The EMDR Therapist Weekly aims to provide a weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next. To achieve this, we occasionally invite subject matter experts as guest writers. I'm excited to introduce a returning guest writer this week: Dr. Amber Quaranta-Leech, LPC-S

Dr. Quaranta-Leech is a Licensed Professional Counselor and Supervisor, EMDRIA Approved Consultant and Trainer, and COO of CompassionWorks, LLC. She researches the use of EMDR protocols in high conflict situations and has delivered EMDR trainings to thousands of licensed therapists and EMDR practitioners.

Without further ado, Dr. Amber Quaranta-Leech writes:

The Power of EMDR - and the Power of Group

​
Group Protocols

We know that EMDR therapy can be conducted in groups for children and adults through protocols such as C-GTEP, G-TEP, and EMDR-IGTP. But what do we do when groups need to happen in the most non-ideal of situations? Can group EMDR still be helpful when people are not yet safe, when the crisis is ongoing, when internet and electricity are unreliable, and when the therapist may not even speak the same language as the participants?

That is the question I was looking at in research published in the Journal of EMDR Practice and Research: “Randomized Controlled Trial on the Provision of the EMDR-IGTP-OTS-R for Reduction of Posttraumatic Stress Disorder Symptomology With Mental Health Professionals in Ukraine During the War” (Quaranta-Leech et al., 2025).

We already knew from past research that EMDR group protocols were developed to help more people receive trauma treatment in a shorter amount of time. The EMDR Integrative Group Treatment Protocol was originally developed after Hurricane Pauline in Mexico, when clinicians needed a way to reach large numbers of people after a disaster (Jarero et al., 2006; Jarero et al., 2008). Since then, EMDR-IGTP has been used in humanitarian work after natural disasters, with children, with adults, and with people affected by geopolitical crises (Jarero & Artigas, 2010; Jarero et al., 2014).

IGTP Evolution

The protocol has also continued to develop. EMDR-IGTP was adapted for ongoing traumatic stress as EMDR-IGTP-OTS, recognizing that some people do not have a clean “after the trauma” window. In ongoing traumatic stress, the person may still be living inside the threat, loss, displacement, or uncertainty. The remote version, EMDR-IGTP-OTS-R, was developed when in-person treatment was not safe or practical, including during the COVID-19 pandemic with healthcare professionals working in hospitals (Pérez et al., 2020). Other EMDR studies with healthcare workers during COVID-19 also supported the use of EMDR-based interventions for reducing distress, trauma symptoms, and related mental health concerns during active crisis conditions (Faretta et al., 2022; Fernandez et al., 2022; Fogliato et al., 2022).

EMDR-IGTP-OTS-R follows the eight phases of standard EMDR therapy and keeps the three-pronged focus on past, present, and future. It uses the Butterfly Hug as self-administered bilateral stimulation and includes drawing as a way for participants to represent traumatic material without needing to verbally disclose everything in the group. This is part of what makes the protocol so adaptable. Participants can work internally and symbolically while still receiving the structure, containment, and bilateral stimulation of EMDR therapy.

Randomized Controlled Trial in a War Zone

The Ukraine study stretched this protocol even further. The participants were mental health professionals living and working in Ukraine during the Russo-Ukrainian war. They were not outside observers of trauma. They were professionals serving others while also living inside the same war-related threat as their clients. This created a very real clinical question: Will this protocol still work when the helper is also being impacted? Will it still work when participants are under attack during the time of the study? Will it still work when the sessions cannot be held on consecutive days as recommended?

The answer was yes.

This randomized controlled trial was conducted from October 2023 through January 2024. Fifty-three participants were recruited from the International Institute of Postgraduate Education in Kyiv, Ukraine. Three were removed from final analysis because of inconsistent participant identifiers, leaving 50 participants in the final data analysis. The treatment group included 26 participants, and the control group included 24. Participants were psychologists, psychological consultants, or students training to become mental health professionals, and all were physically located in Ukraine and working in the mental health field during the large-scale invasion (Quaranta-Leech et al., 2025).

The treatment group received six EMDR-IGTP-OTS-R sessions over two weeks, meeting Monday, Wednesday, and Friday rather than on consecutive days. The sessions were provided online through a secure platform. The lead therapist was English-speaking and worked through a Ukrainian interpreter, with trained Emotional Protection Team members present to support participant safety. Most participants attended all six sessions, while others attended five or four sessions. Some missed sessions because Russian attacks on utility infrastructure caused internet disruption during the treatment period (Quaranta-Leech et al., 2025).

Outcomes and Takeaways

The researchers measured PTSD symptoms, subjective well-being, satisfaction with life, resilience, and religious coping at three points: before treatment, after treatment, and six weeks later. PTSD symptoms were measured with the PCL-5. The primary finding was a statistically significant reduction in PTSD symptoms from pretest to six-week follow-up in the treatment group. The treatment group’s median PCL-5 score decreased from 17 at pretest to 10 at follow-up, while the control group remained higher. The treatment group also showed significantly lower PTSD symptoms than the control group at posttest and at follow-up. Changes in overall well-being and resilience were not statistically significant, which is clinically important to state clearly. The strongest finding was not that every measure changed, but that PTSD symptomology decreased even while participants remained in an active war environment (Quaranta-Leech et al., 2025).

