Does EMDR Work for Emergency Services Staff? What the UK Research Says

1 November 2026

People in the police, ambulance and fire services tend to want evidence before they commit to anything, and that's a sensible instinct with any therapy. This guide sets out what UK guidance and research say about EMDR therapy (eye movement desensitisation and reprocessing) for people in these roles, a therapy that works on traumatic memories that stay stuck, including the parts that are less certain. It starts with the general evidence for post-traumatic stress disorder (PTSD), then looks at the smaller body of research with emergency services staff. For how the therapy is adapted for the work itself, see EMDR for emergency services staff.

The short answer

For post-traumatic stress in general, the evidence is strong. This therapy is one of two psychological treatments that NICE recommends, and recent UK reviews and NHS figures show it working about as well as trauma-focused CBT, the other recommended therapy. For emergency services staff specifically, the research is encouraging but smaller and less rigorous. Most of it comes from police officers, and very little covers ambulance crews, firefighters or 999 control room staff.

What NICE recommends

The National Institute for Health and Care Excellence (NICE) guideline on the condition, NG116, recommends EMDR for adults with the condition, or with clinically important symptoms, when they come for help more than three months after a trauma. It also suggests considering it between one and three months after a trauma if the person would prefer it. NICE says the therapy should typically be given over 8 to 12 sessions, with more where it's clinically needed, for example after multiple traumas. It recommends a form of cognitive behavioural therapy as well, so the two sit side by side.

The EMDR recommendation covers trauma outside military combat, which includes the incidents police, ambulance and fire staff attend. It's general PTSD guidance, though, not a guideline written for emergency services staff.

The wider evidence for EMDR therapy

Recent reviews

A 2025 systematic review and meta-analysis by Simpson and colleagues at the University of Sheffield, published in the British Journal of Psychology, pulled together trials published since the NICE guideline. It found EMDR clearly better than waiting list or usual care, and no significant difference between it and trauma-focused cognitive behavioural therapy. Courses tended to be shorter, and in the one economic model available it came out as the most cost-effective option. The authors note that most of the trials were small and at moderate or high risk of bias.

An earlier 2020 meta-analysis by Cuijpers and colleagues was more cautious. It found a large effect against control conditions, but only four of 27 PTSD studies had a low risk of bias, and the advantage over other treatments disappeared in those better-quality studies. Read together, the two reviews say that the therapy helps, that it is roughly as good as the other main approach, and that the quality of the research could be better.

NHS figures

Real-world NHS data points the same way. NHS England figures for 2021 to 2022, reported by Belli and colleagues in 2025, showed a recovery rate of 45.9% across 5,083 completed courses of EMDR therapy in NHS Talking Therapies, against 40.4% across 24,452 courses of CBT. Their own 11-year evaluation of one London service found recovery rates of 43.6% and 40.8%, with no significant difference. These are routine service figures rather than trials, and they count only those who finished treatment.

Research with UK police

Brief therapy in a police service

In 2021, Biggs, Tehrani and Billings published an analysis of clinical data from a support service offering brief therapy to UK police officers (Occupational Medicine, 2021). The 162 officers and staff in the study received around 10 hours of therapy (9 to 12 hours were offered), as EMDR, trauma-focused CBT or a mix of the two.

Symptoms of PTSD, depression and anxiety all fell substantially.
Improvements in PTSD, depression and anxiety were similar for officers with complex PTSD and those with PTSD, although the study did not measure the extra symptoms specific to complex PTSD after treatment.
Officers with complex PTSD who had both direct and indirect occupational trauma (indirect meaning, for example, reviewing crime material or videos) improved less than those with direct trauma alone.

It was an observational study using routine service data. There was no comparison group, and the results are mostly reported for the two approaches together. Even so, the results are encouraging for a short course delivered through an occupational route. The finding on mixed exposure fits NICE's note that more sessions may be needed after several traumas. How many sessions of EMDR are needed? looks at what affects the number.

An intensive service for serving police

In 2022, Police Care UK set up a residential intensive trauma service for serving police officers, combining EMDR with imaginal exposure over two blocks of four and a half days. An early evaluation of its first three groups, published in the EMDR Association UK's journal in 2023 (EMDR Therapy Quarterly), reported interim figures for the 18 officers treated. At the last review, 93% were back at work and 87% no longer met the criteria for complex PTSD or PTSD.

These are striking figures, but they come from a service evaluation, not a trial. The groups were small and there was no comparison group. It's a promising early result rather than settled evidence.

Research across emergency services worldwide

A 2022 systematic review by Morris and colleagues in the Journal of Traumatic Stress (2022) looked across the research with first responders, the term used in most international studies. It found eight studies from around the world.

