> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.

# Best practices for virtual EMDR

> Client environment, browser window, headphones, and how to choose between EMDR 2.0 and Classic — the operational notes that make remote BLS work.

EMDR over video adds a few constraints that aren't there in the in-office
version — bandwidth, screen size, audio delivery, client environment. None
of them are blockers, but each one rewards a small amount of preparation
before the session.

## The client's environment

Before the first session, send a short pre-session note covering the
basics. The defaults that matter:

* **Private, quiet room** — a door that closes. EMDR work is emotionally
  intense; the client needs to know no one else can hear or see them.
* **Stable seating** — a desk chair or armchair, not a couch they sink
  into. Posture matters for visual tracking and for the body scan.
* **Good lighting on their face** — front-lit so you can read their
  expression. Backlight from a window is the worst case.
* **Plug in or charge to 50%+** — a phone dying mid-set is a real
  failure mode. Have them plug in before joining.
* **Tissues nearby** — practical, and signals you've thought through the
  hour.

This is not Rivet-specific — it's standard telehealth prep. Roll it into
your existing pre-session note.

## The browser window

The BLS canvas fills whatever viewport the client is in. That means:

* **Phone in portrait** works but the canvas is tall and narrow. Horizontal
  paths read smaller relative to the screen. A phone in **landscape** gives
  the stimulus more horizontal range — recommend it for the first session.
* **Tablet** is the sweet spot. iPad in landscape, Android tablet, both
  give a comfortable canvas with the client at a natural distance.
* **Laptop or desktop** works well — full-screen the browser so menu bars
  and tabs don't pull focus.
* **External monitor with the client at 24"+ distance** — large stimulus,
  natural eye movement range. Excellent for in-office hybrid setups.

In your pre-session note, ask the client to **maximize or full-screen the
browser window** before they join. Browsers handle full-screen with F11
(Windows / Linux) or Cmd+Ctrl+F (macOS), or the maximize button on the
title bar.

## Headphones for the audio modality

If you're running EMDR 2.0 (the default), the audio modality is on. For
the audio to work as bilateral stimulation, the client needs **stereo
audio output** with a clear separation between left and right.

Recommend, in order:

1. **Over-ear or on-ear headphones** — best. Full L↔R separation.
2. **Wired earbuds** — equivalent, smaller footprint. Have these as a
   fallback if the client doesn't have headphones.
3. **AirPods or Bluetooth earbuds** — work, but warn the client that
   Bluetooth audio occasionally hiccups and the audio modality could
   stutter during reconnects.
4. **Laptop speakers** — work, but the L↔R panning is much weaker when
   both speakers are 6 inches apart. Acceptable for trial; suboptimal for
   ongoing work.
5. **Phone speakers** — single mono output on most phones. **Audio
   modality is functionally lost.** Either switch to visual + haptic, or
   ask the client to add earbuds.

Mention headphones explicitly in your pre-session message. The single
biggest preventable failure mode is a client with great visual and a
mono speaker.

## EMDR 2.0 vs Classic — choosing

Rivet defaults to EMDR 2.0 as the launch mode. The published outcomes are
equivalent to Shapiro standard with fewer sets needed. But the choice
matters per client.

Reach for **EMDR 2.0** when:

* You're trained in EMDR 2.0 and comfortable with the dual-task pacing
* The client tolerates the multimodal stimulation (visual + audio)
* The client engages well with cognitive load — they can count
  backward, name categories, do mental math without overwhelm
* You want shorter sessions or fewer sessions to reach the same SUDS
  reduction

Reach for **Classic** when:

* You're trained in Shapiro standard EMDR and want to stay in that
  protocol
* The client is overwhelmed by multimodal stimulation
* The client has cognitive load limits — head injury history, ADHD,
  active substance withdrawal — that make dual-task prompts counter-
  productive
* The session is doing resource installation (Phase 2) where the
  goal is calming, not loading

This is a per-client and per-session choice, not a permanent setting.
Switch between the modes in the Configure modal at any time.

## Pace within the session

A few orienting notes that come from EMDR clinical practice, not from
Rivet's tooling:

* **Start with a brief test set.** Before any reprocessing, run a short
  set with neutral content — count backward from 50 by 3s, looking at the
  butterfly, for 20 seconds. Check the client tolerates the stimulus
  before introducing the target.
* **Watch the SUDS curve as you go.** Each between-sets card shows the
  sparkline so far. A descending line is the typical pattern. A flat or
  rising line is a clinical signal — adjust the rate, switch the
  dual-task category, or check the target.
* **Plan for closure.** Don't run reprocessing into the last 5 minutes of
  the hour. Whatever the SUDS arc looks like at that point, you need time
  for the Container resource or another closure tool. The
  [Container template](/clinical-templates/emdr/container) lives in the
  EMDR templates section for this reason.

## Network conditions

Rivet's video is end-to-end encrypted. About 90–95% of sessions connect
directly between you and the client; 5–10% go through a relay when a
direct connection isn't possible — the relay passes encrypted data it
can't read.

A weak connection degrades video here the way it does anywhere. **Rivet
will not stop a set for you** — a set runs its own timer regardless of what
the connection is doing. So if the picture stalls, the sound breaks up, or
you lose sight of your client's face partway through a set, stop the set
yourself, get the connection back, and start the next one when you can see
them again. See [Practitioner controls](/emdr/practitioner-controls).

Worth agreeing on this with your client before the first set, the same way
you'd agree what happens if the call drops mid-hour: if either of you loses
the other, the set stops.

## What to do at session end

After the last set's SUDS, the session arc card renders. Before tapping
Done, **tap Copy** to drop the session summary on your clipboard. Paste
it into your session note or your EHR. The values clear when the
Workspace closes — Copy is the export path.

See [The session arc](/emdr/the-session-arc).

## Related articles

<CardGroup cols={2}>
  <Card title="Setting up an EMDR session" icon="sliders" href="/emdr/setting-up-an-emdr-session">
    The Configure modal walkthrough — mode, rate, modalities, dual-task.
  </Card>

  <Card title="Practitioner controls" icon="hand" href="/emdr/practitioner-controls">
    Spacebar start and stop, speed changes mid-set, and what to do when the
    connection degrades.
  </Card>

  <Card title="Who should not use EMDR" icon="circle-x" href="/emdr/who-should-not-use-emdr">
    Contraindications, training requirements, and what the Workspace is
    and isn't.
  </Card>
</CardGroup>
