Can EMDR therapy actually be done over a video call? The short answer is yes, and for many people it works just as well as sitting in a therapist’s office. Online EMDR therapy has become a legitimate, clinically supported option, not a workaround or a lesser substitute. That said, it does require some specific setup, and there are situations where it is not the right fit. Understanding how virtual EMDR sessions are structured, what the research and professional standards say, and what you need to make it work at home will help you decide whether this format makes sense for you.
What online EMDR therapy actually involves (and how it differs from regular video therapy)
Most people picture therapy as talking. EMDR is different. It uses bilateral stimulation, meaning rhythmic, alternating sensory input to both sides of the body, while you hold a distressing memory in mind. In an in-person session, this often means following the therapist’s moving hand with your eyes. Online, the bilateral stimulation has to be adapted, and that adaptation is where most people’s questions start.
Therapists trained in virtual EMDR delivery typically use one or more of the following approaches:
- Tapping: You tap alternately on your own knees, shoulders, or hands while the therapist guides the pace. This is often the most reliable option because it requires no additional technology.
- Audio tones: Alternating tones delivered through headphones, either via a dedicated EMDR app or a shared audio tool the therapist controls remotely.
- Visual tools: Some platforms include a moving dot or bar on screen that replicates the eye movement component.
The misconception worth addressing here is that eye movements are the only “real” form of bilateral stimulation. They are not. The research base for EMDR includes studies using tapping and audio tones, and EMDRIA, the professional association that sets EMDR standards internationally, recognizes multiple forms of bilateral stimulation as valid. What matters is the alternating, rhythmic quality, not the specific sensory channel.
The rest of the session structure, including history-taking, identifying targets, resourcing, and closure, translates to video with very few modifications. If you have done EMDR therapy in person before, a virtual session will feel familiar in its rhythm and pacing.
The professional standards behind online EMDR therapy in Nova Scotia
Offering therapy online is not a free-for-all. In Nova Scotia, social workers providing services through electronic means are governed by a specific professional standard. NSCSW Standard 9 requires that social workers delivering services via telephone or other electronic means act ethically, ensure personal professional competence, protect clients, and uphold the values of the profession. This means your therapist is not just expected to know EMDR; they are professionally obligated to be competent in delivering it through a virtual format specifically.
That distinction matters more than it might seem. A therapist who trained entirely in person and simply moved their practice online without additional preparation is not meeting that standard. Competence in virtual delivery includes understanding the limits of the medium, knowing when to refer a client to in-person care, and having a plan for what happens if the connection drops mid-session during an emotionally activated moment.
What to ask about your therapist’s online EMDR training
When you are considering a virtual EMDR therapist, it is reasonable to ask directly: have you received specific training or consultation in delivering EMDR online? For context, EMDRIA Certified Therapist status requires at least 50 EMDR sessions with a minimum of 25 clients, 20 hours of consultation from an EMDRIA Approved Consultant (at least 10 of those individual), 12 hours of EMDRIA Credits, and at least two years of post-licensure experience. Certification does not automatically include virtual delivery training, but it does indicate a serious level of commitment to the modality. A therapist who holds that credential and has sought additional consultation on virtual delivery is a strong sign you are in capable hands.
Setting up your space: what most guides skip
The practical setup for online EMDR matters more than for regular talk therapy, and most articles on this topic gloss over the specifics. Here is what actually makes a difference.
Privacy is the first concern. EMDR can bring up intense emotional responses. You need a space where you will not be interrupted, where you cannot be overheard, and where you feel safe enough to let your guard down. A bedroom with a locked door is often better than a home office with thin walls. If you live with others, a white noise machine outside the door can help. One practical scenario: a client who works from home might find that the same desk where they take work calls creates a mental association with performance and productivity, which can interfere with the kind of open, receptive state EMDR requires. A different chair in a different room can make a real difference.
Technology requirements are more specific than for regular video calls. You need a stable internet connection, a device with a camera that can show your face and upper body clearly, and headphones if your therapist uses audio tones. A laptop or desktop is generally better than a phone because the screen is larger and more stable. Your therapist should send you a technology checklist before your first session. If they do not, ask for one.
The lighting and camera angle question
Your therapist needs to see your face clearly to track your emotional responses during processing. Backlit setups, where a window is behind you, make this difficult. Face a light source rather than sitting in front of one. Camera at eye level, not angled up from a laptop on a low table, helps maintain a natural sense of connection.
When online EMDR therapy works well, and when it does not
Virtual EMDR is not equally suitable for everyone, and a good therapist will tell you this honestly rather than simply taking your booking.
It tends to work well for people who have some prior experience with therapy and are comfortable with the video format, who have a stable living situation with genuine privacy, who are not in acute crisis, and who have already developed some capacity to self-regulate, meaning they can bring themselves back to a calm baseline when distressed. It also works well for people in rural or remote parts of Nova Scotia and Atlantic Canada where in-person trauma-specialized therapy is simply not available within a reasonable distance.
It is less suitable, and sometimes contraindicated, in a few specific situations. If you are experiencing active suicidal ideation or self-harm, in-person care with a higher level of support is more appropriate. If your trauma history involves severe dissociation, meaning you lose track of where you are or who you are during distress, the physical presence of a therapist can be an important grounding anchor that a screen cannot fully replicate. If your home environment is not safe, whether because of an abusive relationship or unstable housing, the privacy and containment that EMDR requires may not be achievable.
This is not a reason to avoid virtual EMDR if you are a good fit. It is a reason to have an honest conversation with your therapist before you start, rather than discovering the mismatch three sessions in.
