EMDR Therapy: Proven Tool or Profitable Trend?

By Brandon Joffe, LCSW

Eye Movement Desensitization and Reprocessing (EMDR) is a proven, effective therapy for post-traumatic stress disorder (PTSD), supported by organizations such as the APA, WHO, and VA. Many clinicians have observed significant changes in clients' processing trauma with this approach. Nonetheless, despite EMDR's genuine therapeutic benefits, I am concerned about the way it is being taught, promoted, and implemented, especially among early-career therapists and within the broader training framework.

The Business Model of EMDR

Obtaining EMDR certification is costly. Basic training ranges from $1,200 to $4,000, with additional consultation hours with certified supervisors adding thousands more. While advanced training is common across therapeutic modalities, the structured, paywalled certification system of EMDR seems somewhat unethical. Opportunities have always existed to become certified in niche specialties. It appears the EMDR certification model focuses more on financial and time commitments rather than ensuring consistent, ethical, and effective practice.

More concerning is that the financial model seems to favor those who transition from client treatment to training others, prompting some to question if the modality sometimes serves more as a business venture than a therapeutic tool. This poses a potential research issue: how unbiased can studies be when the field is dominated by professionals profiting from selling the training?

Concerns About Associates in Training

A significant issue I've noticed is the rising number of unlicensed associate therapists receiving EMDR training. While these therapists are still acquiring core clinical skills, they are being directed towards an advanced modality requiring nuance and flexibility. As a supervisor, I've encountered issues when associates financially commit to the training, becoming more focused on EMDR rather than the basics I aim to teach. It’s crucial to note that mentors or certification supervisors do not assume responsibility for certification trainees. Associates remain under the supervision of their site supervisors, whose licenses are at stake.

There are three main concerns here:

1.   Financial Pressure: Associates typically earn modest incomes, and EMDR training is a significant investment. Once paid for, there's a strong incentive to use it, even if the client may not be suitable.

2.   Premature Specialization: Early-career clinicians should understand core theories and clinical frameworks. Diving into EMDR can shortcut this foundational process, leading to a narrowed perspective too soon in their development.

3.   Clinical Inflexibility: Many new EMDR-trained clinicians struggle to meet clients where they are, instead trying to fit clients into the EMDR protocol regardless of clinical appropriateness. This risks becoming technique-driven therapy rather than person-centered care.

A Protocol Without Consistency

EMDR is intended to be a standardized protocol, but in practice, the quality and style of training vary significantly depending on the instructor. Some trainings stress strict adherence to scripts, while others allow for flexibility and adaptation. This inconsistency undermines EMDR's credibility as a replicable, research-based approach. How can the research remain robust and generalizable if outcomes vary based on the trainer?

Expanding Use Without Research Support

Perhaps the most ethically troubling issue with EMDR is the growing trend of using it to treat conditions beyond trauma, such as anxiety, depression, addiction, and even chronic pain, often without strong empirical support. The APA and Cochrane Reviews clearly state that EMDR is evidence-based for PTSD, but its application for other diagnoses remains largely experimental. Yet, some therapists, particularly those early in their careers, are broadly applying EMDR because it's what they've been trained (and heavily paid) to do.

I had a conversation some time ago with an EMDR supervisor who was mentoring one of my trainees. This individual confidently stated that there is strong evidence showing EMDR is effective in treating addiction, anxiety, and depression. When I asked to see the studies supporting this claim, the materials I received used vague language in the summaries—phrases like “there may be indications that these issues can be treated.”

That kind of language might seem convincing to someone unfamiliar with research methodology, but it’s a far leap from actual evidence. In reality, the studies she sent didn't even directly measure the claimed outcomes.

This highlights a common issue: many people don’t know how to read research critically. As a result, they often misinterpret or overextend what a study is actually saying. It’s easy for hopeful or biased interpretations to get inserted into summaries or conclusions, and then for the general public—or even professionals—to mistake that for solid evidence. But just because something appears in the conclusion of a study doesn’t mean it was measured, demonstrated, or proven in the body of the research. People can project their hopes and aspirations into a study’s summary, but that doesn’t make it scientifically valid.

Applying a new treatment method to vulnerable clients for issues that lack strong research backing raises significant ethical concerns, particularly when those administering it are not yet licensed.

EMDR is not fraudulent. It is effective for many and can be transformative for some trauma clients. However, its current training approach prompts important questions about financial motivations, early use by inadequately trained clinicians, inconsistent teaching standards, and potential methodological bias in upcoming research.

As seasoned professionals, we must remain alert. The mental health field should prioritize clinical integrity over commercial gain, deep therapeutic engagement over quick specialization, and client-centered care over strict adherence to theory.