Rehab Centers That Offer EMDR Therapy

EMDR therapy is a structured form of psychotherapy used to help people process distressing memories or trauma. This guide explains how EMDR treatment works, who it might help and how it can fit into addiction treatment. It also provides checklists and other resources to help you choose a qualified EMDR counseling provider or a rehab that includes EMDR for trauma-informed care.

EMDR stands for Eye Movement Desensitization and Reprocessing. While it sounds quite technical, this therapy helps you reprocess distressing or traumatic memories so they’re less triggering. Through this reprocessing therapy, you pull the rug out from under traumatic or frightening memories so they have less power over your cognitive and emotional state.

It’s a type of talk therapy, although it’s more than simply talking through your challenges or emotions. This evidence-based trauma therapy also leverages bilateral stimulation, such as rapid eye movement, to help individuals make potentially fast gains in treatment.

EMDR is based on the theory that some thoughts get “stuck” in your brain’s system. As you go through each day, your brain processes experiences and information, filing things away into functional areas of memory. However, when faced with an extreme or traumatic experience, fear and other intense emotions can “stall out” the brain’s system.

The result can be that thoughts and memories associated with that experience aren’t processed fully. They feel intense and new each time you consider them, which can lead to a cycle of emotional and behavioral responses that might include panic attacks or substance use.

Through EMDR reprocessing, a trained therapist works with you to help your brain properly deal with these types of memories and thoughts. Part of the EMDR process includes using bilateral stimulation, such as eye movements or tapping, to reduce the intensity with which your brain grabs on to those memories.

EMDR can be an effective treatment tool in various situations. Whether this therapy approach is right for you depends on an assessment of your needs, current stability and treatment goals.

How eye movement desensitization and reprocessing can help:

• EMDR for PTSD. Working to reduce the intrusive nature of past memories can support treatment for post-traumatic stress disorder.
• EMDR for anxiety. When anxiety disorders are linked to distressing events in the past, EMDR may help.
• EMDR for trauma triggers. Lessening the emotional intensity of triggers related to a disturbing event can help you step forward on your recovery journey.
• EMDR for grief. Someone stuck in a painful grief cycle may find it helpful to better process unresolved emotions and sad memories with EMDR.
• EMDR for shame. EMDR can help reduce the impact of negative shame beliefs that may develop after trauma.

Many times, substance use and trauma are connected. Distressing memories, unresolved emotions or chronic stress — all common after traumatic experiences — can cause someone to use alcohol or drugs to self-medicate or increase cravings for substance use. Addressing trauma as part of addiction treatment can support engagement with recovery, better trigger management and long-term coping skills.

However, EMDR isn’t a standalone treatment for substance use disorder. It’s typically used with other evidence-based care, including cognitive behavioral therapy (CBT), medication-assisted treatment (MAT) and relapse prevention planning.

EMDR readiness depends on your ability to tolerate facing emotions within structured trauma-focused environments.

EMDR may be a valuable part of treatment when:

• Distressing memories and related triggers show up consistently in daily life and negatively impact functionality and recovery
• Someone can tolerate thinking about and experiencing trauma-related memories and emotions during sessions with support from a therapist
• Individuals have stable enough routines that they can handle trauma work safety, such as the secure environment supported by a residential rehab
• You receive integrated treatment due to co-occurring mental health and substance use disorders

EMDR is often part of treatment after early detox and rehab. EMDR is typically not a first step when:

• Individuals face unmanaged crises or unsafe living situations that negatively impact EMDR safety, including active withdrawal
• A provider recommends stabilization before EMDR for any reason
• Trauma therapy readiness isn’t apparent for any reason

When therapists and other providers work with someone on a treatment plan for trauma-informed care, they consider what type of therapy is most helpful. They also discuss when each approach might be most appropriate — even if EMDR isn’t right for you now, it may be later.

EMDR session structure changes slightly as you move through its phases.

Here’s a rundown of what happens in EMDR over time:

• Intake and treatment planning. Your therapist takes time to get to know you, your challenges and your goals so they understand what to approach through EMDR.
• Identifying targets and making a plan. You’ll work with your therapist to identify memories and experiences to target and make a plan for reprocessing them.
• Learning coping skills and resourcing tools. Your therapist will help you start building internal and external resources to support recovery.
• Preparation and reprocessing. You’ll attend therapy sessions to prepare for memory reprocessing before the actual reprocessing sessions.

Throughout EMDR preparation and EMDR reprocessing sessions, your therapist will check in by asking you to rate SUD and VOC so they understand where your distress levels are and whether you’re in an appropriate window for toleration.

EMDR treatment phases support a careful approach to memory processing. Each session typically lasts 60 to 90 minutes. Some phases take several sessions; later phases may take place during each session.

