What Does a Virtual EMDR or ART Therapy Session Actually Look Like?

Table of Contents

1. How Bilateral Stimulation Translates Online
2. Setting Up Your Space
3. How the Session Actually Unfolds
4. Why Virtual Can Feel Safer for Some People
5. When Virtual Might Not Be the Right Starting Point
6. Technology Considerations
7. Can Intensive Formats Work Virtually Too?
8. About the Author
9. Frequently Asked Questions
10. Conclusion

A common hesitation about EMDR or ART therapy has nothing to do with the therapy itself, it’s whether something built around eye movements and bilateral stimulation can really translate through a screen. It’s is EMDR and ART effective when conducted virtually? It’s a reasonable question to have. The short answer: yes, both approaches have been successfully adapted for virtual delivery, and for a lot of people, doing this work from home is just as effective, sometimes more comfortable, than sitting in an office. To explain further, bilateral stimulation doesn’t just have to mean eye movement, in fact, it can be done through walking, running, drumming and even tapping, which many of my clients’ prefer. To get a little scientific, Bilateral stimulation is any rhythmic sensory input that alternates back and forth between the left and right sides of the body (left, right, left, right). While the exact neuroscience is still be studied, researchers believe that bilateral stimulation works through dual awareness, brain hemisphere activation, nervous system regulation, and memory reconsolidation. So it doesn’t matter if you are in-person, or virtual just as long as you can do bilateral stimulation for these modalities to be effective. 

Path to Growth Therapy offers both EMDR and ART entirely through secure virtual sessions, which means you don’t have to live near our office to do this work. Many of our clients find that processing difficult material from their own space, on their own terms, makes the process feel more manageable, not less effective. 

How Bilateral Stimulation Translates Online

In person, bilateral stimulation is typically delivered through guided eye movements following a therapist’s hand or a light bar, handheld tactile devices, or alternating tones through headphones. Virtually, most of these translate directly:

• Visual stimulation happens through an on-screen object your therapist controls, which your eyes track left to right.
• Auditory stimulation uses alternating tones through headphones, working identically whether you’re in the room or connecting remotely.
• Tactile options, like small handheld buzzers, can sometimes be mailed ahead of virtual sessions, or replaced with simple self-administered tapping your therapist teaches you; this is often the preferred method second to eye movements. This is a great medium to use especially for client’s who feel they need to close their eyes to visualize and struggle to concentrate while following a ball or light with their eyes. 

What actually drives the therapeutic effect, the alternating, bilateral input itself, doesn’t depend on being physically near your therapist. What matters most is consistency and guidance, both of which hold up well over video. 

Setting Up Your Space

A little preparation makes virtual sessions feel just as contained as in-person ones:

• A private room where you won’t be interrupted
• Headphones, if auditory bilateral stimulation will be used
• Tissues, water, or anything else that helps you feel grounded nearby
• A heads-up to household members that you need uninterrupted time
• A quick tech check ahead of your first session

Your therapist will usually walk you through this setup during an initial consultation, so none of it is something you’re figuring out in the moment.

How the Session Actually Unfolds

A virtual EMDR or ART session generally mirrors the same structure as an in-person one:

1. Check-in – your therapist asks how you’ve been since last time and what feels present today. 
2. Target identification – together, you pinpoint the memory, belief, or feeling to focus on.
3. Processing – bilateral stimulation begins as you hold the memory or feeling in awareness, in short sets with brief check-ins between. 
4. Closure – before the session ends, your therapist makes sure you’re grounded, using techniques to settle any leftover activation.
5. Follow-up – since processing can continue to settle after the session, your therapist typically checks in on this at your next appointment.

The structure, the pacing, and the sense of being actively guided stay consistent whether you’re across the room from your therapist or on a video call. When in the processing phase of EMDR, I often tell client’s to provide brief headlines when sharing what they notice, this allows us to go back in quicker and continuing to process. It feels like a smoother process for the client, making the content easier to grasp when they are sharing very little externally. In ART, the client doesn’t have as many opportunities to share content, it is focused more somatically throughout much of the process initially and moving sensations. Later, the therapist is guiding through various exercises using bilateral stimulation to change images. While both EMDR and ART have hard components to them, I have found that clients’ tend to enjoy ART better, in fact, as odd as it sounds, part of ART are quite fun and empowering. I enjoy seeing how creative clients are in sessions through the use of ART and how their brains know how to heal. 

