Can EMDR Therapy Be Done Online? What Albertans Should Know

TraumaAnxietyDepressionGrief
Written By The Mental Health Clinic

EMDR therapy is widely recognized as one of the most effective treatments for trauma and distressing memories. Traditionally, it is delivered in person while a therapist guides eye movements or other forms of bilateral stimulation during a session.

Because of this hands-on reputation, many people wonder whether EMDR can still work if therapy happens through a video call rather than in the same room as the therapist. With the rapid expansion of virtual counselling across Alberta, this question has become increasingly common. Understanding how EMDR is adapted for online sessions and when virtual treatment is appropriate can help you decide whether this approach may fit your situation.

This article explains how online EMDR works, what research says about its effectiveness, who it may be appropriate for, and what to expect if you begin EMDR therapy through a virtual session.

Can EMDR Therapy Be Done Online?

Yes. EMDR therapy can be delivered through secure video sessions using adaptations such as screen-guided eye movements, alternating audio tones, or therapist-guided tapping. Emerging research suggests that virtual EMDR can produce outcomes comparable to in-person delivery for many trauma-related presentations when conducted by a trained clinician following the standard protocol.

What is EMDR and How Does it Work?

Eye Movement Desensitisation and Reprocessing (EMDR) was developed by Francine Shapiro in the late 1980s and is now recognised by the World Health Organization and the American Psychological Association as an evidence-based treatment for trauma and post-traumatic stress.

Most trauma therapies work primarily through language: talking through what happened, restructuring the thoughts that formed around it, reducing avoidance over time. EMDR works through a different therapeutic mechanism than traditional talk-based approaches. Its core technique is bilateral stimulation (BLS), alternating sensory input delivered through guided eye movements, audio tones, or tapping. The underlying model, Adaptive Information Processing, proposes that traumatic memories can become stored in a way that keeps them feeling current rather than resolved. Research suggests that bilateral stimulation may help support the brain’s processing of those memories, allowing them to be integrated more adaptively, though the precise neurological mechanism is still being studied.

Bilateral stimulation appears to engage the brain's natural information processing system in a way that allows those memories to be integrated more adaptively. EMDR does not require detailed retelling of the traumatic event in the way some talk therapies do. The work focuses on how the memory is held in the nervous system, not on constructing a detailed account of the event. You can learn more about how EMDR therapy is offered at The Mental Health Clinic on our EMDR therapy page.

Is EMDR Therapy Only Used for Trauma?

EMDR is best known as a trauma treatment, but its clinical application is broader than that.

Research supports its use for anxiety, panic disorder, phobias, grief, and distressing memories that continue to shape present-day reactions without meeting the full criteria for a PTSD diagnosis.

The common thread is not a specific diagnostic category but the presence of past experiences that continue to generate a disproportionate emotional or physiological response.

For many people, EMDR is particularly helpful when distressing memories continue to trigger strong emotional or physical reactions despite attempts to manage them through insight or coping strategies alone. If current difficulties are connected to specific memories or events, EMDR may be relevant regardless of how those difficulties are labelled.

Many Albertans accessing online EMDR therapy are not working through acute trauma; they're addressing anxiety, persistent negative beliefs, or emotional responses they can't fully account for through conscious reasoning alone.

Does Online EMDR Actually Work? What the Research Shows

Yes, and the evidence base is stronger than many people expect.

A 2021 service evaluation by McGowan, Fisher, Havens, and Proudlock, published in BMC Psychiatry, examined EMDR delivered remotely during the COVID-19 pandemic across 93 patients and found statistically significant and clinically meaningful reductions across all outcome measures in both adult and younger populations. Fisher’s (2021) paper in the Journal of EMDR Practice and Researchfurther documents the clinical application of remote EMDR delivery.

The EMDR International Association (EMDRIA) has issued formal guidance endorsing telehealth EMDR and maintains a research overview page with an updated list of supporting studies.

The honest position is that the evidence base for online EMDR is strong and still developing. It is somewhat less extensive than the decades of research behind in-person delivery. What the existing research does not support is the assumption that a screen fundamentally undermines the treatment. For most presentations, it doesn't.

