EMDR vs CBT: Which Treatment to Choose

Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) are both psychotherapies used to treat various mental disorders. Whilst EMDR was popularized due to its success with Post Traumatic Stress Disorder, CBT is more commonly used to treat those with symptoms of anxiety and depression.

Throughout this article, we provide in-depth detail about both therapies to decipher which is the best therapy treatment to use for your client.

CBT: A Review

CBT relies on the concept that your feelings, thoughts, actions, and physical sensations are all interconnected. Therefore, negative thoughts and feelings can often trap you in a vicious cycle. To help patients with their problems, CBT therapy focuses on breaking down overwhelming problems into smaller parts. The patient is shown how to establish and change these negative patterns in their life to improve the way they feel. Unlike EMDR therapy, CBT focuses on current issues rather than past ones.

During CBT sessions, the therapist works with the individual to break down and separate out the issues. Thoughts, physical feelings, and behaviors are all identified and broken down – the therapist and individual work together to analyze each area and address how the unhelpful ones impact the client.After this process, the therapist helps the individual recognize negative thought patterns and behaviors in order to facilitate changing them.

Analyzing CBT

CBT as a treatment method has been proven to be viable for a wide range of mental health disorders, including:

• Anxiety
• Depression
• PTSD
• Psychosis
• Eating disorders
• Insomnia

CBT can also be used with individuals suffering from physical conditions, such as Irritable Bowel Syndrome (IBS) and Chronic Fatigue Syndrome to help better manage symptoms.

The structured nature of CBT allows for it to be provided in various formats, including self-help books, groups, and online courses. However, some patients may find CBT therapy to be very time-consuming because of the extra work required for it to be successful. This form of therapy can take a lot of commitment and lead to physical and emotional fatigue for the individual.

  of its rigid framework. Adapting this psychotherapy to suit specific needs for individuals can sometimes be difficult. The nature of this therapy may not be suited to those with severe mental illness – Individuals with complex mental health issues may require not benefit from a sole focus on their present lives. Instead, their mental illness may have stemmed from past experiences, such as an unhappy childhood, failed relationship(s) or something else. Therefore, these factors should be addressed within their treatment. CBT also focuses on the patient as having the sole responsibility for their feelings, thoughts and attitudes and fails to address external issues that may be worsening that person’s mental health.

EMDR: A Review

EMDR therapy, however, harnesses a very different approach. This form of psychotherapy focuses on past traumas potentially affecting the individual’s behavior currently. EMDR does not require talking about issues in detail - instead, this technique utilizes Bilateral Stimulation (BLS) to help the individual reprocess traumatic memories.

The initial phases of EMDR focus on history taking, client preparation, assessment, and desensitization. In these processes, the therapist establishes the underlying trauma that is contributing to the patient's current state. Once this has been verified, the therapist will then begin the process of BLS – asking the patient to focus on the physical sensation of tapping or eye movements. Through this method, the intensity of the traumatic memory becomes less severe, and the individual can reprocess their trauma without an overwhelming psychological response. You can find out more information about the EMDR process and how EMDR therapy works in our helpful guide.

Analyzing EMDR

As well as PTSD, EMDR has been proven as a viable treatment method for a range of disorders, including:

• Depression
• Anxiety disorders
• PTSD
• Psychosis
• Borderline Personality Disorder
• Eating disorders

CBT vs EMDR Therapy

Whilst both psychotherapies have relatively high success rates, you may still be wondering which therapy has the highest efficacy. Few studies have been done to figure out the best possible treatment for individuals experiencing depressive symptoms. However, research from compares the effectiveness of CBT vs EMDR and found interesting results:

‘The key result of this meta-analysis is, participants treated with EMDR had better alleviation of post-traumatic symptoms as compared to participants treated with CBT (p = 0.006). However, the superiority of EMDR at three months follow-ups was not evident. The EMDR also had a statistically significant superiority over CBT (p = 0.005) in alleviating anxiety. Although EMDR was observed to be better than CBT in reducing depression, this difference was not statistically significant.’

Though patients in these various studies found that EMDR was reportedly more helpful in alleviating symptoms of both depression, and anxiety, the data didn’t show the most significant statistical difference when compared to CBT therapy. EMDR showed a higher efficacy rate in reducing anxiety symptoms, and reducing stress in those suffering from PTSD:

‘Regarding reducing anxiety, the current meta-analysis reported that EMDR was better than CBT in alleviating anxiety, which is consistent with the findings of Moreno-Alcazar et al. (2017) who also found a statistically significant difference.’

The overall study showed that both psychotherapies were almost equally as effective – however, EMDR did show a slightly higher rate of efficacy in some instances. Though this study shows very promising results, it is important to notice the researchers only meta-analyzed three major databases. There are various that could have been considered also. For instance, in Seidler’s meta-analytic study comparing EMDR and CBT for treating PTSD, the results found that the treatments were equally efficacious. The contradiction in each study suggests that more can be done when delving into the subject of EMDR vs CBT.

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