Telehealth EMDR: How Online EMDR Therapy Works (And Why It Might Work Better Than You Think)

Illustration of an online EMDR session on a laptop—therapist and client on video call with eye and bilateral arrows; text: Telehealth EMDR

You know that feeling when you cant stop thinking about something that happened - maybe months or even years ago - and it still makes your chest tight? Or when you jump at certain sounds, avoid specific places, or snap at people you love because your brain is stuck replaying old trauma?

That's what brings most people to EMDR therapy. And here's what I wish more people knew: you don’t have to drive 45 minutes to Castle Rock or sit in a waiting room to get help. Online EMDR therapy works - really works - and for a lot of folks, it actually works better than traditional office sessions.

At South Denver Therapy, we've watched hundreds of clients process trauma from their own couches, kitchen tables, and even parked cars. The results? Just as good as in-person sessions, sometimes better. Let me show you how telehealth EMDR actually works, what makes it different, and whether it might be right for you.

What Actually Happens in Online EMDR Therapy

Here's the thing most articles dont tell you: online EMDR isn't some watered-down version of "real" therapy. It uses the exact same 8-phase EMDR protocol that won a Nobel Prize nomination. The only difference is where you're sitting.

The Basic Setup:

You're in your space - could be your bedroom, a quiet corner of your office, or even your car in the Target parking lot (yes, we've had clients do this). Your EMDR therapist appears on your screen through a HIPAA-secure video platform. You can see each other, hear each other clearly, and work through trauma just like you would face-to-face.

But Here's What Makes It Different:

Instead of following your therapist's finger moving back and forth (the traditional EMDR method), you might:

  • Watch a small dot or light bar move across your screen

  • Follow your therapist's hand movements on video

  • Tap your own shoulders in the "butterfly hug" pattern while they time you

  • Listen to alternating tones through headphones (left ear, right ear, left, right)

  • Tap your knees or the table while your therapist keeps count

The bilateral stimulation - that back-and-forth movement that helps your brain reprocess trauma - happens the same way. Your brain doesn't know the difference between following something with your eyes in an office versus on a screen. It just knows: "Left, right, left, right... okay, time to process this memory."

Are You Ready for Online EMDR? Quick Check

Check these boxes mentally - if you can say yes to most, you're ready:

I have a private space where I wont be interrupted for 60-90 minutes
My internet connection is stable (test: can you video call without dropping?)
I have a laptop, tablet, or large phone (bigger screen = easier eye movements)
I have headphones or earbuds (privacy + better sound for bilateral audio)
I feel comfortable with basic video calls (no tech expert skills needed)
I'm okay being in my own space if emotions come up (you'll have support)

Got 4-5 checks? You're good to go. Less than 3? Still call - your therapist can help problem-solve any barriers.

Why Online EMDR Works (According to Your Brain, Not Just Research)

Look, I get it. When you first hear "trauma therapy over Zoom," it sounds weird. How can something so intense work when you're not even in the same room?

Here's the science nobody explains in plain English: EMDR works because of bilateral stimulation and focused attention, not because of physical proximity.

When you move your eyes left-right-left-right (or hear sounds alternating between ears, or tap each shoulder), you're activating both hemispheres of your brain. This mimics what happens during REM sleep - that deep sleep stage when your brain processes emotional experiences.

Think of it like this: your brain is trying to file away a traumatic memory, but it keeps getting stuck in the "scary" drawer instead of the "past event" drawer. EMDR helps your brain finally move that file where it belongs. And your brain doesn't care if the eye movements come from following a therapist's hand or following a dot on your screen - it just needs the bilateral stimulation to work its magic.

The Research Nobody Reads (But Should):

A 2023 study looked at PTSD treatment outcomes and found something interesting: clients doing online EMDR had the same completion rates and symptom improvements as in-person clients. In fact, the online group's PTSD scores were slightly lower by the end of treatment (though both groups improved significantly).

Another study during COVID-19 tracked trauma therapists who switched to telehealth. Their finding? Over 80% of clients felt comfortable with online EMDR and would choose it again. Many therapists noted clients actually opened up faster at home than they did in an office setting.

The EMDR International Association (EMDRIA) - the folks who set the standards for this stuff - officially supports telehealth EMDR and has created specific guidelines to keep it safe and effective.

But here's what the research papers dont capture: the mom who could finally do therapy after her kids went to bed instead of finding childcare. The veteran who felt safer processing combat memories in his own home than in a clinical setting. The college student who continued treatment when she moved back to Parker for summer break.

