Understanding EMDR Therapy
EMDR is an acronym for Eye Movement Desensitization & Reprocessing therapy, a leading evidence-based treatment for Post Traumatic Stress Disorder (PTSD). EMDR therapy uses bilateral stimulation, including eye movement, auditory sounds, or tapping, to process traumatic memories and enable the mind and body to heal naturally.
Many therapists have successfully adapted EMDR protocols for virtual settings. Here are some key considerations and best practices for conducting EMDR online:
- Technology: The therapist and the client need a stable internet connection, a computer or tablet with a camera, and a quiet, private session space.
- Preparation: The therapist and client should test the technology before the first session to ensure everything works smoothly.
Best Practices for EMDR Therapy Online
Adaptation of Protocols: Therapists may need to adjust some aspects of the EMDR protocol for online delivery. For example, they might use visual stimuli (such as moving dots on a screen) or auditory stimuli (such as alternating tones through headphones) instead of traditional hand movements.
Safety and Grounding: Therapists must establish a clear plan for what to do if the client becomes distressed during a session. This might include having a list of emergency contacts and grounding techniques readily available.
Client Comfort: It is crucial to ensure the client is comfortable with the technology and the online therapy format. Some clients may take a few sessions to adjust to the virtual environment.
Therapeutic Relationship: Building and maintaining a strong therapeutic alliance is essential. Therapists should try to engage with clients and create a safe, supportive environment online.
At Silver Lake Psychology, our certified therapists are committed to creating safe and supportive spaces for our clients. Book an appointment with one of our therapists today!
The Benefits of Online EMDR Therapy
Increased Accessibility for Mental Health Treatment
Online EMDR therapy is a convenient option for those who cannot travel to see a therapist or prefer the comfort of their own space. It increases accessibility for mental health treatment, especially for those living in remote areas or with mobility issues.
Flexibility and Comfort
Online EMDR therapy provides flexibility in scheduling and comfort in one’s environment, reducing anxiety and stress associated with in-person treatment.
Example of Online EMDR Process
Assessment: The therapist conducts an initial evaluation to determine if EMDR is appropriate for the client.
Preparation: The therapist explains the EMDR process and ensures the client is comfortable with the technology and the online format.
Desensitization: Using virtual tools, the therapist guides the client through sets of bilateral stimulation while the client focuses on distressing memories or thoughts.
Installation: The therapist helps the client strengthen positive beliefs and emotions associated with the target memory.
Body Scan: The therapist guides the client in a body scan to identify and process any residual physical sensations of distress.
Closure: The session ends with grounding techniques and a review of the client’s experience.
If you’re considering EMDR therapy online, it’s important to discuss it with your therapist to ensure that it fits your needs and that both of you are comfortable with the online format.
Online EMDR therapy differs from in-person EMDR therapy in several ways, primarily due to the nature of the virtual environment. Here are the key differences:
Who Can Benefit from Online EMDR Therapy?
Anyone suffering from PTSD symptoms, including those who have experienced a recent traumatic event or one from months or years ago.Those who are unable to travel to see a therapist due to feelings of trauma, phobias, or anxiety.
Effectiveness of Online EMDR Therapy
Studies and clinical reports suggest that EMDR therapy can be effective online. Research has shown that many clients experience significant improvements in their symptoms, similar to those seen with in-person EMDR therapy.
How is an online EMDR session different from an in-person session?
Technology and Setup
Platform: Online EMDR requires a secure, HIPAA-compliant video conferencing platform. In-person sessions do not require such technology.
Environment: Clients and therapists must ensure they have a quiet, private space for the online session. In-person sessions are conducted in the therapist’s office, which is already set up for privacy and comfort.
Technical Issues: Technical issues, such as a poor internet connection or software glitches, can interrupt online EMDR sessions, which are not concerns in in-person therapy.
Delivery of Bilateral Stimulation (BLS)
Visual Stimuli: In-person therapists often use hand movements for bilateral stimulation. Therapists might use on-screen visual stimuli, such as moving dots or lines, to achieve the same effect online.
Auditory Stimuli: Both in-person and online EMDR can use auditory tones, but online sessions often rely more on these, delivered through headphones.
Tactile Stimuli: In-person sessions can include tactile devices like handheld buzzers that alternate vibrations. Online sessions might use apps or other methods that clients can use at home.
Interaction and Engagement
Therapeutic Alliance: Building a therapeutic alliance might be more challenging online due to the lack of physical presence. Therapists may need to make extra efforts to connect and engage with clients through the screen.
Non-Verbal Cues: Therapists may find it harder to pick up on non-verbal cues and body language through a screen compared to in-person interactions.
Eye Movement Guidance: Directly guiding eye movements is straightforward in person but can be more challenging online. Therapists must adapt their methods to ensure the client follows the visual stimuli effectively.
Safety and Emergency Planning
Crisis Management: In-person therapists can provide immediate support if a client becomes distressed. Online therapists must have a clear crisis management plan, including emergency contact information and grounding techniques.
Session Environment: Ensuring the client has a safe and private environment at home can be more challenging than in a controlled office setting.
Preparation and Follow-Up
Technological Preparation: The therapist and client must be familiar with the technology and have a backup plan in case of technical difficulties.
Pre-Session Check-In: Online sessions should include a pre-session check-in to ensure the technology works and the client is in a suitable environment.
Post-Session Grounding: Therapists may need to spend more time on grounding techniques at the end of an online session to ensure the client is stable before logging off.
Some Benefits of Online EMDR
Accessibility: Online EMDR makes therapy accessible to clients who live in remote areas or have mobility issues.
Convenience: Clients can attend sessions from the comfort of their own homes, which can reduce stress and increase comfort.
Continuity: Online sessions allow for continuity of care during times when in-person sessions are not possible, such as during a pandemic or travel restrictions.
The Future of Mental Health Treatment with Online EMDR
Online EMDR therapy is a promising treatment option for those who may not have access to in-person therapy. With the rise of telehealth and online therapy, online EMDR therapy is becoming a more accessible and effective treatment option for mental health issues.
In summary, while online EMDR requires adjustments and has some unique challenges, it can be as effective as in-person EMDR when appropriately conducted. The key is for therapists and clients to be prepared and comfortable with the virtual format.
Most EMDR associations support the idea that virtual EMDR is as effective as in-person EMDR, although the topic is debated among professionals. Further, the eye movements that are central to EMDR are also discussed among professionals. Some researchers believe that eye movements are unnecessary and that imaginal exposure to trauma paired with nervous system training is the key variable in the effectiveness of trauma treatment. Cognitive behavioral therapy for trauma has also demonstrated positive results and does not include eye movements.
Link to articles on current research:
https://www.emdria.org/blog/online-emdr-therapy-recent-research-and-overview/
