Can Trauma Therapy Be Done Online? What the Research Says
By Jessica Oliver MSW, LCSW | Aspire Counseling
For years, people assumed trauma therapy had to happen in person. And honestly? A lot of therapists thought so too.
Trauma work is deep. It's vulnerable. It often brings up intense emotions. So the idea of doing it through a screen felt risky—like something important would get lost.
If you've had these questions, you're in good company:
"Will online therapy even work for something this serious?"
"Can EMDR actually be done over video?"
"Can I really process trauma through a screen?"
These are fair questions. Until recently, we didn't have much research to answer them.
But now we do. And the results are surprisingly clear.
Online trauma therapy works. Not "kind of." Not "in a pinch." In many cases, it works just as well as in-person treatment.
Let's look at what the research actually shows.
Does Online EMDR Therapy Work for PTSD?
Yes—and the evidence is strong.
A systematic review published in Frontiers in Psychiatry examined 16 studies involving 1,231 participants and found that remote EMDR therapy produced meaningful reductions in PTSD symptoms, anxiety, and depression. The researchers concluded that online EMDR is both feasible and potentially as effective as in-person care.
Before 2020, many clinicians doubted whether EMDR's bilateral stimulation could be delivered effectively online. But the data now tells a different story. Clients improve. Symptoms decrease. Treatment is safe.
At Aspire Counseling, several of our therapists adapted their EMDR work to virtual sessions during the pandemic and never looked back. We use HIPAA-compliant video platforms and techniques like the butterfly hug for bilateral stimulation that work just as well through a screen as they do in our Lee's Summit or Columbia offices.
The bottom line: your brain doesn't care whether healing happens in an office or on a screen. What it needs is a skilled therapist guiding the process.
What Does the Gold-Standard Research Say?
Randomized controlled trials (RCTs) are the most rigorous type of clinical research. They're designed to answer one question clearly: does this treatment actually work?
A systematic narrative review in PMC that analyzed RCTs and meta-analyses found that EMDR therapy is effective for treating PTSD—reducing symptoms, improving diagnosis outcomes, and helping clients across different types of trauma and cultural backgrounds.
Meanwhile, the EMDR International Association documents a growing body of RCTs comparing online therapy to in-person treatment for trauma-related conditions. These include studies evaluating remote EMDR delivery across various populations, and early findings are promising.
This matters because the scientific community is taking online trauma therapy seriously—and the evidence base keeps growing. These aren't informal surveys or anecdotal reports. These are controlled studies designed to test whether virtual care can stand up to in-person treatment. So far, it can.
Can Severe or Complex PTSD Be Treated Online?
This is where people get most skeptical—and understandably so. If someone has been living with severe, chronic PTSD for years, can virtual therapy really make a difference?
A 2024 case study published in Frontiers in Psychiatry examined an intensive online trauma treatment that combined prolonged exposure and EMDR 2.0 for a client with severe, chronic PTSD from childhood trauma. The treatment was delivered entirely online over six days.
The client achieved full remission of PTSD symptoms. Those results held at both one-month and six-month follow-ups. Depression and general psychiatric symptoms also resolved.
This is important for a few reasons. It shows that even complex trauma can be treated remotely. It shows that intensive trauma formats—not just weekly sessions—can be adapted to telehealth. And it shows that clients can make meaningful, lasting progress without ever stepping into an office.
At Aspire Counseling, we've seen similar patterns with our own telehealth clients. We track progress using standardized clinical measures through our Blueprint outcome tracking system. For clients who came to us with PTSD, their scores on the PCL-5 (a widely used measure of PTSD severity) dropped from an average baseline of 30.8 to 14.09 at 20 weeks—an effect size of .93, which researchers consider a large, clinically meaningful improvement. Many of those clients were working with us online.
Has Online EMDR Been Tested in Specialized Populations?
Yes. Researchers aren't just studying online EMDR for "typical" PTSD. They're testing it with populations that have unique needs and barriers to care.
One example: a pilot randomized controlled trial published in Psychological Health studied online EMDR delivered to postpartum women who experienced traumatic births. After just one session, the EMDR group showed significantly higher rates of symptom remission compared to standard care at six weeks postpartum. The women had fewer flashbacks and less distress.
A separate feasibility study found similar results—postpartum women who received early EMDR showed more improvement in trauma-related psychological complaints than those who received usual care, even when they didn't meet full criteria for a PTSD diagnosis.
These studies tell us something important: online trauma therapy isn't just a workaround. It's adaptable. It can be delivered safely by trained professionals. And it can reach people who might never access specialized care otherwise—new parents, people with mobility limitations, and people who live hours from the nearest trauma specialist.
Why Does Online Therapy Work for Trauma?
Trauma therapy isn't about the room. It's about the relationship.
Healing happens when you feel safe, supported, grounded, and connected to your therapist. All of that can happen online.
In fact, many of our clients tell us they feel more comfortable processing trauma from home. They're wrapped in a blanket on their couch. Their dog is next to them. They don't have to drive 30 minutes after an intense session. They can take a few minutes to decompress in their own space before picking up the kids or going back to work.
Your nervous system doesn't need an office. It needs safety. It needs expertise. It needs someone who knows how to guide you through the hard parts without overwhelming you.
We talk a lot about the window of tolerance in trauma therapy—that zone where you can feel your emotions without being flooded by them. A skilled trauma therapist keeps you in that window whether you're sitting across from them or looking at them on a screen. That's what resourcing is all about—building internal tools to help you stay regulated as you do the deeper work.
