Can Bilateral Therapies Like EMDR and ART Work Over Telehealth?

Written by Tina Spendlove, LCMHC

If you have been thinking about bilateral modalities like EMDR or ART for trauma, you may wonder whether it has to happen in an office. For many people, it does not. Bilateral modalities can be done over secure video, and early research on online delivery of services is encouraging. At Podera, these sessions are available by telehealth to adults in Utah, Idaho, and Washington.

This article explains what bilateral stimulation is, how it works on a screen, what the research does and does not show yet, and how to decide whether online bilateral stimulation fits you. Your own goals and comfort level stay at the center of that decision.

What Bilateral Stimulation Is

EMDR stands for Eye Movement Desensitization and Reprocessing, and it uses bilateral stimulation (BLS). It is a structured therapy for posttraumatic stress disorder (PTSD) and other distress tied to painful memories, and was the first bilateral approach, and it is still the most studied.

In BLS, you briefly bring an upsetting memory to mind while paying attention to a back-and-forth movement or touch. The U.S. Department of Veterans Affairs describes how this works in EMDR: the movement helps you stay grounded in the present while your brain processes the past memory. Over time, many people find the memory feels less charged, and they build more helpful beliefs about themselves.

ART, or Accelerated Resolution Therapy, was developed in 2008 by Laney Rosenzweig, a marriage and family therapist. Like EMDR, it uses guided side-to-side eye movements while you hold a memory in mind. ART also pays close attention to what you feel in your body, and it adds a step called voluntary image replacement: you choose new images to replace the distressing ones. You still remember what happened, but the painful pictures lose their grip. You don't have to describe the memory out loud, and ART is often brief, usually one to five sessions of about an hour.

EMDR and ART at a glance:

  • EMDR: more open-ended, your mind goes where it needs to, often about three months of weekly sessions

  • ART: more structured and guided by the therapist, adds image replacement, often one to five sessions

A few things often surprise people:

  • You do not have to describe every detail. You think about the memory, but you usually do not need to tell the whole story out loud.

  • There is no homework. BLS does not require practice assignments between sessions.

  • It starts with preparation. Early sessions focus on learning about trauma reactions and building coping skills before any memory work begins.

A typical EMDR course lasts about three months of weekly sessions lasting 45–60 minutes. Everyone's pace is different, and you and your therapist decide together what to work on and when.

How BLS Works Over Video With EMDR and ART

The steps of BLS stay the same online. What changes is how the back-and-forth movement or touch reaches you. Common options include:

  • Eye movements on screen. You follow a moving object, or a dot that moves across the screen.

  • Tapping. You gently tap your own knees or shoulders, alternating sides.

Your therapist will help you find the method that feels most comfortable. Some people try more than one.

ART uses the same on-screen eye movements, in short sets, with check-ins about what you notice in your body between sets.

A little setup goes a long way:

  • A private room where you will not be interrupted

  • A stable internet connection and two screens, such as a laptop and a tablet. One screen to follow the moving object, and the other to connect with the therapist.

  • A backup plan with your therapist, such as a phone number to call if the video drops

  • Time after the session to rest or take a nap before jumping back into your day

Some people prefer doing this work from home. You are already in a familiar place when the session ends, and there is no drive afterward.

What the Research Says

EMDR itself is a well-studied trauma therapy. The 2023 VA/DoD PTSD guideline recommends three individual therapies for PTSD: prolonged exposure, cognitive processing therapy, and EMDR. Not every guideline ranks it the same way. The American Psychological Association's 2025 guideline lists EMDR as a second-line option, a decision some EMDR researchers have challenged.

Research on EMDR and BLS over video is newer and still growing:

  • A 2024 systematic review in Frontiers in Psychiatry looked at 16 studies of remote EMDR with 1,231 participants. The authors found promising reductions in PTSD symptoms, anxiety, and depression. They also noted small samples, few control groups, and reliance on self-reported measures.

