Does the APA Recommend EMDR? The Guideline, Explained

Yes, but only conditionally. The American Psychological Association’s PTSD treatment guideline lists EMDR as a “conditionally recommended” therapy, one tier below the “strong recommendation” given to cognitive processing therapy, prolonged exposure, and trauma-focused CBT. That’s been true since 2017 and stayed true in the 2025 update, a rating EMDR researchers have publicly disputed.

Maybe you read that EMDR is “APA-recommended.” Maybe you read that the APA just downgraded it. Both claims circulate online, and neither tells you what the guideline actually says. Here’s the real structure behind the headline, what changed in 2025, and why the rating itself is still argued over.

Wait, Which APA Are We Talking About?

Two very different organizations share the initials “APA,” and mixing them up is an easy mistake. The American Psychiatric Association represents psychiatrists and publishes the DSM, the manual that defines PTSD as a diagnosis. The American Psychological Association represents psychologists, and it’s the one that maintains the Clinical Practice Guideline for the Treatment of PTSD in Adults, first published in 2017 and updated in 2025. That’s the guideline this article is about, and every “APA” from here on refers to it.

What Does the APA’s Guideline Actually Say About EMDR?

The guideline sorts treatments into two tiers. A strong recommendation means the panel is confident a therapy’s benefits outweigh its downsides for nearly everyone with PTSD. A conditional recommendation means the panel still endorses the therapy, but with less certainty, usually because the evidence is thinner, more mixed across studies, or doesn’t clearly apply to every patient and setting.

EMDR has always sat in the second group. When the guideline first published in 2017, its development panel gave a strong recommendation to four therapies: cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and prolonged exposure (PE), all trauma-focused, CBT-based approaches. EMDR, brief eclectic psychotherapy, and narrative exposure therapy received conditional recommendations instead, alongside several medications (APA, 2017; American Psychologist guideline summary, 2019).

So yes, the APA recommends EMDR, in the sense that it made the guideline’s endorsed list from the start. It has simply never been in that list’s top tier.

Did the 2025 Update Change EMDR’s Rating?

Not the rating itself. The APA revised the guideline in 2025, and its own EMDR-specific treatment page still lists EMDR as a conditional recommendation, the same category it held in 2017. What moved was some of the company EMDR keeps.

Cognitive processing therapy, prolonged exposure, and trauma-focused CBT now anchor the guideline’s strong-recommendation tier. Cognitive therapy, strongly recommended back in 2017, shifted down into the conditional group alongside EMDR and narrative exposure therapy (APA Monitor on Psychology, 2025). If you’ve seen a headline claiming the APA “downgraded” EMDR in 2025, that’s not quite accurate. EMDR’s own tier hasn’t moved since 2017; a different therapy moved instead.

Recommendation tier	2017 guideline	2025 update
Strong (highest confidence)	CBT, cognitive processing therapy, cognitive therapy, prolonged exposure	Cognitive processing therapy, prolonged exposure, trauma-focused CBT
Conditional (EMDR’s tier)	Brief eclectic psychotherapy, EMDR, narrative exposure therapy, plus select medications	EMDR, cognitive therapy, narrative exposure therapy, plus select medications

Why Doesn’t EMDR Get the Top Tier?

The panel has been fairly consistent about its reasoning: a conditional recommendation reflects evidence that’s less extensive, more variable in quality across trials, or not clearly proven across every setting, not a signal that a therapy fails to work. That’s a real distinction, even if it doesn’t feel like one from the outside.

The reasoning also seems to apply unevenly, by the panel’s own later actions. Cognitive therapy was strongly recommended in 2017 and reclassified as conditional in 2025, using the same review process. That’s a useful data point: whatever moved cognitive therapy down can’t be an EMDR-specific problem, since EMDR didn’t move at all. It suggests the bar for the top tier is narrower than most people assume, not that EMDR was singled out.

Is the APA’s Rating Controversial?

Yes, and this isn’t a fringe complaint. A 2025 critique in the Journal of EMDR Practice and Research argues the APA’s placement underrates EMDR’s actual effectiveness, and notes it puts the APA out of step with several other national and international guidelines that rank EMDR more highly. A similar argument followed the original 2017 guideline: a 2017 paper in Frontiers in Psychology contended the panel’s own data didn’t support rating EMDR below the strongly recommended therapies.

Neither critique claims EMDR lacks evidence. Both argue the opposite, that a substantial evidence base is being represented too cautiously. Whether that’s a fair complaint or simply a stricter reading of smaller, older trials is still an open argument between researchers who agree on the underlying data and disagree on how to weigh it.

How Does This Compare to Other Guidelines?

Other major bodies land in a different place. The World Health Organization first named EMDR alongside trauma-focused CBT as one of only two recommended psychotherapies for PTSD in 2013, and its updated 2023 guidance still rates EMDR a conditional recommendation, on par with the other trauma-focused options it lists, not below them. The VA/DoD Clinical Practice Guideline puts EMDR in its strongest recommendation category, next to cognitive processing therapy and prolonged exposure (2023). The UK’s NICE lists EMDR among its recommended adult PTSD treatments too (2018).