How Bilateral Stimulation is Adapted for Virtual Sessions

This is the practical question most people have. Three main methods are used in virtual EMDR sessions.

Screen-Based Eye Movement Tracking

Screen-based eye movement tracking involves the therapist moving a finger or visual cue across the screen while the client follows with their eyes. With a properly positioned camera and screen, this closely replicates the in-person method. For some clients, this feels the most similar to how EMDR is traditionally delivered in an office. It can also be a useful starting point when the goal is to preserve the structure and rhythm of standard bilateral stimulation as closely as possible in a virtual setting.

Alternating Audio Tones

Alternating audio tones delivered through headphones activate the left and right auditory channels in sequence. This option can work well for clients who find visual tracking tiring, distracting, or physically uncomfortable. It may also be helpful when screen setup is less than ideal, since the effectiveness of audio tones does not depend on following a visual target across the screen. In practice, some therapists use audio tones on their own, while others combine them with additional grounding or pacing adjustments depending on the client’s response.

Therapist-Guided Self-Tapping

Therapist-guided self-tapping, including the butterfly hug (crossing your arms and alternately tapping your shoulders) or alternating knee taps, provides tactile bilateral stimulation.

Research on BLS method comparisons indicates that tapping is a clinically viable alternative to eye movements in virtual delivery, though some evidence suggests eye movements may produce somewhat stronger distress reductions per set. Mischler and colleagues (2021), publishing in Frontiers in Psychology, found that eye movements resulted in greater reductions in subjective distress than tapping in videoconference EMDR sessions, while overall treatment outcomes across both methods remained clinically meaningful. The practical implication is that therapists trained in virtual delivery will discuss BLS options with you and adjust based on your response, rather than applying a single method rigidly.

What is Different in an Online EMDR Session Compared to In-person?

A few things change with virtual delivery, and a good therapist will tell you about them upfront. The therapist's ability to read full-body cues is reduced; in person, shifts in posture, breathing, and muscle tension all signal how processing is progressing. On a video call, the therapist works primarily with what the camera captures, and compensates by checking in more frequently.

The close-down protocol at the end of each session also requires more deliberate attention online. In person, a waiting room and drive home create a natural decompression buffer. Online, you close the laptop and you're already home. Skilled therapists build additional time into the end of virtual sessions specifically for this transition. These differences require clinical attention but don't undermine the treatment.

Who is a Good Candidate for Online EMDR in Alberta?

Geographic access is one of the clearest indicators. For Albertans in rural communities, smaller cities, or any area outside Calgary and Edmonton where EMDR-trained therapists are limited, virtual delivery makes treatment accessible that would otherwise require significant travel or extended wait times. Online EMDR therapy allows clients across Alberta, from Fort McMurray to Lethbridge to smaller communities in between, to work with trained clinicians without those barriers.

When Virtual EMDR Tends to Work Well

Single-incident trauma responds particularly well to EMDR generally, and virtual delivery is well-suited to these presentations. Clients who have done prior therapeutic work and have some existing capacity to manage distress also tend to adapt well to the online format. Having a private, quiet space at home where sessions won't be interrupted is a meaningful practical requirement; when that condition is met, the familiar home environment can actually support the work rather than complicate it.

When In-Person EMDR Is the Better Clinical Choice

A significant dissociation history warrants careful assessment before proceeding with virtual EMDR. Dissociation can intensify during trauma processing, and a therapist's ability to intervene and ground a client in real time is more limited through a screen.

Complex PTSD with limited distress tolerance may also be better suited to in-person work initially, at least until stabilisation is more established. This is not a permanent barrier; it's a clinical pacing decision.

If your home environment doesn't feel safe or private, whether because of relationship dynamics, living situation, or simply no space for an uninterrupted hour, in-person therapy is the more appropriate option.

Processing trauma in an environment where you don't feel secure introduces unnecessary clinical risk that the therapist cannot fully account for remotely.

What to Expect in Your First Online EMDR Sessions

EMDR does not begin with trauma processing. This is one of the most common misconceptions about the approach, and it matters for understanding what early sessions actually involve.     