The Real Differences Between Office EMDR and Online EMDR

Most comparison charts make it seem like online therapy is "pretty good but not quite as good." That's not accurate. Let me show you what actually changes:

Traditional Office EMDR vs Online EMDR

See how they compare

What Changes Traditional Office Online EMDR
Bilateral Stimulation Follow therapist's moving hand or light bar Follow on-screen movement, audio tones through headphones, or self-tapping with guidance
Environment Therapist's office - neutral, clinical space Your space - familiar, comfortable, with your own comfort items nearby
Time Investment 60-90 min session + 30-60 min commute = 2-3 hours total 60-90 min session, no commute = done in under 2 hours
After Session Drive home while processing emotions Already home - can rest, journal, or decompress immediately
Scheduling Flexibility Limited by office hours + your commute time Wider availability - early morning, lunch breaks, evening slots easier
Privacy Waiting room, parking lot, might see someone you know Complete privacy (with headphones) - no one knows you're in therapy
Therapeutic Alliance Face-to-face connection, body language fully visible Strong connection through screen, some body language visible (position camera to show upper body)
Treatment Effectiveness Highly effective for PTSD, anxiety, trauma Equally effective for PTSD, anxiety, trauma (research-backed)

Bottom line: The core therapy is identical. What changes is logistics, not effectiveness. Choose based on what fits your life, not on assumptions about which is "better."

What Actually Happens in a 90-Minute Online EMDR Session

Most people wonder: "Okay but what do I actually DO for 90 minutes on a video call?" Let me walk you through a typical session timeline:

Your 90-Minute Online EMDR Session: What to Expect

1
MINUTES 0-10: Getting Settled

You log in, check audio/video. Your therapist makes sure you can see and hear clearly. Quick check-in: "How's your week been? Any intense dreams or memories come up since last session?" This is your time to mention anything that felt difficult.

2
MINUTES 10-20: Grounding & Preparation

Before diving into trauma work, your therapist helps you feel safe. Might be a "safe place" visualization - imagining somewhere you feel calm. Or teaching you the butterfly hug tapping. This builds your toolbox for if things get intense later.

3
MINUTES 20-25: Targeting the Memory

You identify what memory you're working on today. Your therapist asks: "What image represents the worst part? What negative belief do you have about yourself when you think of it? Where do you feel it in your body?" You rate the distress 0-10. This gives a baseline.

4
MINUTES 25-70: The Processing Phase (The Heart of EMDR)

This is where the magic happens. You hold the memory in your mind while your therapist guides bilateral stimulation. Could be:

  • Following a moving dot on screen (30 seconds of eye movements)
  • Tapping your shoulders in rhythm (30-45 seconds of tapping)
  • Listening to alternating beeps through headphones

After each "set," your therapist pauses: "What are you noticing?" You might report new images, body sensations, emotions, or thoughts. They'll say "Go with that" and start another set. This continues for 30-45 minutes, with your brain gradually reprocessing the memory.

5
MINUTES 70-80: Installation & Body Scan

Once the memory feels less intense (your 10/10 distress is now maybe a 2), your therapist helps install a positive belief. "I am strong now" or "I survived and I'm safe." You do more bilateral stimulation while holding this positive belief. Then a body scan to make sure no tension is left.

6
MINUTES 80-90: Closure & Re-grounding

Your therapist brings you back to the present. Maybe another safe place visualization or breathing exercise. They remind you: "It's normal to feel tired. You might notice more dreams or memories this week - that's your brain continuing to process. Call if you need support." Then you log off and you're already home.

Real talk: The first time feels weird. By session 3-4, it feels normal. By session 6-8, you might forget you're even on a video call because you're so focused on the processing work.

The Benefits Nobody Talks About (But Everyone Experiences)

Everyone mentions "convenience" and "no commute" when they talk about online therapy. But here are the benefits people actually tell us about after doing telehealth EMDR for a few months:

1. The "Immediate Decompression" Factor

When you're in an office, you process trauma for 90 minutes, then you're handed a tissue and sent to your car. You drive home through Littleton or Parker traffic while your brain is still churning. Sometimes you're crying at stoplights.

With online EMDR? Session ends. You close your laptop. You're already in your safe space. You can just sit on your couch and stare at the wall for 20 minutes without anyone judging you. Then make tea and take a nap. That matters more than you'd think.

2. The Control Element

In an office, if you start to panic, you're in the therapist's space. You cant leave easily. Some people feel trapped.

At home, you're in control. You know where the bathroom is. You can take your shoes off. You can wrap yourself in your own blanket. You feel safe enough to actually go deep into the memories because you know you can literally walk away from your computer if you needed to. (Most people never do, but knowing they could makes all the difference.)

3. The Privacy Win

In Castle Rock especially, it's a small community. People worry about running into neighbors in a therapist's waiting room. With online sessions, nobody knows. Your therapy stays completely private.

Plus, some clients do sessions from their parked car in a Target parking lot during their lunch break. It's not ideal, but it's better than skipping therapy because you cant get off work early enough to drive to an office.

4. The Continuity Advantage

Life happens. You move from Highlands Ranch to Parker. A snowstorm hits. You catch a cold. COVID happens. Your car breaks down.

With in-person therapy, these things mean canceled appointments and lost progress. With online EMDR, your therapy continues no matter what. You keep the same therapist even if you move across the state (as long as they're licensed in Colorado).

