., Dehghani, Y., & Pakizeh, A. (2025). Face-to-face versus web-based EMDR therapy in the treatment of generalized anxiety disorder symptoms: A randomized controlled trial. Cognitive Therapy and Research. Link · EMDRIA summary
- Kaptan, S. K., Kaya, Z. M., & Akan, A. (2024). Addressing mental health need after COVID-19: a systematic review of remote EMDR therapy studies as an emerging option. Frontiers in Psychiatry, 14, 1336569. Link
- Lenferink, L. I. M., Meyerbröker, K., & Boelen, P. A. (2020). PTSD treatment in times of COVID-19: A systematic review of the effects of online EMDR. Psychiatry Research, 293, 113438. Link
- Matthijssen, S. J. M. A., Brouwers, T., van Roozendaal, C., Vuister, T., & de Jongh, A. (2021). The effect of EMDR versus EMDR 2.0 on emotionality and vividness of aversive memories in a non-clinical sample. European Journal of Psychotraumatology, 12(1), 1956793. Link
- Alting van Geusau, V. V. P., de Jongh, A., Nuijs, M. D., Brouwers, T. C., Moerbeek, M., & Matthijssen, S. J. M. A. (2023). The effectiveness, efficiency, and acceptability of EMDR vs. EMDR 2.0 vs. the Flash technique in the treatment of patients with PTSD: study protocol for the ENHANCE randomized controlled trial. Frontiers in Psychiatry, 14, 1278052. Link
- Matthijssen, S. J. M. A., & Menses, S. D. F. (2024). Case report: Intensive online trauma treatment combining prolonged exposure and EMDR 2.0 in a patient with severe and chronic PTSD. Frontiers in Psychiatry, 15, 1370358. Link
- 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. Link
- Strelchuk, D., Turner, K., Smith, S., Bisson, J., Wiles, N., & Zammit, S. (2023). Provision of online eye movement and desensitisation therapy (EMDR) for people with post-traumatic stress disorder (PTSD): a multi-method service evaluation. European Journal of Psychotraumatology, 14(2), 2281182. Link
- te Brake, E., Scheepers, F., Mous, T., Visser, I., Vernhout, S., & Velthorst, E. (2025). Comparing the effectiveness of online therapy versus in-person therapy in youth: protocol for a non-inferiority randomized controlled trial. Trials, 27(1), 3. Link
- Code de la santé publique, article L.1111-8 (hébergement des données de santé) [French Public Health Code, article L.1111-8 (hosting of health data)].
Transparency: TIRCIA is a partner of WeMind Therapy (a platform by Moovd). This article contains no commercial links and has not been reviewed by the company.
This article summarises the scientific evidence available at the date of publication. It is no substitute for clinical training, supervision, or the advice of a health professional.
