Is online EMDR therapy as effective as in-person EMDR?

Yes. Research shows that online EMDR therapy produces the same clinical outcomes as in-person sessions. The bilateral stimulation is delivered through self-administered tapping guided by your therapist via video, which is clinically equivalent to eye movements done in an office.

How does EMDR work online without eye movements?

Online EMDR replaces eye movements with bilateral tapping techniques such as alternating knee taps or the Butterfly Hug (alternately tapping your own shoulders). Your therapist observes through the camera, controls the pace, and guides the session exactly as they would in person.

What is the Butterfly Hug in EMDR therapy?

The Butterfly Hug is a bilateral stimulation technique used in EMDR where you cross your arms over your chest and alternately tap your shoulders. It is widely used in telehealth EMDR sessions as an effective substitute for guided eye movements.

Who is online EMDR therapy good for?

Online EMDR is ideal for people with PTSD, trauma, anxiety, or stress-related disorders who prefer remote therapy, have limited access to in-person care, or live in areas where specialized EMDR therapists are scarce.

Can You Really Do EMDR Online?

Becky VanDenburgh
Apr 8
4 min read

By Becky VanDenburgh, LCSW, LCAC

| Think Well Live Well Counseling | thinkwelllivewell.co

A woman in a teal dress sits smiling beside a screen showing a virtual therapy session. Text reads: "VIRTUAL EMDR: EMPOWERING REMOTELY."

Yes, online EMDR therapy is just as effective as in-person EMDR.

If you’ve looked into EMDR therapy and then realized you’d need to do it over video, you might have wondered: Does it actually work the same way? It’s one of the most common questions I hear from potential clients, and it’s a completely fair one. After all, EMDR has a reputation for involving hand movements and eye tracking, things that feel very in-the-room.

The short answer is that yes, it works. But let me explain the why, because understanding the science behind it will help you feel confident going into sessions, wherever you are.

What EMDR Actually Requires

EMDR stands for Eye Movement Desensitization and Reprocessing. Despite the name, the eye movement piece is only one way to deliver what the therapy actually depends on: bilateral stimulation (BLS).

Bilateral stimulation means alternating left-right input to your nervous system, something that rhythmically engages both sides of your brain while you gently hold a difficult memory in mind. This dual focus (the memory + the stimulus) is what does the work. It taxes your working memory just enough that the emotional charge of the memory begins to soften and lose its grip.

Eye movements are one way to create that effect. But so is tapping.

“Online EMDR is not any different at all. I can watch my clients tap through the camera, control the pace, and guide the session exactly as I would sitting across from them in my office.”

Becky VanDenburgh | Think Well Live Well

How I Deliver EMDR Online

Bilateral Tapping, Not Eye Movements

In my virtual sessions, I use bilateral tapping rather than asking clients to follow my hand with their eyes. This is a deliberate choice, as tapping translates to an online setting seamlessly. You can alternate tapping your knees, your shoulders, or use the Butterfly Hug (crossing your arms over your chest and alternating taps on your upper arms).

Through the camera, I can clearly watch your rhythm and speed. I time the sets and let you know when to pause, just as I would if you were sitting in my office. Nothing about my clinical role changes.

The Butterfly Hug

The Butterfly Hug is a method of self-administered bilateral tapping developed in 1998 specifically so people could engage in bilateral stimulation without a therapist physically present. It’s been validated by brain imaging research showing real, measurable changes in the areas of the brain involved in trauma, fear, and emotional regulation. It’s both gentle and remarkably effective.

In a virtual session, I guide you through the technique and stay right there with you on screen, observing, pacing, and supporting the process every step of the way.

What the Research Says

This isn’t just clinical intuition. There’s a strong and growing body of evidence backing up online EMDR’s effectiveness.

16	Studies in a major systematic review of remote EMDR outcomes
1,231	Participants across adult and pediatric populations
88–93%	Of clients report positive experiences with virtual EMDR
≈ Same	Dropout rate versus in-person, no significant difference

One evaluation comparing online versus in-person outcomes found that online EMDR clients finished treatment in fewer sessions on average, possibly because being in a comfortable, familiar environment helps some people access a deeper sense of safety during processing.

The Eight Phases: All Present, All Online

A concern I sometimes hear is that virtual therapy might skip steps or feel less thorough. To be clear: EMDR follows a structured eight-phase protocol regardless of whether we’re in the same room or on a screen. Every single phase is fully present in my online sessions.

01 History & Treatment Planning Understanding your story, your goals, and what we’ll target

02 Preparation Building trust, teaching coping tools, and creating a sense of safety, including virtually

03 Assessment: Identifying the specific memory, the feelings tied to it, and where you feel it in your body

04 Desensitization: Processing the memory with bilateral stimulation until the distress fades

05 Installation: Strengthening the positive belief you want to hold instead

06 Body Scan: Checking for any remaining physical tension and clearing it

07 Closure: Ensuring you leave every session feeling grounded and safe

08 Re-evaluation Reviewing progress at the start of each new session

A Few Practical Things to Know

To get the most out of virtual EMDR sessions, here are a few things I recommend:

Use a laptop or desktop, not your phone. A larger screen allows for better visual connection and a more stable setup, and means I can see you clearly enough to monitor your tapping.
Find a private, comfortable space. One of the genuine advantages of online therapy is that you’re already in your own environment, somewhere that may feel inherently safer than a clinical office. Many clients find this actually deepens the work.
Have headphones available. These help maintain your privacy and can be useful if we incorporate auditory bilateral tones during a session.
Plan a few minutes for yourself after. EMDR can stir things up. Without a commute to decompress, it’s worth building in a short walk, some journaling, or quiet time before jumping back into your day.

Bottom Line

The distance between your home and my office is not a barrier to doing this work. The science of EMDR lives in the protocol, the therapeutic relationship, and the bilateral stimulation, none of which requires us to be in the same room.

If trauma, anxiety, or difficult memories have been holding you back, and the only thing standing between you and starting therapy is a question about whether online therapy could really work, I hope this gives you the answer you needed.

It can. It does. And I’d love to show you.

Ready to get started?

I know reaching out can feel like the hardest part. But you've already done something brave just by reading this far. I'd love to connect, no pressure, just a conversation. My schedule is open, and I'd genuinely love to hear from you.

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