EMDR and CBT Together: Can You Do Both?

Yes — but “together” covers a few different setups, and they’re not equally advisable. EMDR’s professional association cautions against casually mixing the two inside one active treatment plan, but sequencing them, working with two coordinated therapists, or practicing self-guided bilateral stimulation alongside CBT are all workable, well-supported ways to combine them.

Maybe your CBT therapist just brought up EMDR. Maybe you’re weighing both and don’t want to pick wrong. Or maybe you’re already doing trauma-focused work and wondering if a self-guided bilateral stimulation app is safe to use between sessions. These are three different questions, and the honest answer is that “EMDR and CBT together” isn’t one thing — it depends which version you mean.

What does “EMDR and CBT together” actually mean?

In practice, people usually mean one of four different setups:

Setup	What it looks like	Who’s involved
Blended, one therapist	A single clinician trained in both weaves cognitive techniques and memory reprocessing into one treatment plan	One therapist
Concurrent, two therapists	Separate therapists each treat a distinct concern, running at the same time	Two therapists, coordinating
Sequential or phased	Skills-and-coping work first, memory reprocessing later, or the reverse	One or two therapists, one stage after another
Self-guided BLS plus CBT	Practicing bilateral stimulation on your own, between CBT sessions, for everyday stress	You, alongside your CBT therapist

Each has a different level of support behind it. We’ll take them one at a time.

Why would you combine them at all?

CBT and EMDR aim at different layers of the same problem. Cognitive behavioral therapy works on the present: the thought patterns and behaviors keeping distress going right now, per the American Psychological Association. EMDR works on the past: you briefly hold a distressing memory in mind while following bilateral stimulation, and according to EMDRIA, reprocessing tends to happen without much talking.

EMDR’s own theory holds that a lot of present-day patterns are fed by earlier experiences stored in raw, unprocessed form. That’s part of why some clinicians see the two as complementary rather than redundant: CBT works the branch you can see today, EMDR works the root feeding it. Done thoughtfully, combining them can mean covering both layers instead of just one.

Can one therapist blend EMDR and CBT into a single plan?

Some can. EMDRIA notes the combination can be genuinely useful, addressing cognitive distortions and deeper emotional material within the same treatment relationship. But EMDRIA is also direct about the limits: no standard guidelines exist yet for exactly how to integrate the two, and most experts advise against mixing them within the same active session or a tight timeline without a clear plan.

The concern isn’t that the ingredients clash. It’s dosage. Layering two intensive approaches at once can be a lot for your nervous system to metabolize.

And rapidly switching between examining a thought and reprocessing a memory in the same hour can leave you unsure what you’re even working on. That stalls progress instead of speeding it up.

What tends to work better, per EMDRIA, is a phased approach within that one relationship: using CBT-style skills to build stability and coping first, then shifting into EMDR to reprocess specific memories once you’re steadier, rather than blending both in every session.

Can you see two therapists, one for CBT and one for EMDR?

This is what EMDRIA calls concurrent therapy: EMDR with one therapist, another modality like CBT with a second, running at the same time. EMDRIA’s guidance is that this can be genuinely beneficial, not just tolerable, when it’s planned intentionally rather than stumbled into.

It tends to work best when the two therapies are treating clearly separate concerns. CBT with one therapist for ongoing anxious feelings and daily coping, say, and EMDR with another for a specific past experience that keeps resurfacing. It works less well when both therapists are circling the same issue from different angles, since that’s where duplication and mixed messages creep in.

EMDRIA’s guidance for making this work comes down to a few things:

• Each therapist knows about the other, and about what the other is working on
• The goals stay distinct, so no two providers are quietly treating the same thing
• Someone is the clear primary point of contact if a crisis or big decision comes up
• The therapists check in with each other periodically, not only with you

You’re allowed to ask for this. It’s a normal, established way of coordinating care, not an awkward request.

If the second therapy isn’t CBT specifically, the same logic applies more broadly. See our guide to using EMDR alongside talk therapy for that general version of the question.

Does sequencing work better than doing them at once?

Often, yes, and there’s a mechanistic reason it might. A 2019 study in Frontiers in Psychology followed adults who developed PTSD after the same earthquake. Some were randomly assigned to trauma-focused CBT, others to EMDR, and both groups showed similar psychological improvement and similar changes in brain connectivity on follow-up scans. Different route, overlapping destination.