The authors concluded that EMDR can reduce work-related stress symptoms in this group.
Evidence on using it as an early intervention, soon after an incident, was inconclusive.
How the therapy was delivered varied widely between studies, in type, length, frequency and timing.
Every study was rated as weak or medium quality. None was rated high quality.

The authors describe their findings as preliminary and call for better research. That's a fair summary of the field as a whole.

The evidence at a glance

Source	Who	What it found	Limits
NICE NG116 (2018)	Adults with PTSD	EMDR recommended after non-combat trauma, typically 8 to 12 sessions	General PTSD guidance, not specific to emergency services
Simpson et al. (2025)	Adults with PTSD, trials since 2018	Better than waiting list or usual care, no significant difference from the other main therapy, likely cost-effective	Most trials small, moderate or high risk of bias
NHS Talking Therapies (2021 to 2022)	5,083 completed courses	45.9% recovery, against 40.4% for the comparison therapy	Routine data, completers only
Biggs, Tehrani and Billings (2021)	162 UK police officers and staff	Substantial falls in PTSD, depression and anxiety scores after around 10 hours of therapy	No comparison group, approaches mostly reported together
Police Care UK intensive service (2023)	18 serving UK police officers	Interim figures of 93% back at work and 87% below the diagnostic threshold	Early evaluation, small groups, EMDR combined with imaginal exposure
Morris et al. (2022)	Eight international studies	Can reduce work-related symptoms, early use unclear	All studies weak or medium quality

What isn't known yet

The gaps matter if you work outside the police.

Ambulance, fire and control rooms. I'm not aware of published UK trials of EMDR with paramedics, firefighters or 999 call handlers. The general PTSD evidence still applies, but nobody has tested it in these groups specifically.
Years of incidents rather than one. Most trials treat one traumatic event. Many in these jobs carry dozens of memories, from road deaths to a child they couldn't save, and therapy has to process them in some order, and the Biggs study suggests mixed exposure takes longer to shift.
Long-term results. Few studies follow people up beyond a year, and none that I know of track whether staff stay in the job.
Side effects. A 2025 review found that most trials of the therapy barely reported adverse effects. Side effects and shift work covers what is known.

Why EMDR is still controversial

Mostly because of the eye movements. Early claims were strong, and researchers still debate how much the eye movements add beyond holding traumatic memories in mind. The leading explanation is that doing a demanding task while recalling a memory makes the memory less vivid and less emotional. The overall evidence that the therapy helps with post-traumatic stress is not in serious dispute, which is why NICE and the World Health Organization recommend it. For more on how the process works, see EMDR for PTSD.

What this means if you're considering EMDR

The therapy's strongest support comes from the general evidence that NICE draws on. The research specific to emergency services staff points the same way, and the UK police studies are encouraging. It is smaller and less rigorous, and much of it comes from routine services rather than controlled trials.

A few practical points follow from it:

If you have years of different kinds of jobs behind you, a short course may not be enough to process all the memories, and it's worth knowing that at the start.
NICE recommends both. For non-combat incidents after three months either is a reasonable choice, and personal preference is a good reason to pick one. EMDR vs trauma-focused CBT compares the two.
If anxiety or low mood is the bigger problem than particular memories, talk that through at assessment, because a different approach may fit better.
No study can tell you how it will go for you. A good first step is an assessment, where you can ask how the therapist would approach your situation.

In my experience, clients can experience a considerable reduction in distress levels, and increased resilience and coping skills. That isn't a promise, but it is why I think it is worth exploring.

Frequently asked questions

What is the success rate of EMDR?

It depends on the measure. In NHS Talking Therapies in 2021 to 2022, 45.9% of those who completed EMDR for PTSD met the service's definition of recovery. Many more improve without reaching that threshold.

Is EMDR better than CBT?

Not clearly. UK reviews and NHS data find the two similar, and EMDR courses tend to be shorter.

How many sessions does it take?

NICE suggests 8 to 12 as typical, with more after multiple traumas. The police study above used around 10 hours.

Does it work online?

Online therapy is widely used for this, and early research is encouraging. Can EMDR therapy online be effective? looks at the evidence.

Do the results last?

Long-term follow-up is limited, so it's hard to say with confidence. If a new incident stirs up an old memory, a few top-up sessions are common.

Does it help with anxiety and low mood too?

In the UK police study, depression and anxiety fell alongside other symptoms. EMDR is not a first-line therapy for depression on its own.

Getting started

If you're not sure whether what you're dealing with is PTSD, PTSD in emergency services workers may help you decide whether it's worth getting assessed. If worries about your job are holding you back, is counselling confidential? covers what each route to help means for your privacy.

I offer EMDR therapy and person centred counselling in Nottingham and online. You can get in touch to ask whether EMDR might suit you.

If you are in crisis now, ring 999, ring NHS 111 and choose the mental health option, or ring Samaritans free on 116 123.

Sources

More about EMDR therapy