Preparing Clients for Online EMDR

Preparing a client for online EMDR covers two things: the clinical preparation that is part of the standard protocol (history, preparation and stabilisation), and the practical preparation that makes remote delivery reliable. This guide focuses on the practical side and on safety planning specific to remote work. Whether a given client is suitable for online EMDR remains a clinical decision.

What is established: preparation and stabilisation are core phases of the standard EMDR protocol (Shapiro, 2018).

What general telehealth guidance asks for: informed consent that addresses the remote modality, attention to privacy and security, knowing the client's location and local emergency resources, and a plan for technology failure (APA, 2013).

What is supported by some research: a systematic review found reductions in PTSD symptoms in the available online EMDR studies, though the evidence base was limited (Lenferink et al., 2020).

Use the checklist below over one or more sessions before reprocessing begins, so nothing is new on the day.

• A laptop, desktop or tablet; a phone screen is usually too small for comfortable visual BLS.
• An up-to-date browser.
• Device charged or on mains power, with power-saving and notifications turned off.
• A trial run of the BLS link in a preparation session. The client view is described in what a client sees during online EMDR.

• A private room with a closed door, where the client will not be interrupted or overheard.
• A comfortable seat facing the screen, with the screen roughly at eye level.
• Calm lighting without strong glare on the screen.
• Water and any personal grounding objects within reach.

• Fullscreen for visual stimulation.
• Headphones for auditory BLS, so tones alternate correctly between left and right.
• A comfortable volume checked before the first set.
• Screen positioned so the client can follow the stimulus edge to edge without turning their head (see using a monitor or TV as a light bar).

• Discuss who else is at home and whether the client can speak freely.
• Use your usual secure video platform; send the BLS link through a channel you already trust.
• Explain what the BLS tool does and does not collect. For BilateralSync, see the security page.

• Test the connection at the time of day sessions will be held.
• Agree a backup: phone number for the therapist to call if video fails.
• Agree that if the connection drops during reprocessing, the client uses a practised grounding resource and the session moves towards closure once reconnected.

• Informed consent that covers the online modality.
• The client's address during sessions and local emergency contacts.
• An updated safety plan, and support available after the session.
• Grounding and containment resources rehearsed online.

Closure considerations are discussed in remote EMDR closure and grounding; the full therapist-side workflow is in how to set up an online EMDR session.