5. The "This Actually Fits My Life" Feeling

Parents especially love this: they can do therapy after kids go to bed, during naptime, or while their partner watches the kids in another room. No scrambling for childcare. No feeling guilty about taking three hours out of your day for a 60-minute session.

You can finally do therapy at 8pm after your kids are asleep. It makes trauma therapy possible when logistics would have made it impossible otherwise.

The Concerns People Have (And Honest Answers)

Let's address the stuff people worry about but dont always ask:

"What if I have a breakdown and my therapist cant physically help me?"

Real talk: it feels scarier than it is. Here's what actually happens:

Your therapist monitors you closely on video. They're trained to spot distress - change in breathing, facial expression, body language. If you start to dissociate or panic, they stop immediately and guide you through grounding techniques.

"Look around your room. Tell me 5 things you can see. Now 4 things you can touch."

The butterfly hug tapping (crossing your arms and tapping your shoulders) is something you can do yourself instantly. Your therapist coaches you through it.

If something truly extreme happened (extremely rare), your therapist has your phone number and emergency contact. They'd call you, stay on the line, and if needed, contact local crisis support. But in hundreds of online EMDR sessions, this almost never happens. Most "intense moments" are just crying or strong emotions - totally normal and manageable with verbal support.

"What if my internet drops right in the middle of processing a trauma memory?"

This is why good online EMDR therapists do preparation. Before you ever start processing, you agree on a plan:

  • Therapist has your phone number

  • If call drops, they call you immediately

  • You can finish processing by phone if needed, or just do grounding and reschedule

  • Most platforms auto-reconnect within 30 seconds anyway

In practice, a dropped call usually just means a pause, reconnect, and continue. Think of it like a grounding break. Your brain won't break if there's a 60-second interruption.

"Can I really open up emotionally through a screen?"

Most people say yes, sometimes more so than in person.

There's something about being in your own space that makes vulnerability easier. You're not in a stranger's office with neutral art and uncomfortable furniture. You're in your space with your stuff.

Plus, the slight distance of a screen actually helps some people. It's paradoxical - you feel close enough to connect but just separated enough to feel safe talking about really hard stuff.

After 2-3 sessions, most clients say the screen disappears. You're just talking to your therapist. The technology becomes invisible.

"What if someone in my house overhears me talking about trauma?"

Three-part solution:

  1. Headphones (they cant hear your therapist, you speak quietly)

  2. Pick a time when you have privacy (early morning, evening, during work hours if working from home)

  3. White noise machine outside your door if needed

Many clients tell family they're on a "work call" or "virtual appointment" and ask not to be disturbed. You dont have to tell anyone it's therapy if you dont want to.

Worst case scenario? Some clients do sessions from their car parked at a quiet park. Not perfect, but it works. Where there's a will, there's a way.

"Is it really as effective as in-person therapy?"

Yes. Multiple studies say yes. EMDRIA says yes. And honestly, if your choice is between online EMDR or no EMDR because you cant make the logistics work, online wins every time.

The therapeutic mechanisms - bilateral stimulation, focused attention, therapist guidance - are identical. Your brain processes trauma the same way whether the eye movements come from a screen or a therapist's hand.

Who Benefits Most from Online EMDR Therapy

Online EMDR isn't for everyone, but it's amazing for certain situations. You might especially benefit if you:

Live in Castle Rock, Parker, Highlands Ranch or surrounding areas and don't want to drive 30+ minutes to Denver for specialized trauma therapy. At South Denver Therapy, we serve clients throughout the South Metro area through secure telehealth.

Have mobility issues, chronic illness, or chronic pain that makes traveling to appointments difficult. EMDR can be done from bed if needed.

Work weird hours or have a demanding schedule. Teachers, healthcare workers, shift workers - online sessions can happen early morning, late evening, or even lunch breaks.

Are parenting young kids and can't easily get childcare for therapy appointments. Schedule during naptime or after bedtime.

Feel safer in your own environment. Veterans with hypervigilance, people with agoraphobia, those who need to know exactly where the exits are - being home gives you control.

Have trauma related to specific locations or situations. If your trauma involves medical settings, schools, or certain buildings, doing therapy at home removes those triggers.

Live in a small town where privacy is a concern. Nobody sees you going to therapy if therapy comes to you.

Need treatment continuity. If you travel for work, move frequently, or have unpredictable schedules, online EMDR keeps your treatment consistent.

Have social anxiety about being in waiting rooms or meeting new people in person. Starting therapy online can feel less intimidating.

Want to try EMDR but feel hesitant about committing to in-person appointments. Lower barrier to entry - easier to start, easier to maintain.

