Face-to-Face Versus Web-Based EMDR Therapy in the Treatment of Generalized Anxiety Disorder Symptoms: A Randomized Controlled Trial

This randomized controlled study examined the effectiveness of face-to-face versus web-based Eye Movement Desensitization and Reprocessing (EMDR) for Generalized Anxiety Disorder (GAD).

Sixty-five patients were randomly assigned to face-to-face EMDR (n = 23), web-based EMDR (n = 23), or a waiting-list control condition (WLCC) (n = 23). Treatment consisted of ten sessions. Symptom changes were assessed post-treatment and at one- and three-month follow-ups using the Generalized Anxiety Disorder 7-Item scale, Penn State Worry Questionnaire, State-Trait Anxiety Inventory, and Beck Anxiety Inventory. Participants also recorded daily anxiety and worry levels from two weeks before treatment to two weeks after follow-up.

Linear mixed-model analyses showed significant improvements in both treatment conditions compared to WLCC, with large effect sizes (e.g., GAD-7: d_pre−post = 1.90 for face-to-face, d_pre−post = 1.59 for web-based). No significant differences between treatment conditions were found, except for worry. Treatment effects remained stable at follow-ups.

Both face-to-face and web-based EMDR are effective for GAD. However, because wait-list control is used, symptom improvements cannot be attributed solely to EMDR. Future studies using active control groups are warranted.

Approved by the Research Ethics Committee of Bushehr University of Medical Science (IR.BPUMS.REC.1402.070) and registered retrospectively in the Iranian Registry of Clinical Trials (IRCT20240716062442N1).