Guideline body	Most recent version	Where EMDR sits
American Psychological Association	2025	Conditional recommendation, one tier below CPT, prolonged exposure, and trauma-focused CBT
World Health Organization	2013, updated 2023	Conditional recommendation, on par with trauma-focused CBT and other listed options, none ranked below EMDR
VA/DoD Clinical Practice Guideline	2023	Top recommendation tier, alongside CPT and prolonged exposure
NICE (UK)	2018	Listed among recommended adult PTSD treatments

Four expert panels, reading much of the same trial data, reached different confidence levels. For a closer look at each one, see our dedicated pages on the WHO guidelines on EMDR and the EMDR in the VA/DoD guidelines; is EMDR evidence-based? rounds up all four side by side.

Does This Affect Self-Guided Bilateral Stimulation or Apps Like EmEase?

No, and this distinction matters. Every trial and every guideline discussed here evaluated therapist-delivered EMDR: an eight-phase protocol delivered by a trained clinician to someone with a diagnosed condition. EMDRIA, the field’s own professional association, states plainly that EMDR therapy should only be offered by properly trained, licensed clinicians. None of this guideline, or that standard, was built around a self-guided app, and PTSD itself is not something to self-treat.

If PTSD or a specific traumatic memory is part of your story, the guideline’s own logic points the same direction: work with a licensed, EMDR-trained therapist. Our guide on finding an EMDR therapist walks through what to look for, and EMDR and PTSD: What the Research Actually Shows covers the fuller picture of what helps. For the broader “does this actually work” question, see does EMDR work?

EmEase, a self-guided EMDR app, is something different: a wellness practice inspired by the bilateral-stimulation technique EMDR is built around, meant for everyday stress rather than diagnosed PTSD.

If you do practice bilateral stimulation on your own for a stressful memory or moment, a few things matter more than the technique itself. Stabilize first, with grounding or a calm-place practice, before bringing anything uncomfortable to mind. Go slow, starting with something small and recent rather than your heaviest memory. Know your stop-conditions: if distress climbs past a 7 out of 10 and won’t settle, stop and ground instead, and treat that as a sign to consider professional support.

None of that is a substitute for the therapy this guideline evaluated, and it isn’t meant to be.

The Bottom Line

Does the APA recommend EMDR? Yes, it has since 2017, and it still does after the 2025 update. That recommendation has always carried a “conditional” label, one tier below trauma-focused CBT, cognitive processing therapy, and prolonged exposure, and a real body of EMDR researchers thinks that label undersells the evidence.

Other major guidelines, including the WHO’s and the VA/DoD’s, put EMDR closer to the top. Read the tier, not just the headline: it tells you more than “recommended” or “not recommended” ever could.

Frequently asked questions

Does the APA recommend EMDR for PTSD?

Yes. The American Psychological Association’s PTSD guideline gives EMDR a “conditional recommendation,” alongside cognitive therapy and narrative exposure therapy. That’s one tier below the “strong recommendation” given to cognitive processing therapy, prolonged exposure, and trauma-focused CBT. EMDR has held this same tier since the guideline’s original 2017 version.

Is this the American Psychological Association or the American Psychiatric Association?

The Psychological one. Both organizations use the initials “APA,” which causes real confusion. The Psychiatric association publishes the DSM; the Psychological association maintains the PTSD treatment guideline this article covers, including its rating of EMDR.

What’s the difference between a “strong” and “conditional” recommendation?

A strong recommendation means the panel is confident a therapy helps most people with PTSD. A conditional recommendation means the panel still endorses it, but with less certainty, usually because the evidence is thinner, more mixed, or doesn’t clearly apply across every patient and setting.

Did the APA’s 2025 update downgrade EMDR?

Not exactly. EMDR was already conditionally recommended in 2017, and it’s still conditionally recommended after the 2025 update, so its own tier didn’t change. What changed is that cognitive therapy moved from the strong tier into EMDR’s conditional tier, and trauma-focused CBT was named specifically in the top group.

Why do the WHO and VA/DoD rank EMDR higher than the APA does?

They weighed the same general evidence differently. The WHO (2013) and VA/DoD (2023) both place EMDR at or near their top tier, while the APA rates it conditional. A 2025 critique in the Journal of EMDR Practice and Research argues the APA’s placement underrates the evidence.

Does the APA’s EMDR rating say anything about self-guided apps?

No. Every study behind this guideline tested therapist-delivered EMDR for diagnosed PTSD, not a self-guided app. EmEase, a self-guided EMDR app, offers the bilateral-stimulation technique for everyday stress. It doesn’t diagnose or treat PTSD and isn’t the therapy this guideline evaluated.