That matters. This study shows that even in bleak, unstable, and imperfect conditions, EMDR therapy can still have a meaningful impact. It also supports the idea that processing may continue after sessions are complete. In the study, the most significant reduction appeared at six-week follow-up rather than immediately after treatment, which fits with the Adaptive Information Processing model: once a pathogenic memory is activated and processed, the nervous system may continue moving that material toward more adaptive storage.

For clinicians, this research is both humbling and hopeful. It reminds us that EMDR is not limited to the therapy office, perfect conditions, or carefully controlled settings. EMDR can be used in group formats, across language barriers, through interpreters, online, and in the middle of ongoing crisis. It is not strictly time bound, because we can work with past, present, and future material. It is not strictly language bound, because so much of the work happens through memory networks, body experience, image, emotion, and bilateral stimulation. It is not strictly culture bound, because it supports the client’s own adaptive healing system rather than forcing meaning through one narrow cultural lens.

There is power in held space. There is power in bilateral stimulation. There is power in helping pathogenic memories move toward adaptive resolution, even when the world around the client has not yet become safe.

Dr. Amber Quaranta-Leech

If you or someone you know is ready to dive into the world of EMDR with the Basic Training, or going to step up your game with Advanced trainings, join the CompassionWorks crew in-person, hybrid, or fully online. Train with Experts, Heal with Compassion.
​
For our Helicon subscribers enjoy 10% off of any Basic or Advanced Trainings using the coupon code: Helicon10. Check out our offerings today: https://compassionworks.com/courses/​

Reference List:

Faretta, E., Garau, M. I., Gallina, E., Pagani, M., & Fernandez, I. (2022). Supporting healthcare workers in times of COVID-19 with eye movement desensitization and reprocessing online: A pilot study. Frontiers in Psychology, 13, Article 964407. https://doi.org/10.3389/fpsyg.2022.964407

Fernandez, I., Pagani, M., & Gallina, E. (2022). Post-traumatic stress disorder among healthcare workers during the COVID-19 pandemic in Italy: Effectiveness of an eye movement desensitization and reprocessing intervention protocol. Frontiers in Psychology, 13, Article 964334. https://doi.org/10.3389/fpsyg.2022.964334

Fogliato, E., Invernizzi, R., Maslovaric, G., Fernandez, I., Rigamonti, V., Lora, A., Frisone, E., & Pagani, M. (2022). Promoting mental health in healthcare workers in hospitals through psychological group support with eye movement desensitization and reprocessing during COVID-19 pandemic: An observational study. Frontiers in Psychology, 12, Article 794178. https://doi.org/10.3389/fpsyg.2021.794178​

Jarero, I., & Artigas, L. (2010). The EMDR integrative group treatment protocol: Application with adults during ongoing geopolitical crisis. Journal of EMDR Practice and Research, 4(4), 148–155. https://doi.org/10.1891/1933-3196.4.4.148

Jarero, I., Artigas, L., & Hartung, J. (2006). EMDR integrative treatment protocol: A post-disaster trauma intervention for children and adults. Traumatology, 12(2), 121–129. https://doi.org/10.1177/1534765606294561

Jarero, I., Artigas, L., Montero, M., & Lena, L. (2008). The EMDR integrative group treatment protocol: Application with child victims of a mass disaster. Journal of EMDR Practice and Research, 2(2), 97–105. https://doi.org/10.1891/1933-3196.2.2.97

Jarero, I., Artigas, L., Uribe, S., & Miranda, A. (2014). EMDR therapy humanitarian trauma recovery interventions in Latin America and the Caribbean. Journal of EMDR Practice and Research, 8(4), 260–268. https://doi.org/10.1891/1933-3196.8.4.260

Pérez, M. C., Estévez, M. E., Becker, Y., Osorio, A., Jarero, I., & Givaudan, M. (2020). Multisite randomized controlled trial on the provision of the EMDR integrative group treatment protocol for ongoing traumatic stress remote to healthcare professionals working in hospitals during the COVID-19 pandemic. Psychology and Behavioral Science International Journal, 15(4), Article 555920. https://doi.org/10.19080/PBSIJ.2020.15.555920​

Quaranta-Leech, A., Zaporozhets, O., Jarero, I., & Holland, D. (2025). Randomized controlled trial on the provision of the EMDR-IGTP-OTS-R for reduction of posttraumatic stress disorder symptomology with mental health professionals in Ukraine during the war. Journal of EMDR Practice and Research, 19, Article 0007. https://doi.org/10.34133/jemdr.0007

​
​Thanks for reading Helicon's EMDR Therapist Weekly, where we aim to provide a weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next.

​
​If you're not already subscribed, subscribe here. You can also click here to learn about what Helicon is building, or apply to join the waitlist for early access to the platform, if you're an EMDR provider and want to connect with others on the same path.

Disclaimer: The information contained in this article is for informational purposes only. This is not legal or clinical advice and we make no guarantees about the outcomes or results from information shared in this document. Proceed at your own risk and discretion.​
​