  • A 2021 survey study in Frontiers in Psychology gathered reports from 23 therapists on 102 video EMDR sessions. Patients' distress ratings dropped by about 73% within a session, similar to in-person studies. This was an early, uncontrolled study of single sessions, so it cannot prove how well full treatment works.

ART is newer than EMDR, so the research is still catching up, but what's there so far is encouraging. A 2024 review of five studies, including two randomized trials, found that people's PTSD symptoms dropped a lot. The researchers called ART promising and hope to see more large trials, and so do I. Published studies haven't looked at ART over video yet. It uses the same guided eye movements as online EMDR, which early research supports.

I'm also encouraged by research on the back-and-forth movement itself. A review of 26 studies found that adding eye movements helped painful memories feel less vivid and less upsetting. One small study found eye movements worked better than tones.

The fair summary: online EMDR (or BLS) looks feasible and promising, and larger controlled trials are still needed. No therapy, online or in person, can promise a specific result.

Is Online BLS, Like EMDR or ART, a Good Fit for You?

Online BLS may be worth exploring if:

  • Painful memories still feel vivid or keep intruding on your life

  • You want a structured approach that does not require retelling every detail

  • Getting to an office is hard because of distance, schedule, health, or caregiving

  • You feel more at ease working from your own space

  • You'd like a brief, structured approach like ART

Sometimes a different plan makes more sense first. You and your therapist might slow down, spend more time on coping skills, or consider in-person or more intensive care if:

  • You are not safe right now, or you are still in an unsafe situation

  • You often lose track of time or feel disconnected from your surroundings when stressed

  • You do not have a private, quiet place for sessions

These are not rules about who can or cannot do BLS. They are topics to talk through together, so the plan matches your needs and goals. If you are in crisis, call or text 988 or call 911.

BLS (EMDR and ART) at Podera Therapy

Podera is a telehealth-only practice based in Utah. As a therapist at Podera, I offer EMDR, along with Accelerated Resolution Therapy (ART) and Internal Family Systems (IFS). I offer these modalities to adults 18 years old and up. The states where I hold a license include Utah, Idaho, and Washington, so BLS is available to adults located in those states.

If you live in Nevada, North Carolina, Oregon, or South Carolina, reach out anyway. We can talk through what Podera can offer in your state or help you find a good referral. You can also learn more on our trauma and PTSD therapy page.

Therapy at Podera follows your lead. You decide what you want to work on, and your values and goals shape the plan. Faith-informed care is available if you want it, and secular therapy is always an option.

We accept many insurance plans and also offer self-pay rates. See Insurance & Rates or our guide, Does Insurance Cover Online Therapy?

Frequently Asked Questions

Is online BLS as effective as in-person? Early studies are promising, but most were small and lacked control groups. Researchers are still running larger trials. Your therapist can talk with you about whether video is a good fit.

Is ART faster than EMDR? ART is designed to be brief, often one to five sessions in studies, while EMDR often runs about three months of weekly sessions. No studies have compared them head-to-head yet, and your pace depends on you and what you're working on.

Do I have to talk about my trauma in detail? Usually not. You will think about the memory during processing, but you do not need to share every detail out loud.

What if I get overwhelmed during a session? Preparation sessions build calming skills first. During processing, you can pause at any time, and your therapist will help you settle before the session ends.

Can teens do online BLS at Podera? My work is with adults. If you are 14 to 17 and want therapy for yourself, reach out to ask what options are available.

Take the Next Step

Curious whether online BLS could help you? Book a free 15-minute consultation. We will answer your questions, check that we are licensed where you live, and talk about whether EMDR, ART, or another approach fits your goals. There is no pressure and no commitment.

Schedule your free 15-minute consultation or call or text (385) 351-5473.

This article is for education only. It is not a diagnosis or a substitute for care from a licensed professional.

Sources

Tina Spendlove, LCMHC

Tina is a licensed clinical mental health counselor at Podera Therapy. She helps adults move through trauma, anxiety, and low self-worth using ART, EMDR, and IFS, and sees clients by telehealth in Utah, Idaho, and Washington.

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