That said, online EMDR might not be the best fit if you:

  • Have no private space available for sessions

  • Have unstable housing or are in crisis

  • Are actively suicidal or self-harming (higher level of care needed first)

  • Have very young children who need constant supervision (hard to focus)

  • Strongly prefer face-to-face interaction and would feel disconnected online

  • Have severe tech anxiety that would interfere with sessions

Most of the time, your EMDR therapist can help you figure out if online is a good fit during an initial consultation call.

The Technical Setup That Actually Matters (Keep It Simple)

Let me cut through the noise. You don't need fancy equipment. Here's what actually makes a difference:

Device: Laptop or Tablet (Bigger is Better)

Your phone technically works, but eye movements are harder to follow on a small screen. Laptop is ideal. Tablet is good. iPad works great.

Why size matters: if you're following a moving dot, you need enough screen real estate for your eyes to actually move left-right. A 3-inch phone screen doesn't cut it.

Internet: Stable Beats Fast

You don't need gigabit fiber. You need stable connection. Here's the test: can you FaceTime someone for 20 minutes without dropping? Then you're fine for EMDR.

Wired ethernet > strong WiFi > weak WiFi. If your WiFi is spotty, consider sitting near the router or using an ethernet cable.

Audio: Headphones Are Non-Negotiable

Why: privacy + sound quality for alternating audio tones. Any headphones or earbuds work. Doesn't matter if they're $20 or $200 - just needs to be comfortable for 90 minutes.

Wireless vs wired? Both fine. Just make sure they're charged if wireless.

Camera: Built-In is Fine

You don't need an external webcam. Your laptop's built-in camera works. Just position it so your therapist can see your face and upper body. They need to see your eyes and read your body language.

Pro tip: prop your laptop up at eye level (stack it on books if needed). Looking straight ahead is more comfortable than looking down for 90 minutes.

Lighting: Face the Light

Sit facing a window or lamp. Your face should be lit, not silhouetted. Your therapist needs to see your expressions clearly.

Don't: sit with a bright window behind you (you'll be a dark shadow) Do: sit with light source in front or to the side

Space: Quiet and Private Wins

Your bedroom with the door closed is better than your living room with roommates around. Basement office? Perfect. Car in a parking lot? Not ideal but works if that's all you have.

The must-haves: you won't be interrupted, you can speak freely, no one can overhear (or you have headphones).

Backup Plan: Have Your Therapist's Phone Number

Write it down before your first session. If tech fails, you can call and finish the session by phone. Some therapists can do EMDR by phone using audio tones and self-tapping.

That's it. You don't need special software, light therapy equipment, or a professional setup. Just the basics done well.

Tech Issues? Quick Fixes for Common Problems

🔇
Therapist Can't Hear Me

Quick fix: Check mic icon in video window - click to unmute. Try headphones instead of computer mic.

Still not working? Close and reopen the video session, or restart browser.

📹
Video is Frozen or Laggy

Quick fix: Turn off video briefly, then turn back on. Close other apps eating bandwidth (especially streaming video).

If it keeps happening: Move closer to WiFi router or switch to wired connection for next session.

📡
Call Dropped Mid-Session

Quick fix: Don't panic - your therapist will call your phone within 60 seconds. Take 3 deep breaths while you wait.

Usually reconnects automatically. If not, click the session link again or wait for therapist's call.

👁️
Can't See Moving Dot for Eye Movements

Quick fix: Tell your therapist - they'll switch to audio tones through headphones or guide you in self-tapping instead.

EMDR has backup methods. Screen-share issue? No problem - tapping works just as well.

🔊
Can't Hear Alternating Tones in Headphones

Quick fix: Check headphone connection. Try adjusting volume. Make sure they're actually connected (not playing through computer speakers).

If tones don't work: Switch to eye movements or tapping - equally effective.

🚪
Someone Walked In During Session

Quick fix: Tell therapist "Need a second" and mute yourself. Deal with the interruption. Unmute when ready. Your therapist will wait.

Prevention: Lock door, put "Do Not Disturb" sign, or schedule when others are out.

Remember: Technology glitches happen. Your therapist has dealt with every possible tech issue multiple times. Just communicate what's happening, and you'll figure it out together. The therapy can continue even with imperfect tech.

How to Find an Online EMDR Therapist (The Real Process)

Here's what most articles dont tell you: not every therapist who lists "EMDR" on their website is actually trained in EMDR. And not every EMDR therapist is good at doing it online.

What to Look For:

1. EMDRIA Training Ask: "Are you EMDRIA-trained in EMDR?" Real EMDR training is 20-50+ hours of specific instruction. It's not something you learn in a weekend workshop.

EMDRIA-certified therapists have completed extensive training, consultation, and continuing education. You can search the EMDRIA directory to verify.

2. Telehealth Experience Ask: "How long have you been doing EMDR via telehealth? How many online EMDR clients have you worked with?"

You want someone who's comfortable with the technology and has adapted their EMDR skills to the online format. Someone who started offering telehealth in 2020 and has done 200+ online sessions knows what they're doing.