Over the years of conducting EMDR in sessions with clients, I have noticed a few things. One is that often times it’s tough for the human mind to comprehend that traumatic and difficult experiences can ever just be a memory and parts of ourselves might doubt or resist or even be fearful, especially when first processing these experiences when the level of distress is still high. I occasionally use IFS, Internal Family Systems, to work with parts that are interfering with the progress or healing that is trying to take place. Other times, just naming this doubt, processing it and allowing time to trust the process as the client gets the hang of what EMDR is, they begin to trust that their SUDs (units of distress) decrease and the process starts flowing. 

I also notice as clients get closer to the goal of 0, or in some cases a SUDS 1, where there is neutrality in the memory, clients’ feel a sense of shock, confusion, bewilderment that it can’t possibly ever be a zero because it’s so terrible or there is a blocking belief that prevents this, this is another point in the session that might need some special finessing. In any of these cases, it is rare that I have seen clients not make some gains in a session through the use of both modalities. When my clients’ are starting to share positive resourced thoughts I know that the SUDs are decreasing and we are on the right path towards healing. 

Why Virtual Can Feel Safer for Some People

Trauma work is inherently vulnerable, and doing it from your own space, your own couch, your own blanket, an environment you control, can lower the barrier to fully engaging. Some clients find they’re able to let their guard down more easily at home than in a clinical office. 

When Virtual Might Not Be the Right Starting Point

Virtual sessions aren’t automatically ideal for everyone. If you experience significant dissociation, have a history of psychiatric crises requiring close in-person monitoring, or don’t have access to a private, safe space, in-person sessions may make more sense, at least until enough stabilization has occurred to consider transitioning to virtual care. A responsible therapist will assess this with you honestly rather than assuming virtual works for every situation.

Technology Considerations

Reliable video and audio quality matter more in trauma-focused work than in general talk therapy, since bilateral stimulation depends on consistent visual or auditory input. It helps to have:

• A stable connection, wired if possible
• A quiet space with minimal background noise
• Headphones for any auditory bilateral stimulation work
• A screen large enough to comfortably track visual stimulation, if that method is used

Can Intensive Formats Work Virtually Too?

Yes. Multi-hour or multi-day intensives, which condense weeks of processing into a shorter, focused timeframe, can also be delivered virtually. This is especially useful if you don’t have a local specialist trained in EMDR or ART, or you want significant progress without spreading sessions across many months. Breaks are built in through multi-hour intensives and extended sessions and potentially several targets can be addressed in one single intensive.

About the Author

Sheila Trabelsi, LPC, LAC, LMHC, is a licensed therapist and the founder of Path to Growth Therapy, serving clients across Colorado and Washington. With 16+ years of clinical experience and advanced training in EMDR, Accelerated Resolution Therapy (ART), Trauma recovery, couples therapy, and nervous system-focused approaches, Sheila helps adults work through anxiety, trauma, relationship challenges, grief, and major life transitions. Her approach combines genuine connection, practical tools, and evidence-based strategies to help clients move beyond simply understanding their struggles and begin creating meaningful change.

Frequently Asked Questions

Is virtual EMDR or ART as effective as in-person sessions?

Growing clinical experience and research support that virtual delivery can be comparably effective for many clients, provided the technical setup allows for consistent bilateral stimulation and there’s a private, safe space to do the work.

Do I need special equipment for virtual sessions?

Not necessarily. Many sessions rely on on-screen visual stimulation or simple auditory tools through headphones. Some therapists may mail a tactile device if that’s your preference.

What if I feel overwhelmed during a session and my therapist isn’t physically there?

Your therapist guides you through grounding and stabilization in real time, just as they would in person, and won’t end a session while you’re highly activated without working through it together first.

Can I do a virtual intensive instead of weekly sessions?

Yes. Condensed intensive formats can be delivered virtually and are a good option for faster progress or when local access to a trained specialist isn’t available.

Conclusion

If distance, logistics, or comfort have kept you from starting trauma-focused therapy, virtual EMDR or ART may remove that barrier without compromising the work itself. Contact us with any questions about how virtual sessions work, or schedule your session to see if it’s the right fit for you.