How a typical online EMDR session is structured
If you have never done EMDR before, knowing what to expect in a virtual session can reduce the anxiety of starting. The structure is more predictable than most people expect.
Early sessions, often the first two to four, focus on history-taking and preparation. Your therapist will ask about your current life circumstances, your support network, your sleep, and what brought you in. They will also teach you stabilization and resourcing skills before any trauma processing begins. This is not a formality. It is clinically necessary, and a therapist who rushes past it to get to “the trauma work” is skipping something important.
Once processing begins, a session typically opens with a brief check-in, moves into identifying the target memory or experience, establishes the negative belief connected to it and what you would rather believe instead, and then begins sets of bilateral stimulation. Between sets, your therapist will ask what you noticed, and you will report back. This back-and-forth continues until the distress associated with the memory decreases.
Sessions almost always end with a closure phase, regardless of where the processing is. Your therapist will guide you back to a regulated state before you log off. You should not be left activated and alone at the end of a session. If that has happened to you in a previous experience, it is worth raising with any new therapist before you begin.
Insurance, billing, and the practical realities of virtual therapy in Atlantic Canada
Coverage for online therapy in Nova Scotia and Atlantic Canada varies significantly depending on your insurance plan. Many extended health benefits plans cover registered social workers and psychologists regardless of whether sessions are delivered in person or virtually, but the specific language in your policy matters. Some plans specify “in-person” sessions only, while others have updated their wording to include telehealth. Checking your policy before your first session, rather than after, saves a frustrating surprise.
A few things worth knowing: some insurers require a referral from a physician for coverage to apply, even for social work services. Others require that the provider hold a specific designation. If you have questions about how billing works or what designations Wholetherapy’s clinicians hold, the FAQ page covers these details, or you can contact us directly before booking.
One edge case that comes up more than people expect: if your insurance runs out mid-treatment, virtual therapy can sometimes be more flexible in terms of session frequency and scheduling, which may allow you to continue at a reduced pace rather than stopping entirely. It is worth discussing this possibility with your therapist early, not when you are already in the middle of processing difficult material.
How to get started with online EMDR therapy at Wholetherapy
Starting is usually simpler than people expect, and the first step does not require you to have everything figured out. Wholetherapy is a trauma-focused psychotherapy clinic based in Dartmouth, Nova Scotia, serving clients across Atlantic Canada through both in-person and virtual sessions.
When you reach out, you will typically have a brief initial conversation to talk about what you are looking for, answer any questions about the process, and confirm that virtual EMDR is a reasonable fit for your situation. This is not a sales call. It is a genuine clinical check-in, and it is appropriate to ask questions during it.
A few things to have ready when you make contact: a sense of what you are hoping to address (you do not need a diagnosis or a perfectly articulated problem), your insurance information if you plan to use benefits, and a realistic picture of your schedule. EMDR sessions are often 60 to 90 minutes, and the processing work means you may want some buffer time afterward rather than jumping straight into a work meeting.
If you are not sure whether EMDR is the right approach for what you are dealing with, that is a completely reasonable thing to raise. A good therapist will help you think through whether EMDR, another trauma-focused approach, or something else entirely makes the most sense for where you are right now. You can learn more about the approach on the EMDR therapy page, or reach out through the contact us page to start a conversation.
Frequently asked questions
Is online EMDR therapy as effective as in-person EMDR?
The available clinical evidence and the experience of trained EMDR therapists suggest that virtual delivery can be comparably effective for many clients, particularly those who are well-prepared and have a stable, private environment. The key variables are therapist competence in virtual delivery, the quality of your setup at home, and whether you are an appropriate candidate for virtual work given your history and current circumstances. It is not a universal substitute for in-person care, but for many people it is a genuinely good option rather than a compromise.
What equipment do I need for online EMDR therapy sessions?
At minimum, you need a device with a working camera and microphone (a laptop or desktop is preferable to a phone), a stable internet connection, and a private space where you will not be interrupted. Headphones are strongly recommended, both for audio privacy and because some therapists use audio tones as the bilateral stimulation method. Your therapist should walk you through any platform-specific requirements before your first session, and it is worth doing a test connection in advance.
Can online EMDR therapy be done in Nova Scotia?
Yes. Therapists registered with the Nova Scotia College of Social Workers (NSCSW) are permitted to deliver services electronically, and NSCSW Standard 9 sets out the professional obligations that govern this practice. Wholetherapy offers virtual EMDR sessions to clients in Nova Scotia and Atlantic Canada. Whether virtual delivery is appropriate for your specific situation is something to discuss with your therapist before starting, as there are some clinical presentations where in-person care is more suitable.
What happens if the internet connection drops during an EMDR session?
A competent virtual EMDR therapist will have a protocol for this before your first session begins, not after it happens. Typically this means agreeing on a backup contact method (usually a phone number), a plan for what you will do if the connection drops during processing (often a specific grounding or containment exercise), and a way to reconnect quickly. If your therapist has not discussed this with you, raise it yourself. It is a basic safety consideration for virtual trauma work, not an unusual request.
How do I know if an EMDR therapist is properly trained and certified?
EMDRIA, the international professional association for EMDR therapy, offers a Certified Therapist credential that requires at least 50 EMDR sessions with a minimum of 25 clients, 20 hours of consultation from an EMDRIA Approved Consultant (at least 10 individual), 12 hours of EMDRIA Credits, and at least two years of post-licensure experience. You can ask any therapist directly about their EMDR training and whether they hold EMDRIA certification. It is also worth asking specifically about their experience delivering EMDR in a virtual format, since basic EMDR training does not automatically cover online delivery.