Can I Do Trauma Therapy Online?
Updated: 6 days ago
It’s a reasonable question to have. Trauma therapy involves the body, the nervous system, and sometimes very physical sensations of activation or shutdown. It seems like the kind of work that would require being in the same room as someone. For a long time, many trauma therapists assumed the same thing.
That assumption has shifted because most of the approaches used for trauma-specific work translate to telehealth well, some almost seamlessly.
Brainspotting is a good example. It relies on eye position and internal processing rather than physical contact, which makes it naturally suited to video. A therapist can guide the process, track a client’s responses on screen, and support the same kind of processing that would happen in person. DBR works similarly. Neither approach was designed around touch to begin with, so the format doesn’t take much away from them either.
EMDR raised more questions early on, mostly around bilateral stimulation, the left-right pattern that’s part of how it works. In-office EMDR often uses a light bar or hand buzzers. For years, that made telehealth EMDR feel like a compromise. Purpose-built browser tools like BLS Studio have closed most of that gap, letting a moving visual target run right on a client’s own screen during a session, which keeps the bilateral component intact without requiring anyone to be in the same physical space.
Ego state and parts-oriented work tends to be the most straightforward of all. It’s primarily verbal and imaginal, working with internal parts through conversation and internal attention rather than physical technique. Most people find it translates to a screen with very little friction.
This doesn’t mean telehealth is a perfect substitute in every case. Someone managing significant dissociation or someone whose safety depends on a higher level of in-person containment, may genuinely need in-office support, at least for a period. And telehealth still requires the basics: a private space, a stable connection, and a willingness to stay engaged with body sensations through a screen instead of across a room. Those aren’t small requirements for everyone.
For many adults, though, especially those managing complex or long-standing trauma while juggling work, caregiving, or an unpredictable schedule, telehealth removes a barrier that used to keep trauma work out of reach entirely. It also opens access across the state rather than just within driving distance of one office.
Trauma therapy done online isn’t a lesser version of the in-person process. For most people, it’s the same work, adapted to a format that fits their actual life.
Trauma work doesn't require being in the same room to be real work. It requires the right approach, applied with the same care either way.
More on this at The Regulated Mind — subscribe on Substack for ongoing essays on nervous system regulation, complex trauma, and integration.
Nathanael "Nando" Schlecht is the founder of Nando Therapy, a Licensed Associate Counselor and trauma therapist based in Tucson, AZ, specializing in complex trauma, dissociation, and nervous system regulation. He is trained in DBR, Brainspotting, Ego State Therapy, EMDR, and ERP (Exposure and Response Prevention). Offering in-person sessions in Tucson and online therapy throughout Arizona.
Schedule a session: https://www.nandotherapy.com/therapy-contact
Related Reading:
How to Find a Trauma Therapist in Tucson What to look for in modality, pacing, fit, and format when deciding whether a trauma therapist is the right match.
What Happens in the First Trauma Therapy Session?
What the early phase of trauma treatment usually looks like before deeper processing begins.
When Is Dissociation a Trauma Response and When Is It Something Else? A closer look at dissociation and why some clients may need more careful pacing or additional containment during trauma work.
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