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Trauma therapies: finding your way between EMDR, the Flash technique, brainspotting and the rest

A guide to understanding the main approaches and what we know about their effectiveness

Marie-Agnès Thulliez

By Marie-Agnès Thulliez · Author · Publishing Director8-minute read

A person standing at a crossroads of paths in a meadow at sunrise, calmly looking in the different directions

EMDR, CBT, the Flash technique, brainspotting, body-based approaches: when you are looking for help after trauma, the list of methods on offer can make your head spin. They rest on different levels of evidence.

This guide presents the main approaches, what they offer and what research says about them today, to help you ask the right questions.

Two levels of evidence

To find your way, it helps to distinguish two categories:

LevelWhat it meansExamples
Recommended first-lineMany controlled studies show solid effectiveness, recognised by most official guidelines (the degree varies between countries and organisations)Trauma-focused cognitive behavioural therapies (including prolonged exposure, cognitive processing therapy, cognitive therapy), EMDR
Promising, yet to be confirmedEncouraging controlled trials, but still few in number, modest in size or conducted outside clinical populationsFlash technique, Somatic Experiencing, brainspotting, neurofeedback

"Yet to be confirmed" means that the evidence is not yet plentiful or robust enough to appear in official guidelines. These approaches can be useful, particularly alongside other support.

First-line recommended therapies

EMDR therapy combines brief recall of a traumatic memory with bilateral stimulation, such as eye movements. It is recommended in France (HAS, 2007) as well as internationally. To find out more: EMDR: what happens in therapy.

Trauma-focused cognitive behavioural therapies bring together several methods. Prolonged exposure therapy helps you return gradually, and safely, to the memory and to the situations you have been avoiding. Cognitive processing therapy helps you identify and loosen the thoughts that keep suffering going, such as guilt or a sense of constant danger.

The US Department of Veterans Affairs and Department of Defense guideline strongly recommends three psychotherapies: prolonged exposure, cognitive processing therapy and EMDR (Schnurr et al., 2024). The American Psychological Association, in its 2025 update, is more measured: it strongly recommends trauma-focused cognitive behavioural therapies, and recommends EMDR conditionally, on the same footing as cognitive therapy and narrative exposure therapy (APA, 2025). These differences concern the strength of the evidence more than usefulness: the choice can also take account of your preferences and of the therapist's training.

Promising approaches

The Flash technique was developed by the psychologist Philip Manfield in connection with EMDR. It seeks to reduce the charge of a memory without having to confront it directly: the person focuses on a positive resource while the memory stays in the background. Several randomised trials exist: in volunteers, it reduced the intensity of a distressing memory as well as a short version of EMDR, while being rated as more pleasant (Brouwers et al., 2021); after road traffic accidents, it did better than a stress management module on intrusive memories and avoidance (Yaşar et al., 2022). Other trials have been conducted after the 2023 earthquakes in Turkey (results still in preprint) and in patients with breast cancer, where it did as well as, though not better than, online cognitive behavioural therapy (Savaş et al., 2026; Flash Technique, n.d.). A Dutch randomised trial (130 patients planned) is comparing EMDR, EMDR 2.0 and the Flash technique in people with post-traumatic stress disorder; to our knowledge, its results have not yet been published (Alting van Geusau et al., 2023). The results are encouraging, but the trials remain few and are often conducted outside clinical populations.

Somatic Experiencing is a body-based approach that draws on bodily sensations and aims, according to its developers, to help the nervous system regain its balance. A randomised trial of 63 people with post-traumatic stress disorder showed, after 15 sessions, a clear reduction in symptoms and depression compared with a waiting-list group (Brom et al., 2017). A 2021 literature review notes early positive results, from studies that are still heterogeneous and need further support (Kuhfuß et al., 2021).

Brainspotting starts from the idea that the position of one's gaze is linked to the way the brain processes an experience: the therapist helps the person find a point in the visual field associated with an emotion, and stay in contact with whatever arises. A first randomised trial in people with post-traumatic stress disorder compared 5 sessions of brainspotting with usual psychotherapy: both groups improved, with an apparent advantage for brainspotting. But fewer than half of the participants completed the study, and the US National Center for PTSD considers that more robust studies are needed (National Center for PTSD, 2024). Other studies, of limited methodological quality, also show improvement, with no demonstrated advantage over EMDR (Brainspotting, n.d.).

Neurofeedback trains the brain using its own electrical signal. Early results are encouraging but fragile: what we know about it.

Many other methods are on offer. Before committing, always ask which studies they are based on.