The Free Consultation and Early Sessions

Our EMDR clinician at The Mental Health Clinic begins with a free 20-minute consultation. For EMDR specifically, this conversation covers your history, what's brought you in, whether EMDR is likely to be a good fit for your situation, and what the process involves. It's a no-cost way to assess fit before committing to anything.

The first full sessions focus on Phase 1 (history-taking) and Phase 2 (preparation and stabilisation).

Before any memory processing begins, your therapist builds a set of internal resources with you: grounding techniques, containment strategies, and a clear working understanding of your window of tolerance.

This preparation phase is what makes active processing possible without destabilising you between sessions, and a well-trained therapist will not skip or compress it.

What Happens During an Online EMDR Therapy Session?

During an online EMDR session, you and your therapist meet through a secure video platform, similar to other virtual counselling appointments. Most clients are seated comfortably in a chair rather than lying down.

At certain points in the session, your therapist may ask you to briefly focus on a memory, image, thought, or feeling connected to what you are working on. You do not have to describe the entire experience in detail. Instead, the goal is simply to bring the memory or feeling into awareness.

While you are focusing on that experience, bilateral stimulation may be used for short periods. This might involve following a visual cue on the screen with your eyes, listening to alternating tones through headphones, or tapping your shoulders or knees in a guided pattern.

During these short sets of stimulation, you are usually noticing what happens internally. That might include thoughts, emotions, body sensations, or new memories that come to mind. After each set, the therapist may ask what you noticed before continuing.

You are not expected to talk continuously while the stimulation is happening. Instead, there are natural pauses where you briefly describe what came up or how things are shifting.

Over time, many people find that the emotional intensity connected to the memory begins to change. Some notice the memory feels more distant, less overwhelming, or connected to new insights about what happened.

Near the end of the session, therapists usually allow time for the work to settle so that you feel grounded before finishing the appointment.

3 Factors That Affect Online EMDR Therapy Success

1. Your Physical Environment

In a therapy office, the physical space contributes to a sense of containment that supports trauma processing. Online, your space has to be constructed deliberately.

Identify one consistent space in your home for sessions; the consistency itself matters, as your nervous system will begin to associate it with the work. Reduce interruption risks, have water nearby, and have a plan for how you’ll signal to others that you’re unavailable.

It also helps to decide in advance what you’ll do if activation lingers after a session ends: a short walk, something warm to drink, avoiding demanding conversations for a while. Having the plan before you need it reduces the cost of not knowing what to do.

2. Screen Setup and Camera Position

If eye movements are being used, your screen needs to be at eye level and roughly an arm's length away. When a laptop sits flat on a table and you lean back in a chair, eye movements become more vertical than horizontal, which reduces their effectiveness.

Camera height, screen distance, and lighting on your face all affect what your therapist can see and deliver. Headphones matter if audio tones are being used. Spending a few minutes on setup before your first session is worth it.

3. Stabilisation Before Processing

Before beginning deeper trauma processing, therapists typically spend time helping clients develop strategies to manage distress if strong emotions arise during or after sessions.

This preparation can include learning grounding techniques, understanding your window of tolerance, and identifying ways to settle your nervous system if activation increases. Practising these skills between sessions helps ensure that trauma work progresses at a pace that feels manageable and safe.

Accessing Online EMDR Therapy in Alberta: Cost and Coverage

Most people in Alberta access EMDR therapy through private counselling services. Sessions are typically paid for privately and may be reimbursed through extended health benefits depending on the details of your insurance plan.

Many benefits plans cover services provided by registered mental health professionals such as psychologists, counselling therapists, Canadian Certified Counsellors, social workers, or registered provisional psychologists. Clients usually pay for the session upfront and then submit their receipt to their insurance provider for reimbursement.

Virtual EMDR therapy also allows clients across Alberta to work with trained clinicians without needing to travel. For people living outside major centres such as Calgary or Edmonton, this can make it much easier to access therapists with specialised trauma training.

What to Look for When Choosing an EMDR Therapist Online

If you are considering EMDR therapy, it is reasonable to ask about a therapist’s training and experience with the approach.