3. Trauma-Specific Focus Some therapists do EMDR occasionally. Others specialize in trauma treatment. Look for someone who lists trauma therapy, PTSD, or EMDR as their main focus - not just one thing on a long list.

4. Licensed in Your State They must be licensed in Colorado if you're in Colorado. That's not negotiable. Telehealth doesn't bypass licensing requirements.

Local Options in Castle Rock and South Denver:

At South Denver Therapy, we specialize in EMDR and trauma treatment for individuals and couples throughout the South Metro area. Our therapists are EMDRIA-trained and have extensive experience with telehealth EMDR. We serve clients in Castle Rock, Parker, Highlands Ranch, Littleton, and throughout the Denver metro area.

Our Pricing: We offer online EMDR therapy with Carissa for $175 per 60-minute session. This rate is for both telehealth and in-person sessions.

We also offer traditional in-person EMDR therapy if you prefer office sessions, plus specialized EMDR for anxiety and EMDR for PTSD treatment.

The First Call (What to Actually Ask):

When you reach out to a potential EMDR therapist, here are the questions that matter:

  1. "Are you EMDRIA-trained in EMDR? Can you tell me about your training?"

  2. "Do you have experience with [your specific issue - PTSD, anxiety, infidelity trauma, etc.]?"

  3. "How many telehealth EMDR clients have you worked with?"

  4. "What technology platform do you use? What do I need on my end?"

  5. "What happens if we have a tech issue during processing?"

  6. "How do you typically adapt bilateral stimulation for online sessions?"

  7. "What are your rates? Do you take insurance?"

A good therapist will answer these clearly and make you feel comfortable. If someone can't explain their EMDR training or gets defensive about questions, keep looking.

What to Expect for Cost:

Telehealth EMDR typically costs the same as in-person EMDR: $150-$250 per session in Colorado, depending on the therapist's experience and location. Some therapists take insurance. Many do not (EMDR is specialized training).

Sessions are usually 60-90 minutes. Many therapists recommend weekly sessions initially, then spread out to biweekly as you progress.

If cost is a barrier, ask about:

  • Sliding scale rates

  • Out-of-network insurance reimbursement (you pay upfront, insurance reimburses you later)

  • Whether they offer shorter sessions at reduced rates

  • Local training clinics where graduate students provide EMDR under supervision at lower cost

Red Flags to Watch For:

  • Promises to "cure" your trauma in 1-3 sessions (EMDR works, but it's not magic)

  • Can't clearly explain their EMDR training

  • Pushes you to start processing trauma in the first session (good therapists build safety first)

  • No clear tech backup plan

  • Makes you feel rushed or uncomfortable asking questions

  • Isn't licensed in your state

Trust your gut. You should feel comfortable with your therapist, even through a screen.

The Timeline: How Long Does Online EMDR Actually Take?

The most common question: "How many sessions until I feel better?"

The honest answer: it depends on what you're treating.

For a single-incident trauma (car accident, assault, witnessing a traumatic event): typically 3-12 sessions. Could be faster if it's one clear memory with no complications.

For complex trauma or childhood trauma: 6 months to 2+ years. Multiple memories, more layers to process. Takes time, and that's okay.

For PTSD: EMDR is FDA-approved for PTSD, and studies show significant improvement in 6-12 sessions for many people. Some need more.

For anxiety related to specific events: 4-10 sessions often makes a significant difference.

Here's what a typical trajectory looks like:

Sessions 1-3: History and Preparation

You're not processing trauma yet. You're building skills, learning grounding techniques, and helping your therapist understand what you've been through. This is not wasted time - it's the foundation that makes the processing work.

Sessions 4-8: Processing Begins

You start targeting specific memories. Each session, you work on one memory or aspect of trauma. You might feel tired, emotional, or have vivid dreams as your brain continues processing between sessions. This is normal and means it's working.

Sessions 9-15: Deeper Processing

You're hitting related memories or different aspects of the main trauma. Progress might feel slow (you're in the thick of it) but you're doing the work.

Sessions 16+: Integration and Maintenance

The memories are less intense. You're strengthening positive beliefs. Sessions might spread to every other week. Eventually monthly check-ins, then done.

What Influences the Timeline:

  • Complexity of trauma (single event vs years of experiences)

  • Your current stability and support system

  • Whether you're in crisis or relatively stable

  • Co-occurring issues (depression, substance use, etc.)

  • Your ability to do between-session self-care

  • How well you tolerate the processing work

Some people move faster. Some slower. Neither is wrong. Healing happens at the pace it happens.

Safety and Connection: How Your Therapist Keeps You Safe Online

This is probably your biggest concern, right? "How can I process trauma safely when we're not in the same room?"

Here's how trained EMDR therapists make virtual trauma therapy safe:

Before You Ever Start Processing:

Your therapist will:

  • Get a detailed trauma history (what they're working with)

  • Assess your stability (are you safe, housed, supported?)