The eight phases of EMDR are:

1. History and treatment planning. For the first few sessions, your therapist talks to you about your history and traumatic experiences. Together, you select specific targets — past events and thoughts — to address with EMDR.
2. Preparation. During this phase, you work on learning techniques to help you deal with any emotional disturbances that might come from EMDR work. Across multiple sessions, your therapist will help ensure you’re stable and prepared for memory processing.
3. Assessment. The third phase requires you to consider the targets — the memories and thoughts — and associate them with negative self-beliefs. You’ll also pick a positive self-belief you want to replace them with and rate emotions and beliefs on the VOC and SUD scales. The goal is to create a baseline from which to approach the rest of EMDR treatment.
4. Desensitization. EMDR desensitization involves focusing on the target thought or memory while the therapist leads you through bilateral stimulation. Depending on your preferences and needs, you may move your eyes back and forth, listen to bilateral sounds or experience tapping. The goal is to reduce the target’s impact on your thoughts and emotions, thereby decreasing SUD.
5. Installation. During EMDR installation, you work on strengthening positive beliefs and increasing VOC.
6. Body scan. During this time, you consider the original target and pay attention to any tension or body sensation related to negative thoughts, emotions or the target memory. EMDR body scanning helps you discover if there’s more work to do on a specific target.
7. Closure. At the end of every session, your therapist takes you through closing out the work done in that session and understanding what might occur before the next.
8. Reevaluation. At the beginning of every new session, your therapist takes you through evaluating the work done so far and whether any adjustments are required to the treatment plan.

EMDR side effects occur in some cases, although studies tend to indicate that they’re mild to moderate and temporary.

Side effects may include:

• Temporary increased emotional intensity and vivid dreams
• Fatigue
• Feeling unable to settle well between sessions

EMDR emotional intensity and other side effects are why strong safety planning and coping skills work are necessary. While most side effects are mild, you should contact your provider right away if you experience severe, frightening or otherwise worrying side effects.

Understanding EMDR vs CBT or other trauma therapy options can help you make informed treatment decisions.

In many inpatient rehabs and outpatient treatment programs, integrated therapy plans include several options, such as:

• Cognitive behavioral therapy. CBT focuses on identifying and changing thought and behavior patterns.
• Exposure-based approaches. Exposure therapy works through gradual focus on memories or traumatic situations to reduce potentially unhelpful avoidance habits.
• Dialectical behavior therapy. DBT focuses on emotional regulation and distress tolerance.
• Motivational enhancement therapy. This approach helps build a person’s internal motivation to change substance use behaviors or engage in rehab and long-term recovery.

EMDR can be used in a variety of treatment settings, including:

• Residential rehab
• Intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs)
• Traditional outpatient office settings
• Telehealth

Providers will consider pacing and intensity of EMDR to match the treatment setting and your needs. For example, in residential settings, EMDR may be sequenced between stabilization and discharge planning. Outpatient office settings or telehealth EMDR might be part of continued aftercare.

EMDR therapist qualifications and other signs of high-quality treatment are important to look for.

Follow this checklist when considering EMDR options:

• Ensure the rehab or program is accredited by a third-party accrediting body for mental health care, such as the Joint Commission or CARF.
• Ask whether the facility holds a state license, if applicable.
• Therapists should be credentialed and have experience in EMDR therapy.
• The treatment approach should include strong stabilization and resourcing and shouldn’t rush right into reprocessing.
• Ask whether the provider is experienced in treating co-occurring substance use and mental health disorders, if applicable.
• Ensure the therapist works with other clinicians in inpatient environments or coordinates care with your other providers in outpatient environments.
• The provider should offer clear, written policies for safety, support between sessions and crisis planning.

An unqualified EMDR therapist or rehab center that doesn’t work with your best interests in mind can do more harm than good for your recovery.

EMDR red flags to watch for include:

• A provider that’s unable or unwilling to explain their licensing, accreditation or relevant training
• Skipping the assessment and preparation phases
• A therapist who dismisses your concerns about safety or pressures you to continue EMDR therapy despite concerns
• Guarantees about outcomes or one-size-fits-all treatment approaches
• No plan for coordinated care, especially when treating co-occurring conditions

The cost of EMDR treatment depends on your insurance coverage, how many sessions you need and your treatment level of care. Before committing to addiction treatment or EMDR therapy, ask for a full insurance verification.

This helps you understand:

• Whether the provider is in-network. Insurance companies typically cover in-network claims at higher amounts than out-of-network claims.
• What your deductible and copay are. These figures help you understand how much of the treatment you may be responsible for.
• Whether your plan covers EMDR and how many sessions. Some policies limit the number of sessions paid for each year.

You can also ask potential providers about EMDR cost and whether they offer sliding scales or financial assistance.

Questions to ask an EMDR therapist include:

• What training do you have in EMDR?
• How do you structure the phases?
• How will we decide if I’m ready for reprocessing work?
• What coping tools will I have to use between sessions?
• How do you handle high distress reactions?
• How do you coordinate care if I’m in addiction treatment or taking medication?
• What’s your plan if symptoms spike or cravings increase?

EMDR is one potential tool that might be used in recovery, particularly when someone has a history of trauma or a co-occurring diagnosis of anxiety or PTSD. Continuing care, strong relapse prevention support and a personalized treatment plan are essential to supporting success with any type of treatment, including EMDR.

If you’re ready to start your recovery journey, Help.org can help you find a rehab center that offers EMDR therapy.