There is a common assumption that EMDR needs to happen in person, and I understand where that belief comes from. EMDR can involve vulnerable material, strong emotions, and shifts in how we experience our bodies and surroundings. It feels intuitive that this kind of work would be better suited to a therapist’s office.
In my experience, however, EMDR does not automatically need to happen in person. For some clients, telehealth offers meaningful benefits. In fact, being able to do this work from home can make the experience feel more comfortable, familiar, and manageable.
That does not mean telehealth is the right fit for everyone. One of the primary things I consider when working with a client is not simply “Can we do EMDR through telehealth?” but rather “Is telehealth the best setting for you and the work we’re doing?”
What I Like About Doing EMDR Through Telehealth
One of the things I have come to appreciate about telehealth EMDR is the environment it allows clients to create around themselves.
In an office, I have control over the physical space, but the client is still entering my environment. Through telehealth, clients have much more say in what surrounds them. They can choose where they sit, how the room feels, what they keep nearby, and what helps them feel grounded.
I often encourage clients to think intentionally about their space before beginning EMDR. This might mean:
- Finding a room where they have total privacy
- Getting comfortable with a blanket or pillow
- Keeping a favorite object or grounding tools within reach
- Adjusting the lighting to their preference
I don’t expect someone’s home to look like a therapy office. In fact, I don’t want it to. Part of what makes telehealth valuable is that clients remain in an environment that is familiar and personally meaningful. For many people, that familiarity makes it easier to feel safe enough to be vulnerable.
Creating a Transition Into the Session
I am particularly mindful that telehealth doesn’t always offer a natural transition into therapy. When someone drives to an office, there is built-in time between their day and their appointment. With telehealth, a client may be answering an email one minute and beginning therapy the next.
Creating a deliberate transition is especially important when doing EMDR. Rather than immediately jumping into processing, we spend time noticing how the client is arriving at the session—checking in with their body, grounding, or simply slowing down. This doesn’t have to be elaborate; sometimes the transition is just taking a few quiet minutes to settle into the space and shift attention away from the rest of the day.
Creating a Transition Out of the Session
I think just as much about what happens at the end of an EMDR session. When we finish processing difficult material, I don’t want a client to feel as though they have to immediately close their laptop and jump back into their routine.
We take time to reconnect with the present moment, notice what is happening internally, and ensure the client feels oriented before ending the call. Common resources established early on include engaging the five senses through grounding techniques, visualizing a calm scene or secure place, or utilizing a “container” to set memories aside until we are ready to revisit them.
Another benefit of telehealth is that the client is already home. Rather than driving immediately after emotionally intensive work, they can transition into their next activity from a familiar space. If time allows, I encourage them to continue easing out of the session by taking a shower, going for a short walk, or eating a comforting snack. Of course, that benefit only exists when home is a supportive environment, which is an important consideration.
When In-Person EMDR May Be the Better Choice
I don’t view telehealth as inherently better or worse than in-person therapy—it is simply another option. There are situations where I recommend in-person therapy instead, or where a client decides it feels better for them.
Telehealth may not be the best fit when:
- It is difficult to create a private or safe space at home: If someone in the home is part of the client’s trauma history, is emotionally triggering, or compromises privacy, home may not provide the security needed for trauma processing.
- Transitions are particularly challenging: Some clients struggle to shift into therapy without a physical separation between their daily environment and the therapeutic space—or find it hard to transition back into their day afterward.
- Technology interferes with the work: Frequent interruptions, unreliable Wi-Fi, or audio/video glitches can become frustrating and disruptive during EMDR.
- The client prefers in-person therapy: This is reason enough. Some people feel more connected, grounded, or comfortable being physically present with their therapist.
- A different level of care is needed: Telehealth isn’t intended to replace every form of mental health care, and part of my role is helping clients determine what setting makes the most sense.
These aren’t failures of telehealth. They are reminders that the setting is a key part of the therapeutic assessment.
Finding What Helps You Feel Safe Enough to Do the Work
Ultimately, there is no universally “correct” way to do EMDR. The goal is to find a setting where you feel safe, supported, and connected enough to engage in the work. For some, that means sitting in a therapist’s office. For others, it means sitting in their own living room wrapped in a blanket. For many, that preference changes over time.
What matters is paying attention to the individual rather than assuming one format works for everyone. Telehealth EMDR is a thoughtful, effective approach when the circumstances are right, and part of providing responsible care is knowing when another setting serves the client better.
Trauma therapy asks a lot of us. The environment in which that work happens should support the process, not become another barrier to it.
If you are interested in telehealth trauma therapy, contact our intake team at info@mindfulness.com to schedule an intake with Christine!