Therapy & EMDR Intensives

Therapy and EMDR intensives seem like they are popping up everywhere. Several larger therapy practices are incorporating them to their services and it's only a matter of time before they are trending on social media (if they aren't already, that is). With so much buzz, it can be hard to tell if these are really necessary or helpful, especially when considering the cost of them. Let's take a look together at what they are, what the research is saying and who these can be helpful for.

Therapy and EMDR intensives are simply longer sessions. The length will depend on the therapist and their practice, but typically they are about 2-3 hours, but some go up to 8. For most therapists working with insurance, we are only able to bill for 53 minutes and insurance won't cover more than one session/week, unless there is a crisis or a specific need for it. While a lot can be accomplished in 53 minutes, it still is a short amount of time, especially if you are running a few minutes late. With a 2 hour+ time slot, that gives you more time to ease into session, start feeling comfortable and really transitioning into processing work, without having to be interrupted. With EMDR in particular, these intensives are helpful so that you can complete processing for each memory in session and not have to leave difficult wounds open. It gives you the time to really get into reprocessing, without having to be interrupted for winding down at session end, or if you need a break from reprocessing, but aren't quite done, you have the flexibility to do so.

Research on therapy, particularly EMDR, intensives is relatively scarce due to how new they are, but many researchers in our field are working on new studies to try and prove the validity of intensives to insurance panels. According to a study done in the Netherlands, where a lot of EMDR research tends to emerge from, EMDR intensives are effective long-term at managing PTSD symptoms to the extent that in their 3-month follow-up, some participants who engaged in EMDR intensives no longer met criteria for PTSD (van Pelt, Fokkema, de Roos, & de Jongh 2021). Another similar study was done in 2023 and found similar results, also including that no incidents occurred during the intensives, which is demonstrating mounting evidence towards the safety of EMDR intensives, as well as the efficacy (Bongaerts, Van Minnen, & de Jongh, 2023).

If you are considering an EMDR intensive, talk to your current therapist or find an EMDR therapist offering intensive sessions in your area. They can be completed virtually, or in person, depending on you and the therapist's evaluation of what is most appropriate. When deciding to do an EMDR intensive, understand that there is still an evaluation and assessment portion in the course of therapy. You and your therapist will need to meet a few times before the intensive to discuss safety planning and your history of symptoms and dissociation. You also want to discuss realistic outcomes with your therapist, such as how many intensives this may take and how many memories per session is realistic for you to try to work through. These are not the same for everyone. Depending on the number and intensity of your memories, only one or two memories may be processed in one intensive.

In the long-term, EMDR intensives are shown to be more cost effective. While they are more cost up front, oftentimes being able to work straight through the memory does go quicker than it being broken into several sessions, even though you're taking more time all at once. Also, if you are able to get through several memories in a period of time, this is also going to help with the cost effectiveness of doing an EMDR intensive. Do understand that upfront, however, the cost can be much greater than if you were to attend weekly sessions. Insurance will not cover intensive sessions at this time, but some researchers, such as Ricky Greenwald of the Trauma Institute, are passionately working to change this.

While much of this blog focused on EMDR intensives, please know that therapy intensives can offer the same values, just without the use of EMDR. 50 minute sessions are beneficial and what the vast majority of Americans receiving care receive, but it is also ok if you feel that it is not enough time for you to get your needs met. Intensive sessions don't have to be for EMDR only and again, the goal of your intensive session should always be discussed with the therapist during your assessment and evaluation.