Eye Movement Desensitization and Reprocessing (EMDR) is most commonly delivered individually, but researchers have developed structured adaptations that allow several people to participate in treatment at the same time.
Group EMDR uses many of the principles found in individual EMDR, including attention to distressing memories and bilateral stimulation, which involves alternating left-right sensory input.
The main difference is how these procedures are organized so participants can work on their own experiences within a shared session.
Research has examined group EMDR with adults and children affected by natural disasters, displacement, violence, and other distressing experiences.
The evidence suggests that group EMDR can help reduce post-traumatic stress disorder (PTSD) symptoms, depression, and anxiety. However, researchers also recognize important differences in study quality, treatment methods, and follow-up periods.
Why Was EMDR Adapted for Group Treatment?
Individual EMDR generally involves one therapist working with one person through a structured treatment process.
This format allows treatment to be tailored closely to an individual's experiences and needs.
However, researchers and clinicians have also explored ways to make EMDR available to larger groups, particularly when many people have experienced the same disaster or major event.
Group EMDR protocols were developed to allow several participants to receive structured treatment during the same session without requiring everyone to discuss their personal experiences publicly.
One of the earliest approaches emerged following Hurricane Pauline in Mexico in 1997, when mental health professionals were responding to the needs of children affected by the disaster.
This work contributed to the development of the EMDR Integrative Group Treatment Protocol, which combined standard EMDR principles with structured group activities.
Since then, researchers have investigated group adaptations in different countries and settings.
How Does Group EMDR Differ From Individual EMDR?
Group EMDR is not simply an individual EMDR session delivered to several people simultaneously.
It uses specific adaptations that allow participants to focus on their personal experiences while following a shared treatment structure.
Individual processing within a group
Participants may work on different memories or aspects of an event during the same session.
Although the therapist provides shared instructions, each person focuses on their own material.
Drawing and written exercises
Some group protocols use drawings, symbols, or written words to help participants represent distressing experiences.
This allows individuals to engage with their memories without explaining every detail to other group members.
Self-administered bilateral stimulation
In individual EMDR, therapists may guide eye movements, alternating sounds, or tapping.
Some group protocols use movements that participants can perform themselves, such as the Butterfly Hug or guided eye movements involving a worksheet.
These methods allow several people to engage in bilateral stimulation while receiving instructions from a group facilitator.
Structured session procedures
Group EMDR generally follows a defined sequence that includes preparation, identifying distressing material, processing, and closure.
The therapist or facilitator guides the group through the relevant activities while monitoring participants' responses.
What Is the EMDR Integrative Group Treatment Protocol?
The EMDR Integrative Group Treatment Protocol (EMDR-IGTP) is one of the most established group adaptations.
Developed by Ignacio Jarero, Lucina Artigas, and colleagues, the protocol combines EMDR's eight-phase approach with group treatment procedures.
It commonly uses drawings and the Butterfly Hug to support individual processing within a group.
How does the protocol work?
Participants begin with preparation activities that explain the treatment process and introduce ways to remain comfortable and focused.
They may then create drawings representing a distressing experience or a particular aspect of that experience.
Participants focus on their drawings while using bilateral stimulation.
After a period of processing, they may create another drawing and reflect on whether the experience feels different.
The process can be repeated as directed by the protocol.
Activities involving future expectations, body awareness, and closure may also be included.
Importantly, participants can work on their own material without being required to describe their memories in detail to the group.
The protocol has been studied with both adults and children, including people affected by disasters and ongoing stressful circumstances.
What Is the Butterfly Hug in Group EMDR?
The Butterfly Hug is a method of self-administered bilateral stimulation used in several group EMDR protocols.
It involves crossing the arms over the upper chest and gently tapping alternate sides of the body.
This creates a left-right pattern of sensory stimulation.
In group treatment, participants may use the Butterfly Hug while focusing on an image, drawing, or other material identified during the session.
The technique allows several individuals to engage in bilateral stimulation without the therapist having to guide each person's eye movements separately.
The Butterfly Hug is one component of a structured treatment protocol. It is not, by itself, equivalent to completing EMDR therapy.
What Is the EMDR Group Traumatic Episode Protocol?
Another established adaptation is the EMDR Group Traumatic Episode Protocol (G-TEP).
