Is Online EMDR Therapy as Effective as In-Person?

Yes, which surprises most people. This is probably the question I get asked most by people considering EMDR therapy for the first time, and here is the honest answer from a therapist who has been doing this work entirely online for the past few years.

How Does EMDR Work Over Video?

The most important part of EMDR is bilateral stimulation, the alternating left-right movement that helps your brain reprocess difficult memories. In person, a therapist might do this by moving two fingers back and forth in front of you, using a light bar where your eyes follow a moving light, or using pulsers, sometimes called buzzers. These are small handheld tools that provide tactile bilateral stimulation, alternating physical sensations from left to right in your palms without you needing to track anything with your eyes.

‍Remotely, there are a few ways to recreate this: a therapist can move their fingers across the screen for you to follow, or there are apps where the therapist controls a moving ball on your screen while you track it with your eyes.

I have used the remote app before, but at faster speeds it can strain the eyes. Some clients described the moving ball as blurry or pixelated, which left them feeling dizzy rather than focused. I have also guided clients through following my fingers on screen, but movement on a video call can sometimes increase the chance of the connection freezing at exactly the wrong moment, or bring on a bit of motion sickness.

What I use now is guided self-tapping. I walk clients through the tapping pattern and pace it with them in real time, rather than having them track something moving on a screen. It also gives clients a bit more autonomy in their own processing, which tends to feel good in a process that can already feel vulnerable.

Why I Moved to Self-Tapping for Remote EMDR

Honestly, I used to feel hesitant about doing EMDR remotely at all, and I was not sure self-tapping would hold up compared to in-person methods. I have been surprised at how well it has worked for my clients, producing results that are just as effective as the other methods I have used, remote or in-person. Like any form of EMDR, doing it well over video does take real skill and experience, but done well, it works.

I have actually experienced self-tapping myself as a client, and it is the method I found most comfortable, which is part of why I lead with it now the most.

What Does the Research Say About Remote EMDR?

A 2021 study by McGowan and colleagues, cited by EMDRIA, the EMDR International Association, looked at 93 patients treated by 33 therapists using remote EMDR. The study found "statistically significant and clinically meaningful reductions" across all four psychometric measures used, in both adult and youth populations, and reported that client outcome "was not related to therapist experience."

A more recent systematic review published in Frontiers in Psychiatry (Kaptan, Kaya, and Akan, 2024), which looked at 1,231 participants across 16 studies, reported that "both face-to-face and online deliveries exhibited significant reductions in PCL-5 scores, with no significant differences between the two modes of delivery" in the studies that directly compared them.

To be fair to the research itself, the review's authors were careful to note real limitations too, including small sample sizes and a need for more robust comparative trials before drawing firm conclusions. Still, what exists so far lines up with what I have seen in my own practice: remote EMDR is not a lesser version of in-person work, just a different delivery method for the same evidence-based approach.

What Surprised Me About Doing EMDR Remotely

Here is something I did not expect going in — remote EMDR can actually feel less disjointed than in-person sessions.

When I used to do EMDR in person, I would be sitting there with a paper treatment plan and a pen, writing something down every time a client reported a new detail. For clients, especially with a newer EMDR therapist, that can feel oddly disruptive. Imagine reprocessing something painful while your therapist is reading off of a script in front of them, looking down to write, turning pages, or not making eye contact while they ask the next question. It can feel clunky at exactly the moment you need it to feel steady.

Working remotely, I am looking directly at my client the entire time, even while I am taking notes. There is no visible page-turning or writing to notice, which makes the whole session feel more continuous, and I can maintain eye contact throughout.‍ ‍

It has also made me a more organized EMDR therapist. Everything lives in one place I can reference in a single view, including prior memories, negative beliefs that came up, and what we have already worked through, instead of pulling out different sheets or paperwork every session to piece the history back together. The goal would be that the therapist that you meet has already prepared everything; however, in reality, when a client shows up to session, sometimes there is new material that has come up, or something that was not planned to be addressed that suddenly takes precedence. It’s challenging to be fully prepared to just flow, and I am talking from both as a therapist as well as a client who has been in that situation.

The Most Common Concern I Hear From New Clients

Most people who have never done EMDR have seen the classic demo of a therapist sitting directly across from a client, moving two fingers back and forth. It is the version that gets circulated most, so it makes sense that people are not sure how EMDR could possibly work through a screen.

They are often surprised to learn self-tapping is an option, and as someone who has done EMDR both as a therapist and as a client myself, I can say it felt just as effective either way. One added benefit with self-tapping is that you can close your eyes throughout, something you cannot do if you are tracking a therapist's moving fingers.

Why Online Therapy Works Especially Well for High-Achieving Professionals

With EMDR in particular, working through difficult material is most effective with consistent, ideally weekly sessions, especially when the memories involved carry real weight. For clients juggling demanding careers, cutting out a commute makes that consistency far more realistic.

There is another piece that does not get talked about enough, which is that after reprocessing something difficult in an EMDR session, it is common to feel raw or emotional afterward. Driving home in that state adds a whole extra step. Online sessions remove that step entirely, since you are already home, already somewhere comfortable, with the ability to take care of yourself right away instead of getting back in a car.

The Honest Bottom Line

Sometimes the hardest part of therapy is simply getting yourself to show up, physically walking somewhere new, especially during a hard season. Online therapy removes that barrier entirely. And from where I sit as a clinician, working this way has made me more efficient and better organized than I ever was flipping through a folder of paperwork mid-session. But logistics aside, finding a therapist who feels like the right fit is one of the most important factors in your healing journey. Feeling safe, comfortable, and accepted for who you are makes the greatest difference — the same way you sometimes just "click" with certain people. When you find that fit, you can feel it, sometimes right away and sometimes it happens over time, just like any relationship.

Common Questions About Online EMDR Therapy

Can EMDR really be done through online therapy? Yes. While the classic image of EMDR involves a therapist moving their fingers in front of you, bilateral stimulation can be recreated remotely through guided self-tapping, screen-based tracking tools, or a therapist's own on-screen movement, and it can be just as effective as in-person methods.

What is self-tapping, and does it work as well as in-person methods? Self-tapping is a form of bilateral stimulation where the client, guided by the therapist, taps the area under the clavicle, arms, or knees in an alternating left-right pattern instead of following a therapist's fingers or a moving light. In my experience, it has been just as effective both remotely and in-person, while giving clients more comfort and autonomy in the process.

Is online EMDR right for everyone? For most people who are seeking EMDR, yes, but the experience can depend on having a private, comfortable space for sessions and a therapist who is experienced in delivering EMDR remotely, as it takes skill to do well over video.

How do I get started with online EMDR therapy? The best first step is a free consultation to talk through what you are working through and whether EMDR is a good fit. Book a free consultation to get started.

Sources: McGowan et al. (2021), cited via EMDRIA; Kaptan, S.K., Kaya, Z.M., & Akan, A. (2024), Frontiers in Psychiatry.