You may want to ask questions such as:

  • What EMDR training have you completed?

  • How much experience do you have using EMDR in your practice?

  • Have you delivered EMDR through virtual sessions before?

These questions can help you understand whether a therapist is comfortable delivering EMDR in an online setting and whether the approach is a good fit for what you are hoping to work on.

Working With an EMDR Therapist in Alberta Online

At The Mental Health Clinic, EMDR therapy is offered by Amy, a therapist trained in the EMDR protocol who works with adults experiencing trauma and related concerns. Sessions are delivered virtually for clients across Alberta. A free 20-minute consultation is available to discuss your history, answer questions and determine whether EMDR is a good fit.

Frequently Asked Questions About Online EMDR Therapy

Can EMDR Therapy Be Done Without Eye Movements?

Yes. Alternating audio tones and therapist-guided tapping are used as BLS alternatives in virtual EMDR, and overall treatment outcomes across these methods remain clinically meaningful. Research does suggest eye movements may produce somewhat stronger distress reductions per processing set, which is why therapists trained in virtual delivery will typically attempt eye movements first and use tapping as an alternative when eye movements are difficult or not preferred. Many clients do prefer tapping for its sense of control and familiarity.

Is Online EMDR as Effective as In-Person EMDR?

For most presentations, yes. Research comparing telehealth and in-person EMDR delivery has found comparable outcomes for post-traumatic stress symptoms when conducted by a trained clinician following the standard protocol. The adaptations used for virtual bilateral stimulation delivery do not appear to reduce treatment effectiveness in the existing literature.

Is Online EMDR Therapy Safe for PTSD or Complex Trauma?

It can be, with appropriate clinical assessment. The key variables are your dissociation history, your current capacity to regulate distress, and the safety and privacy of your home environment. A thorough assessment before treatment begins is essential, and active processing should not start until stabilisation work is well-established. If you have concerns about your suitability, raise them in the consultation; that conversation exists specifically to address them.

How Many Online EMDR Therapy Sessions Will I Need?

This varies depending on the nature of the trauma, how long it has been unresolved, and individual factors like distress tolerance and existing coping capacity. Some people notice improvement within a relatively short number of sessions, while others require longer-term work depending on the complexity of what they have experienced. Your therapist will give you a more specific sense of what to expect after the initial assessment.

Does Alberta Health or Insurance Cover EMDR?

Alberta Health Care does not typically cover registered therapist services for most Albertans, though some exceptions exist. Coverage usually comes through employer-sponsored extended health benefits or supplementary insurance plans. Most plans covering psychological services will cover EMDR delivered by a registered professional, but which designation is covered varies by plan. Clients typically pay upfront and submit receipts to their insurer for reimbursement; confirm the details of your plan before booking.

How Do I Find a Trained EMDR Therapist in Alberta?

The EMDR International Association (EMDRIA) maintains a searchable directory of trained and certified therapists that can be filtered by location and telehealth availability. When searching, look specifically for therapists who list virtual EMDR as a service rather than assuming any EMDR-trained clinician is prepared for online delivery. The Mental Health Clinic offers virtual EMDR therapy across Alberta through Amy, whose training and trauma specialisation are detailed on the EMDR therapy page.

Online EMDR Therapy in Alberta: What Matters Most

The scepticism about whether online EMDR works is understandable given the treatment's origins. Virtual delivery changes some things about how sessions run; it doesn't change what the treatment can do. For Albertans in Calgary, Edmonton, Red Deer, Lethbridge, and the many smaller communities across the province where EMDR-trained therapists are difficult to find locally, virtual access isn't a compromise. For a lot of people, it's the only realistic option.

What makes EMDR work, whether online or in person, is a trained therapist following a structured protocol with clinical attention to pacing and stabilisation. The medium matters less than most people assume going in.

 Educational Disclaimer

This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you're experiencing mental health concerns that interfere with your daily functioning, please reach out to a qualified mental health professional. If you're in crisis, contact your local crisis line or emergency services immediately.

The Mental Health Clinic
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