Developed by Elan Shapiro, G-TEP is based on an individual EMDR approach designed to address traumatic episodes.
The group version uses a structured worksheet that helps participants identify and process different aspects of a distressing event.
How does the worksheet approach work?
Participants use drawings, written words, or symbols to represent relevant parts of an experience.
The worksheet includes areas for identifying distressing material as well as personal resources and present-day supports.
Participants are guided to focus on specific aspects of the event while using bilateral stimulation.
Unlike protocols that primarily use the Butterfly Hug, G-TEP commonly incorporates eye movements guided by the worksheet.
This format helps organize treatment while allowing participants to work individually within the group.
G-TEP has been studied particularly among refugees and people affected by disasters or other major events.
Are There Different Group EMDR Protocols?
Yes. Researchers have described several group adaptations designed for different populations and circumstances.
A 2021 systematic review identified four main protocols used in the studies it examined.
| Group EMDR protocol | Main approach |
|---|---|
| EMDR Integrative Group Treatment Protocol (EMDR-IGTP) | Combines structured group activities, drawing, and the Butterfly Hug |
| EMDR Integrative Group Treatment Protocol for Ongoing Traumatic Stress (EMDR-IGTP-OTS) | Adapts the group protocol for people experiencing continuing stressful circumstances |
| EMDR Group Traumatic Episode Protocol (G-TEP) | Uses structured worksheets and bilateral stimulation to process aspects of traumatic episodes |
| EMDR Group Protocol for Children (EMDR-GP/C) | Uses age-appropriate activities and procedures designed for children |
These approaches share important EMDR principles but differ in how sessions are organized and how participants engage with the material.
Researchers therefore examine the outcomes of each protocol rather than treating every group EMDR intervention as identical.
What Does the Research Evidence Show About Group EMDR?
One of the most comprehensive reviews was published by Kaptan and colleagues in Clinical Psychology & Psychotherapy in 2021.
The researchers systematically examined studies investigating group EMDR in adults and children.
The review included 22 studies involving 1,739 participants.
Of these studies:
13 examined EMDR-IGTP.
4 examined G-TEP.
4 examined EMDR-IGTP-OTS.
1 examined a group protocol developed for children.
Twelve studies used a single-group design, measuring participants before and after treatment.
Ten studies included two groups, allowing researchers to compare outcomes between different treatment conditions.
What did the review find?
Across the included studies, group EMDR was associated with reductions in PTSD symptoms, depression, and anxiety.
Several studies also reported lower levels of subjective distress after treatment.
These findings suggested that structured group EMDR interventions may provide meaningful benefits for people experiencing trauma-related difficulties.
However, the review identified important methodological limitations.
The studies varied considerably in participant characteristics, treatment protocols, number of sessions, and outcome measures.
Because of these differences, the researchers could not combine the results into a single statistical meta-analysis.
They also identified concerns about the risk of bias in several studies.
The overall conclusion was that group EMDR showed encouraging results, but stronger research was needed to establish the consistency and size of its treatment effects.
What Have Randomized Controlled Trials Found?
Randomized controlled trials provide useful evidence because participants are assigned to different treatment conditions.
One study by Yurtsever and colleagues, published in Frontiers in Psychology in 2018, examined G-TEP among Syrian refugees experiencing post-traumatic stress symptoms.
The study included 47 adults, randomly assigned to either a group EMDR intervention or a control condition.
Eighteen participants received group EMDR, while 29 were assigned to the control group.
Participants receiving G-TEP completed two treatment sessions over three days.
Researchers measured PTSD and depression symptoms before treatment, afterward, and at a four-week follow-up.
What were the results?
The group receiving EMDR showed significantly greater reductions in PTSD and depression symptoms than the control group.
The study also reported that:
61.1% of participants receiving group EMDR no longer met the diagnostic criteria for PTSD after treatment.
This reduction was maintained at the four-week follow-up.
In the control group, 10.3% no longer met PTSD diagnostic criteria immediately after the study period, and 6.9% did so at follow-up.
These findings provided controlled evidence that G-TEP could reduce trauma-related symptoms in the population studied.
However, the sample was relatively small, and the follow-up period was short.
The researchers recommended larger studies with longer follow-up periods to examine whether similar results would be maintained.
What Has More Recent Group EMDR Research Found?
Research published after the 2021 systematic review has continued to examine group EMDR in different populations.