That overlap is part of why many clinicians reach for sequencing instead of simultaneous use. If both approaches are working toward some of the same territory, doing them back-to-back, skills first and specific memories second, or the reverse, tends to be easier to track than doing both in every session. You always know which tool is active, and why.

There’s no single required order. What you’re working on, and how steady you feel day to day, matters more than which modality goes first.

What does the research say about combining them?

Less than you’d hope, honestly. Dedicated trials testing one formal, combined EMDR-CBT protocol are still thin. What we have instead: solid evidence that each works well on its own (for the full comparison, see EMDR vs CBT), guidance from EMDR’s own professional association on how to combine them responsibly, and real-world data on what clinicians actually do.

That last piece is telling. A 2023 survey of 346 therapists, trained primarily in CBT, EMDR, or both, appeared in Frontiers in Psychology. It found that in real practice, clinicians already blend elements from both approaches more than formal protocols suggest.

Psychoeducation about trauma was the single most common technique used across the board, and EMDR-trained therapists reported applying EMDR techniques off-label to concerns beyond PTSD. The guidance says don’t casually mix; practice shows a lot of quiet blending happens anyway, typically without a formal joint protocol behind it.

Meanwhile, a smaller trial compared EMDR and CBT head-to-head for low self-esteem, published in Frontiers in Psychology in 2017. Both produced significant, similarly sized improvement on their own, over ten weekly sessions. That’s evidence for each modality working independently, not for combining them, but it’s a useful reminder: you don’t necessarily need both to see real change. Sometimes one, done well, is enough.

What are the risks of combining them?

Mostly overload, not danger. EMDRIA is direct that stacking two intensive approaches without a plan can trigger more anxiety rather than less, leave you feeling emotionally flat or foggy, or bring old material to the surface before you’re ready to work with it. None of that means combining is a bad idea. It means combining without coordination is.

The practical version of that risk is duplication: two providers unknowingly working the same ground, giving you conflicting homework, or neither one feeling like your main relationship. That’s a coordination problem, not a failure of either therapy, and it’s fixable with the safeguards above.

Can you practice self-guided bilateral stimulation while you’re doing CBT?

This is a different, easier question. Formal EMDR is therapist-delivered. But its core ingredient, bilateral stimulation, is simple enough to use on your own for everyday stress, entirely separate from any trauma reprocessing your therapist might be doing. Our self-guided vs. therapist-led EMDR explainer covers that distinction in more depth.

If you’re already doing CBT and want something for the moments in between sessions, self-guided bilateral stimulation doesn’t compete with your CBT homework. It’s a different kind of tool for a different kind of moment: a racing mind before a session, a tense week you’re carrying into the next one. EmEase, a self-guided EMDR app, guides that practice with visual and audio bilateral stimulation at app.emease.com, a wellness practice inspired by EMDR therapy, not a second course of treatment layered onto your CBT. If you’d rather start with the manual version, our beginner’s guide to self-guided bilateral stimulation walks through it step by step.

Worth saying plainly: this isn’t the same as asking your CBT therapist to also do formal EMDR reprocessing with you, which is the blended or concurrent question from earlier. It’s closer to journaling or a breathing practice, something you do for yourself between appointments, not a second clinical treatment. Mentioning it to your therapist is still a good idea. Our guide to using a bilateral stimulation app between therapy sessions walks through that conversation.

How do you make combining care actually work?

A short list, but it covers most of what goes wrong:

1. Tell every provider, or yourself, if one piece is self-guided, about everything else you’re doing
2. Get specific about what each piece is for, out loud, so nothing overlaps by accident
3. Decide who your primary point of contact is if something comes up between sessions
4. Expect it to take real time and energy; don’t pile more on just because you technically can
5. If you feel more confused or stuck rather than steadier, treat that as a signal to simplify, not push through

The bottom line

“EMDR and CBT together” can mean four different things, and most of them work, when they’re planned rather than improvised. What EMDR’s own professional body advises against is the casual version: mixing both inside the same session without a clear reason behind it. Sequencing, coordinated concurrent therapists, and self-guided bilateral stimulation alongside CBT all have real support behind them.

If you’re actively weighing the two rather than combining them, our EMDR vs CBT comparison breaks down how they differ and which tends to fit which situation. And if a therapist has suggested combining approaches for you specifically, that conversation is worth having directly with them. They know your history and your pace better than any article can.