  • Teach you grounding techniques you can use on your own

  • Create a crisis plan (emergency contacts, local crisis numbers)

  • Get your physical location each session (in case emergency services needed)

  • Make sure you have a phone backup if technology fails

  • Confirm you have privacy and won't be interrupted

During Processing:

Your therapist is watching you constantly. They're trained to notice:

  • Dissociation (eyes glazing over, not responding)

  • Overwhelm (rapid breathing, visible panic, freezing)

  • Disconnection (you stop engaging, shut down)

If they see any red flags, they stop immediately. No exceptions. They'll bring you back to the present through grounding techniques before continuing.

Safeguards Built Into Online EMDR:

  1. Visible Stop-Start Control: You can see your therapist, they can see you. If either of you needs to stop, you just speak up. The therapist controls the pacing - they won't push you past what you can handle.

  2. You're In Your Safe Space: Unlike an office where you might feel trapped, you're home. You have your comfort items, your familiar surroundings. You can take a bathroom break without asking permission. This autonomy actually makes processing safer for many people.

  3. Tech as a Boundary: Some people find the screen creates helpful emotional distance. You can access deep trauma without feeling physically too close. The slight separation helps you stay grounded.

  4. Emergency Protocols: Before starting EMDR, you provide:

    • Your current address

    • Emergency contact person and their phone

    • Your permission to contact them or local crisis services if needed

    This is rarely used, but it's there.

  5. Session Ending Protocols: Your therapist will never leave you in an activated state. The last 10-15 minutes of every session are dedicated to bringing you back to baseline. You'll do grounding, calming techniques, maybe revisit your safe place visualization. You're not left hanging.

  6. Between-Session Support: Many online EMDR therapists offer email check-ins or crisis phone calls if you're having a hard time between sessions. You're not on your own for seven days after intense processing.

What Happens If You Dissociate or Panic?

Your therapist notices immediately (you stopped responding, your eyes changed, your breathing pattern shifted). They'll:

  1. Stop the bilateral stimulation

  2. Call your name: "Sarah, can you hear me? Sarah, look at me."

  3. Give grounding instructions: "Sarah, I need you to look around your room. Tell me five things you can see. Look at me. Can you see me?"

  4. Use physical grounding: "Sarah, press your feet into the floor. Feel the chair under you. Tap your knees."

  5. Stay with you until you're back

If you don't respond at all, they'll use the phone backup - call you to check in, or contact your emergency person.

In hundreds of sessions, most "intense moments" resolve with simple grounding. True emergencies are incredibly rare, and protocols exist for them.

The Bottom Line on Safety:

Is online EMDR as safe as in-person? Yes, when done by a trained therapist with proper protocols.

Is it safer? For some people, yes - being home provides more control and safety.

Is it less safe? Only if you don't have privacy or your therapist isn't properly trained in telehealth EMDR.

Choose a therapist who takes safety seriously, and you'll be well-supported through the process.

Therapist appearing on a laptop screen during an online EMDR telehealth session with a client.

Common Questions About Online EMDR Therapy

Online EMDR: Your Questions Answered

Q: Can EMDR therapy really be done online effectively?

Yes, and research backs this up. Multiple studies show that online EMDR produces the same outcomes as in-person EMDR for treating PTSD, anxiety, and trauma. A 2023 study found no difference in dropout rates, completion rates, or symptom improvement between clients doing EMDR online versus in an office. The EMDR International Association (EMDRIA) officially supports telehealth EMDR and has created specific guidelines for therapists. The bilateral stimulation - whether from eye movements, tapping, or audio tones - works the same way regardless of whether you're in an office or on a video call. Your brain processes trauma effectively in both settings.

Q: What equipment do I need for online EMDR sessions?

The basics are simple: a laptop or tablet (bigger screen is better for eye movements), stable internet connection, and headphones or earbuds for privacy and audio quality. You also need a quiet, private space where you won't be interrupted for 60-90 minutes. That's it. You don't need special equipment, professional lighting, or expensive technology. Your device's built-in camera and microphone work fine. Most therapists use standard video platforms like Zoom or Doxy.me that you can access through any web browser - no special software required.

Q: How does the therapist do the eye movements when we're not in the same room?

Therapists have several methods for online bilateral stimulation. The most common is using an on-screen tool that displays a moving dot, bar, or light that moves left-right for you to follow with your eyes. Some therapists use their hand movements on video that you track on your screen. For audio bilateral stimulation, you'll hear alternating tones through headphones - beep in left ear, beep in right ear, back and forth. For tactile stimulation, your therapist guides you in self-tapping techniques like the butterfly hug (crossing your arms and tapping your shoulders alternately). All of these methods create the same bilateral brain stimulation that EMDR requires. Most therapists will try different methods to find what works best for you.

Q: What happens if my internet connection drops during a session?