Group EMDR among forced migrants
A 2025 study by Chauliac and colleagues, published in the European Journal of Psychotraumatology, investigated an adapted G-TEP program for adults who had experienced forced migration.
The study included 71 participants with PTSD.
Researchers adapted the standard group protocol to include additional preparation and stabilization sessions, several trauma-processing sessions, and a final session focused on reintegration.
Participants completed standardized questionnaires measuring PTSD, depression, psychological distress, and quality of life.
The researchers found significant reductions in PTSD and depressive symptom scores.
Among 46 participants with paired scores on the relevant questionnaire, the proportion meeting questionnaire criteria for complex PTSD decreased from 60.9% before treatment to 15.2% afterward.
The study also reported an 80% average session attendance rate and a 15% dropout rate.
These findings suggest that the adapted group program was feasible and was associated with improvements in this clinical setting.
However, the study did not include a control group. The results cannot establish how much of the improvement was caused specifically by the intervention.
Group EMDR among adolescents affected by earthquakes
A 2026 study published in Frontiers in Psychiatry examined group EMDR among adolescents affected by the 2023 earthquakes in Türkiye.
The study included 120 adolescents aged 13 and 14, with 62 participants in the intervention group and 58 in a comparison group.
Researchers examined PTSD symptoms, anxiety, depression, and resilience.
The study reported improvements in trauma-related symptoms and psychological well-being among adolescents receiving the group intervention.
Participants also described the value of activities involving drawing, preparation, and group support.
Because the study used a nonrandomized design, its findings need to be interpreted with that limitation in mind.
Together, these more recent studies add information about how group EMDR can be adapted for different populations, although they do not remove the need for larger, well-controlled trials.
Is Group EMDR as Effective as Individual EMDR?
Research has not established that group EMDR is consistently equivalent to individual EMDR across different conditions and populations.
The two approaches share treatment principles, but they differ in how procedures are delivered and how much individual attention is available during a session.
The 2021 systematic review included only a small number of studies that directly compared group EMDR with another active treatment, including individual EMDR.
This means the available comparisons are not sufficient to conclude that the approaches produce identical outcomes.
What can be said with more confidence is that group EMDR has demonstrated beneficial outcomes in several research settings.
Whether group or individual treatment is more appropriate may depend on the person's needs, preferences, and the particular treatment program.
What Are the Potential Benefits of Group EMDR?
Researchers have identified several practical reasons for investigating group EMDR.
Greater access to treatment
Group sessions allow several people to participate during the same period.
This may be helpful in settings where many people are seeking support and access to individual appointments is limited.
Less need for detailed verbal disclosure
Drawing and worksheet-based activities allow participants to work on personal experiences without publicly describing every detail.
This can make group participation more approachable for people who prefer greater privacy.
Shared support
Being part of a group may offer a sense of connection with others who have experienced difficult circumstances.
However, the amount of interaction varies between protocols, and group EMDR does not necessarily involve extensive sharing.
Adaptability across settings
Researchers have used group EMDR with children, adolescents, adults, refugees, disaster survivors, and other populations.
The use of drawings, symbols, and structured instructions also provides opportunities to adapt activities for different ages, languages, and cultural contexts.
These are potential advantages of the format. They do not mean that group treatment automatically produces better outcomes than individual care.
How Do Researchers Measure Whether Group EMDR Works?
Researchers evaluate group EMDR using several types of outcome measures.
| Research outcome | What it measures |
|---|---|
| PTSD symptom severity | Changes in unwanted memories, avoidance, emotional reactions, and other trauma-related symptoms |
| Depression | Changes in depressive symptoms before and after treatment |
| Anxiety | Changes in reported anxiety and associated distress |
| Subjective distress | How upsetting a particular memory or experience feels to the participant |
| Daily functioning | Changes in the ability to manage activities and responsibilities |
| Treatment participation | Attendance, completion, and dropout rates |
| Follow-up outcomes | Whether improvements are maintained after treatment ends |
Some studies use structured clinical interviews, while others rely on standardized self-report questionnaires.
Both approaches provide useful information, although they measure somewhat different aspects of participants' experiences.
Researchers may also compare participants receiving group EMDR with people receiving another intervention or with those assigned to a waiting-list condition.