Why Working With a Trauma Specialist Matters—Especially Online
Here's something we want to be direct about.
Not all therapy is trauma therapy. And not all therapists are trauma specialists.
Talking about your week can help you cope. Learning breathing exercises can get you through a hard day. But if you want to actually heal from PTSD—to stop carrying the past into every room you walk into—you need someone trained in evidence-based trauma treatment.
This is even more important online. Without specialized training, a well-meaning therapist might open up traumatic material without knowing how to help you contain it. That's like pulling threads from a tangled knot without knowing how to keep the whole thing from unraveling.
A trauma specialist knows how to open that up gently, work through it at a pace your nervous system can handle, and help you put things back in a way that feels organized and safe. That's true in person. It's true online. And the research supports it.
When looking for an online trauma therapist, ask about their specific training in approaches like EMDR, CPT, or TF-CBT. Ask whether they track outcomes. Ask how many trauma clients they've worked with. These questions matter more than whether the session happens in an office or on a screen.
Who Benefits Most from Online Trauma Therapy?
Online trauma therapy is especially helpful if you're:
A busy professional in Kansas City who can't take two hours out of your workday for a therapy appointment, commute included. (Some of our clients log on during their lunch hour or before the office opens—we wrote about this in our post on lunch hour therapy sessions.)
A parent who needs therapy during nap time or after bedtime because your schedule doesn't have room for anything else right now.
Someone living in rural Missouri with limited access to trauma specialists. If you're in Kirksville, West Plains, the Lake of the Ozarks area, or the Bootheel region, the nearest EMDR-trained therapist might be hours away. Online therapy eliminates that barrier entirely.
A trauma survivor who feels safer at home. Some people aren't ready to sit in a waiting room or drive to an unfamiliar office. Processing trauma from your own couch, with your own comfort around you, can actually make the work feel more manageable.
Someone with chronic pain, a disability, or health challenges that make commuting difficult or exhausting. You shouldn't have to spend your limited energy getting to an appointment.
A college student at Mizzou, Truman State, Missouri State, or any other campus in the state who needs specialized trauma care that isn't available through your university counseling center.
If you hold it together at work but fall apart at home... if you avoid certain places because they bring up memories you'd rather not feel... if you want to heal but sitting in a waiting room feels like too much right now—online therapy might be exactly what you need.
In other words, if you have a busy life and can’t get to a trauma specialist on a regular basis very easy…online trauma therapy might be a fantastic option.
Online Trauma Therapy at Aspire Counseling
Our trauma therapists are trained in evidence-based approaches including EMDR, CPT, IFS, and TF-CBT. Three of our EMDR therapists recently completed advanced training in integrating polyvagal theory into trauma processing—specifically to better serve clients who experience shutdown, dissociation, or emotional overwhelm during sessions.
We also offer trauma therapy intensives using CPT—a one- to two-week program where you meet with a therapist twice daily for concentrated, structured trauma processing. Some clients choose this option because weekly sessions feel too slow for where they are in life. However, it’s worth noting that our trauma intensives are generally held in person in our Lee’s Summit office.
How do I know online trauma therapy is working?
We don't just assume therapy is working—we measure it. Every client completes standardized assessments through our Blueprint outcome tracking system so we can see whether symptoms are actually improving. Our data shows consistent, measurable results: a 98% client satisfaction rate, large effect sizes across PTSD and anxiety measures, and strong therapeutic alliance scores that stay high throughout treatment.
We've helped clients across Missouri—from Kansas City to Columbia to small towns hours from either office—calm their nervous systems, sleep better, reduce panic, reconnect with loved ones, and finally process what happened to them.
You don't have to live near our Lee's Summit or Columbia offices to work with a trauma specialist. You can heal from anywhere in Missouri.
Ready to Find Out If Online Therapy Is Right for You?
Every new client starts with a free 30-minute consultation. You'll talk directly with a therapist—not a receptionist—about what you're going through and whether online therapy is a good fit.
Call us at (816) 287-1116 for our Lee's Summit office or (573) 328-2288 for Columbia. You can also request an appointment online.
No pressure, no judgment—just compassionate support when you're ready.
About the Author
Jessica Oliver (formerly Jessica Tappana), LCSW, is the founder and Clinical Director of Aspire Counseling. She earned her Master's of Social Work in 2012 and has been treating trauma and PTSD ever since. Jessica specializes in Cognitive Processing Therapy, EMDR, and trauma therapy intensives.
Jessica founded Aspire Counseling in 2017 because she saw too many people stuck in therapy that wasn't working—sessions that felt supportive but never actually resolved the trauma. She built a practice where every therapist is trained in at least one evidence-based trauma treatment, outcomes are tracked with standardized measures, and clients can access specialized care whether they're in Lee's Summit, Columbia, or logging on from their kitchen table in Poplar Bluff.
Her team includes therapists trained in CPT, EMDR, IFS, and TF-CBT who work with adults, teens, and children across Missouri. Three of Aspire's EMDR therapists recently completed advanced training in integrating polyvagal theory into trauma processing to better serve clients who experience shutdown or dissociation.
About Aspire Counseling
Aspire Counseling provides specialized therapy for trauma, anxiety, OCD, and depression at our offices in Lee's Summit and Columbia, Missouri, as well as online throughout the state. Our therapists are trained in evidence-based approaches including EMDR, CPT, ERP, IFS, and TF-CBT. We offer free 30-minute consultations to help you find the right therapist. Call (816) 287-1116 or reach out online to get started.