Before starting EMDR, your therapist will create a backup plan. Typically, if the call drops, your therapist will immediately call your phone number. You can either reconnect to the video or finish the session by phone using audio tones or guided tapping. Most video platforms automatically try to reconnect within 30-60 seconds anyway. A brief interruption doesn't harm the therapy - think of it as an unplanned grounding break. Your therapist knows how to handle this smoothly and will make sure you're stable before ending the session, whether by video or phone. In practice, dropped calls are rare with stable internet, and when they happen, they're just a minor inconvenience, not a crisis.

Q: Is online EMDR therapy as safe as in-person therapy?

Yes, when done by a properly trained EMDR therapist following EMDRIA's telehealth guidelines. Your therapist monitors your reactions on video and will stop immediately if they notice signs of overwhelm or dissociation. Before processing trauma, you'll create a safety plan that includes emergency contacts and crisis protocols. If intense emotions come up, your therapist guides you through grounding techniques verbally - having you look around your room, name objects, press your feet into the floor, or do self-tapping. For some people, being in their own safe space actually makes EMDR feel safer than being in an office. You have more control, you're surrounded by familiar things, and you can decompress immediately after without driving home through traffic while emotional. Trained online EMDR therapists use the same safety protocols as in-person therapy, just adapted for virtual delivery.

Q: How many sessions of online EMDR will I need?

This varies widely based on what you're treating. For a single traumatic event (like a car accident or assault), you might need 3-12 sessions. For complex trauma or multiple memories, expect 6 months to 2+ years of treatment. PTSD typically shows significant improvement within 6-12 sessions for many people, though some need more. Anxiety related to specific events often improves within 4-10 sessions. The first 2-3 sessions are usually preparation - building skills and safety - before processing begins. Your timeline depends on trauma complexity, your current stability, and how well you tolerate the processing work. Your therapist can give you a better estimate after your initial assessment, but healing happens at the pace it needs to happen.

Q: Can I do EMDR if I don't have complete privacy at home?

Privacy is important for EMDR, but you can get creative. Use headphones so others can't hear your therapist, and schedule sessions when you're alone (early morning, late evening, when others are at work/school). Some clients lock their bedroom or office door and put a "do not disturb" sign. Others schedule sessions during their lunch break and do them from a parked car in a quiet parking lot - not ideal, but it works. A white noise machine outside your door can mask voices. If you truly can't find any private time or space, talk to your therapist about options. They might help you problem-solve, or suggest in-person sessions where privacy is guaranteed. But most people can find a workable solution with some planning.

Q: Will I feel as connected to my therapist through a screen?

Most people say yes after a few sessions. The first 1-2 video sessions might feel slightly awkward while you adjust to the format, but by session 3-4, the technology becomes invisible. You'll focus on the therapy, not the screen. Many clients report feeling just as connected to their online therapist as they would in person - sometimes more so because being in their own safe space helps them open up. The screen can actually create helpful distance for discussing difficult topics. You can still see facial expressions, hear tone of voice, and have real emotional connection. If after several sessions you're not feeling connected, that's worth discussing with your therapist - it might be the medium, or it might be the therapist fit. But for most people, the therapeutic relationship develops just fine through video.

Q: What conditions can be treated with online EMDR therapy?

Online EMDR effectively treats the same conditions as in-person EMDR. This includes PTSD from single incidents or complex trauma, anxiety disorders, panic attacks, phobias, depression related to past events, grief and loss, OCD, symptoms from infidelity or betrayal trauma, childhood trauma and abuse, performance anxiety, and disturbing life events that still cause distress. EMDR was originally developed for PTSD and has the most research backing for trauma treatment, but it's increasingly used for anxiety, panic, and other issues rooted in negative experiences or beliefs. If you have traumatic memories, disturbing thoughts, or emotional reactions that feel stuck or out of proportion to current situations, EMDR might help. Your therapist will assess whether EMDR is appropriate for your specific situation during the initial consultation.

Q: How do I find a qualified online EMDR therapist?

Look for therapists who are EMDRIA-trained (you can verify this through the EMDRIA directory) and have specific experience with telehealth EMDR - ask how long they've been doing online EMDR and how many virtual clients they've worked with. Make sure they're licensed in your state (Colorado if you're here). Look for someone who specializes in trauma treatment, not just lists EMDR among many other approaches. During your initial consultation, ask about their training, their experience with your specific issue, what technology they use, and what their emergency protocols are. A good therapist will answer these questions clearly and make you feel comfortable. If you're in the Castle Rock, Parker, or South Denver area, South Denver Therapy offers EMDRIA-trained therapists with extensive telehealth EMDR experience who specialize in trauma, PTSD, anxiety, and relationship trauma.

Q: Does insurance cover online EMDR therapy?

Insurance coverage for telehealth therapy has expanded significantly, especially after 2020. Many insurance plans now cover online therapy sessions the same as in-person sessions. However, whether a specific therapist accepts your insurance depends on whether they're in-network with your plan. Many specialized EMDR therapists don't take insurance directly but can provide superbills for out-of-network reimbursement - you pay upfront and your insurance reimburses you a portion. Coverage varies widely by plan, so call your insurance company to ask: Does my plan cover telehealth therapy? Is EMDR covered as a treatment modality? What are my out-of-network benefits? You can also ask potential therapists directly about insurance acceptance, sliding scale options, or payment plans if cost is a concern.