How to choose

  • Start with a mental health professional trained in trauma: a doctor, psychiatrist, psychologist or psychotherapist. They will be able to assess your situation.
  • Opt first for a recommended therapy, especially if your symptoms are significant.
  • Promising approaches can complement other support, or be offered by a trained therapist when they suit your situation better.
  • The relationship with the therapist matters a great deal: you should feel able to trust them and feel that your pace is respected.
  • Be wary of promises of a quick cure and of methods that ask you to give up a recognised treatment.

To understand what happens after trauma: What is trauma?.

Need help now?

Suicidal thoughts: contact a crisis line: 988 (US/Canada), Samaritans 116 123 (UK and Ireland), or find a local helpline at findahelpline.com. In France: 3114, free and confidential, 24/7.

Immediate danger: call your local emergency number (999 in the UK, 911 in North America, 112 in the EU).

Victim support: contact your local victim support services (in France, 116 006, free, every day).

Key points

  • Trauma therapies rest on different levels of evidence.
  • For most guidelines, trauma-focused cognitive behavioural therapies and EMDR are the first-choice treatments.
  • The Flash technique, Somatic Experiencing, brainspotting and neurofeedback have encouraging early controlled trials, yet to be confirmed.
  • A trial comparing EMDR, EMDR 2.0 and the Flash technique is under way in the Netherlands; its results are awaited.
  • The quality of the relationship with the therapist matters a great deal.

References

  1. Alting van Geusau, V.P., de Jongh, A., Nuijs, M.D., Brouwers, T.C., Moerbeek, M. and 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. Available at: https://doi.org/10.3389/fpsyt.2023.1278052.
  2. American Psychological Association (2025) Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD). 2025 update (first version: 2017). Available at: https://www.apa.org/ptsd-guideline/treatments (accessed 16 October 2026).
  3. Brainspotting (n.d.) Research and case studies. Available at: https://brainspotting.com/about-brainspotting/research-and-case-studies/ (accessed 16 October 2026).
  4. Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K. and Ross, G. (2017) 'Somatic Experiencing for posttraumatic stress disorder: a randomized controlled outcome study', Journal of Traumatic Stress, 30(3), pp. 304–312. Available at: https://doi.org/10.1002/jts.22189.
  5. Brouwers, T.C., Matthijssen, S.J.M.A. and de Jongh, A. (2021) 'The effects of the Flash Technique compared to those of an abbreviated eye movement desensitization and reprocessing therapy protocol on the emotionality and vividness of aversive memories', Frontiers in Psychology, 12, 741163. Available at: https://doi.org/10.3389/fpsyg.2021.741163.
  6. Flash Technique (n.d.) Published research about the Flash Technique. Available at: https://flashtechnique.com/wp/research/ (accessed 16 October 2026).
  7. Haute Autorité de santé (2007) Affections psychiatriques de longue durée. Troubles anxieux graves [Long-term psychiatric conditions: severe anxiety disorders]. Guide médecin ALD 23. Saint-Denis: HAS. Available at: https://www.has-sante.fr/portail/upload/docs/application/pdf/guide_medecin_troubles_anxieux.pdf (accessed 16 October 2026).
  8. Kuhfuß, M., Maldei, T., Hetmanek, A. and Baumann, N. (2021) 'Somatic experiencing – effectiveness and key factors of a body-oriented trauma therapy: a scoping literature review', European Journal of Psychotraumatology, 12(1), 1929023. Available at: https://doi.org/10.1080/20008198.2021.1929023.
  9. National Center for PTSD (2024) Clinician's Trauma Update, 18(4), August: summary of the randomised trial by Horton et al. on brainspotting. Available at: https://www.ptsd.va.gov/publications/ctu_docs/ctu_v18n4.pdf (accessed 16 October 2026).
  10. Savaş, E. et al. (2026) 'A randomized controlled trial of internet-based cognitive behavioral therapy (iCBT) and EMDR-flash technique (iEMDR-FT) for improving mental health in breast cancer patients', Current Psychology, 45(1), 79. Available at: https://doi.org/10.1007/s12144-025-08723-w.
  11. Schnurr, P.P. et al. (2024) 'The management of posttraumatic stress disorder and acute stress disorder: synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline', Annals of Internal Medicine, 177(3), pp. 363–374. Available at: https://doi.org/10.7326/M23-2757.
  12. Yaşar, A.B. et al. (2022) 'A randomized-controlled trial of EMDR Flash Technique on traumatic symptoms, depression, anxiety, stress, and life of quality with individuals who have experienced a traffic accident', Frontiers in Psychology, 13, 845481. Available at: https://doi.org/10.3389/fpsyg.2022.845481.

This article offers general guidance, up to date at the date of publication. It is no substitute for the advice of a doctor, who alone can make a diagnosis, or for support from a psychologist or psychotherapist.

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