Doctoral study into intensive therapy reveals insights for practice and service design

Intensive therapy models for post-traumatic stress are gaining attention, particularly where traditional weekly therapy can feel slow, disruptive, or difficult to sustain. A recent qualitative study explored how clients themselves experience intensive Eye Movement Desensitisation and Reprocessing (EMDR), offering valuable insights for clinicians, services, and commissioners considering this approach

Rather than focusing on symptom scores alone, this research centred the client voice, using in-depth interviews with people who had completed intensive EMDR programmes. The findings highlight how and why intensive formats may support meaningful change.

Key findings: what mattered most to clients

Two overarching themes emerged:

1. Psychological safety is central

Participants consistently described intensive EMDR as feeling safe, despite the emotional intensity of trauma work. This sense of safety came from two main sources.

First, clients experienced the intensive format as a protected space, separate from everyday life. Many used metaphors such as a “bubble” or “laboratory” to describe a contained environment free from distractions and competing demands. This separation allowed deeper focus, self-care, and commitment to the therapeutic process.

Second, safety was reinforced through a continued connection. Knowing that therapy resumed the next day—or even later the same day—reduced fear of being left alone with distress. Clients felt reassured that unfinished work could be revisited quickly, which increased confidence, agency, and willingness to fully engage.

2. A changing sense of self

Clients did not describe change only in terms of reduced symptoms. Instead, many reported profound shifts in how they understood themselves and their lives.

Some experienced sudden moments of clarity or insight—described as “wow” moments—where long-standing patterns or reactions changed unexpectedly. Others spoke about living more authentically after treatment: feeling calmer, more present, more in control, and better able to relate to others.

Importantly, participants often described these changes as self-driven rather than something “done” to them by a technique or therapist. Healing was experienced as emerging from within, supported by the structure and safety of the intensive format.

Implications for clinical practice

For practitioners, this research highlights that how therapy is delivered matters as much as what model is used. Intensive EMDR appears to support engagement by:

• reducing avoidance between sessions

• maintaining therapeutic momentum

• minimising disruption from daily life

• allowing clients to invest fully without prolonged destabilisation

The findings also challenge the assumption that psychological safety requires lengthy preparation or a long-established therapeutic relationship. Instead, safety can be fostered through clear structure, containment, continuity, and shared decision-making.

Implications for service development

For services and organisations, intensive therapy offers a credible alternative pathway for people who struggle with weekly therapy or require time-limited interventions. Designing effective intensive programmes requires attention not only to clinical protocols, but also to environment, pacing, continuity, and client autonomy.

This study supports offering intensive EMDR as part of a choice-based trauma care system, rather than a niche or last-resort option. It also underscores the need for clearer definitions, feasibility studies, and service models that balance clinical effectiveness with ethical delivery and duty of care.

In summary

Intensive EMDR was experienced by clients as safe, empowering, and transformative. By centering psychological safety and sustained engagement, intensive formats for trauma recovery may offer an important development in trauma treatment—particularly for individuals living with complex or long-standing post-traumatic stress. To view the research article click here.

This research highlights the growing relevance of intensive, psychologically safe trauma therapy models. Organisations, charities, clinicians, and services interested in research collaboration, feasibility studies, or service development in this area are invited to make contact.

References

Butler, S.-J., & Ramsey-Wade, C. (2024). How do clients experience intensive EMDR for post-traumatic stress? An interpretative phenomenological analysis. European Journal of Trauma & Dissociation, 8, Article 100479. https://doi.org/10.1016/j.ejtd.2024.100479

Trauma recovery, intensive EMDR,