Q: What should I do right after an online EMDR session?

Plan for quiet downtime after EMDR sessions. Trauma processing is emotionally and mentally taxing, so you might feel tired, slightly raw, or emotionally sensitive. Don't schedule demanding activities immediately after. Good options: take a walk, rest or nap, journal about your experience, drink water and have a light snack, spend time with a pet, do something calming you enjoy. Avoid: difficult conversations, important decisions, alcohol or substances, intense work tasks. Many people schedule EMDR in late afternoon or evening so they can relax the rest of the day. It's also normal to have vivid dreams or memories surface in the days following a session - this means your brain is continuing to process. That's actually good, not a sign something's wrong. Call your therapist if you're struggling between sessions - many offer brief check-ins by phone or email.

Infographic asking if online EMDR is effective, showing benefits like accessibility, comfort of home, and evidence-based results.

Your Next Steps: Starting Online EMDR Therapy

If you're reading this, chances are you've been carrying something heavy for a while. Maybe it's trauma from your past. Maybe it's anxiety that won't quit. Maybe it's memories that keep replaying when you're trying to sleep.

Here's what I want you to know: you don't have to keep living with it, and you don't have to drive all over the South Denver area to get help.

Starting online EMDR is simpler than you think:

Step 1: Reach Out for a Consultation (Free, No Pressure)

Most EMDR therapists offer a free 15-20 minute phone consultation. This is your chance to ask questions, hear about their experience, and see if you feel comfortable with them. You're not committing to anything - you're just exploring whether it's a good fit.

Step 2: Do an Initial Assessment Session

If you decide to move forward, the first full session is usually assessment and history-taking. Your therapist learns about your trauma, your symptoms, your current support system. They explain how EMDR works and what to expect. You ask any remaining questions. Together, you decide if online EMDR is right for you.

Step 3: Build Your Skills (Preparation Phase)

The next 1-3 sessions focus on preparation. Your therapist teaches you grounding techniques, the safe place visualization, how to do self-tapping. They make sure you have the emotional tools to handle intense processing work. This isn't filler - it's the foundation.

Step 4: Start Processing

Once you're ready, you begin targeting specific traumatic memories. This is where the real work happens. Each session, you chip away at the power those memories have over you. It's not easy, but you'll have support every step of the way.

Step 5: Heal and Integrate

Over time, the memories lose their emotional charge. The nightmares stop. The triggers don't trigger anymore. You start believing the positive things about yourself. You graduate from weekly to biweekly to monthly sessions, then you're done.

Getting Started in Castle Rock and South Denver

If you're in Castle Rock, Parker, Highlands Ranch, Littleton, or anywhere in the South Denver metro area, we can help.

At South Denver Therapy, we specialize in EMDR therapy for trauma, PTSD, and anxiety. All of our therapists are EMDRIA-trained with extensive experience in both traditional and telehealth EMDR.

Our Services and Pricing: We offer online EMDR therapy with Carissa Keeter, LCSW for $175 per 60-minute session. Carissa is EMDRIA-trained and has extensive experience helping clients process trauma, PTSD, anxiety, and relationship trauma through both telehealth and in-person sessions.

We work with:

  • Adults dealing with PTSD and childhood trauma

  • Couples recovering from infidelity or betrayal trauma

  • Individuals struggling with anxiety, panic attacks, or phobias

  • Anyone who has traumatic memories that won't let go

We offer online therapy throughout Colorado and in-person sessions at our Castle Rock location. Your choice.

Ready to talk? Here's what to do:

Call us or fill out the contact form on our website. We'll schedule a free consultation to discuss your needs, answer your questions, and figure out if online EMDR is right for you. No pressure, no obligations - just information and support.

You can also check out our other EMDR resources:

The Bottom Line

Online EMDR therapy works. The research says so. Thousands of clients say so. Your brain doesn't care whether the bilateral stimulation comes from an office or a screen - it just knows how to heal when given the right tools.

If the only thing stopping you from getting trauma therapy is logistics - distance, schedule, privacy concerns, mobility issues - then online EMDR might be exactly what you need.

You don't have to white-knuckle your way through flashbacks, anxiety, or painful memories anymore. You don't have to wait until life magically gets less busy. You don't have to figure out how to drive to appointments you can't fit into your schedule.

Healing is possible. And it's more accessible than you think.

Your trauma has taken enough from you. It's time to take your life back. And you can start from your own couch, with your favorite blanket, tea in hand, therapist on screen.

That's the power of online EMDR therapy.

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EMDR for Complex PTSD and Childhood Trauma

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EMDR Therapy for Children and Teens: A Parent’s Guide