Including comparison groups helps determine whether observed improvements are greater than changes that occur without the specific intervention.
What Are the Limitations of Group EMDR Research?
Although group EMDR research includes encouraging findings, several limitations remain important.
Differences between treatment protocols
Not all group EMDR studies use the same procedures.
Some use drawings and the Butterfly Hug, while others use structured worksheets and guided eye movements.
This makes it difficult to combine findings across studies.
Small participant groups
Several controlled studies have included relatively small samples.
Larger trials would help researchers determine how consistently the findings apply to different populations.
Limited long-term follow-up
Some studies assess participants only shortly after treatment.
Longer follow-up periods would provide more information about whether improvements continue over time.
Differences in study quality
The 2021 systematic review identified methodological concerns, including reliance on self-reported outcomes and limitations in how participants were assigned to treatment groups.
These factors affect confidence in the reported results.
Limited direct comparisons with individual EMDR
More studies comparing group EMDR with individual EMDR would help clarify whether outcomes differ across treatment formats.
These limitations do not invalidate the improvements observed in published studies. They explain why researchers continue to investigate group EMDR using more rigorous methods.
What Questions Could Future Group EMDR Research Explore?
Future research could examine which group EMDR protocols are most effective for different populations and circumstances.
Larger randomized controlled trials could compare group EMDR with individual EMDR and other established treatments.
Researchers could also investigate whether treatment outcomes differ according to group size, number of sessions, participant age, or the type of distress being addressed.
Longer follow-up assessments would help determine how consistently improvements are maintained.
Another useful area of research involves understanding which parts of group treatment contribute most to the results, including bilateral stimulation, structured exercises, individual processing, and the group environment.
These questions could help clarify how group EMDR works and how treatment programs can be organized effectively.
What Is the Main Takeaway?
EMDR has been adapted for group treatment through structured protocols that allow several participants to work on their own distressing experiences during the same session.
Approaches such as EMDR-IGTP and G-TEP use drawings, worksheets, bilateral stimulation, and guided procedures to make EMDR suitable for group settings.
Research involving adults, children, refugees, and disaster survivors has found reductions in PTSD symptoms, depression, and anxiety following group EMDR interventions.
A systematic review of 22 studies involving 1,739 participants identified encouraging results while also highlighting limitations in study quality.
More recent studies have added evidence about the practical use of group EMDR in different treatment settings.
Overall, group EMDR is a structured adaptation with encouraging research findings. Further large, controlled studies are needed to clarify its effectiveness across different populations and how its outcomes compare with individual EMDR.
References
Kaptan, S. K., Dursun, B. O., Knowles, M., Husain, N., & Varese, F. (2021). Group eye movement desensitization and reprocessing interventions in adults and children: A systematic review of randomized and nonrandomized trials. Clinical Psychology & Psychotherapy, 28(4), 784–806.
https://doi.org/10.1002/cpp.2549Jarero, I., Artigas, L., & Hartung, J. (2006). EMDR Integrative Group Treatment Protocol: A postdisaster trauma intervention for children and adults. Traumatology, 12(2), 121–129.
https://doi.org/10.1177/1534765606294561Yurtsever, A., Konuk, E., Akyüz, T., Zat, Z., Tükel, F., Çetinkaya, M., Savran, C., & Shapiro, E. (2018). An eye movement desensitization and reprocessing (EMDR) group intervention for Syrian refugees with post-traumatic stress symptoms: Results of a randomized controlled trial. Frontiers in Psychology, 9, 493.
https://doi.org/10.3389/fpsyg.2018.00493Chauliac, N., Vignaud, P., Butet, C., Gautheron, M., Salome, G., Salles, L., Galia, P., & Prieto, N. (2025). Applicability and effectiveness of group EMDR therapy for forced migrants. European Journal of Psychotraumatology, 16(1), 2583875.
https://doi.org/10.1080/20008066.2025.2583875Filazoglu Cokluk, G. (2026). Group EMDR therapy for disaster-affected adolescents: Evaluating effectiveness and navigating implementation challenges in PTSD, depression, and anxiety. Frontiers in Psychiatry, 16, 1691529.
https://doi.org/10.3389/fpsyt.2025.1691529EMDR International Association. EMDR Early Intervention Toolkit.
https://www.emdria.org/library-copy/publications-resources/practice-resources/emdr-early-intervention/
