EMDR – Bilateral stimulation

Before you start

EMDR – Bilateral stimulation is a marketplace tool, in beta. You need Plus and you adopt it from Marketplace → EMDR – Bilateral stimulation → Adopt; it costs nothing on top of the plan. Until you adopt it nothing about EMDR appears anywhere, and trying to record a set says: “Adopt the EMDR tool to record sets.”

Once adopted it appears in four places:

• In the AlchelyMeeting tools panel, during a call — the stimulation runs on the patient's screen and the controls sit beside the video.
• In a session's tools, outside a call — it opens the board for that session in a new tab.
• In the tool dock on your home screen — it asks for the patient, then starts a new in-person EMDR session and opens its board.
• In an individual patient's dock — the same, straight away, with that patient. Couple and group docks leave EMDR out, because ratings are recorded on individual sessions only.

In an AlchelyMeeting call

From the tools panel, choose EMDR – Bilateral stimulation. The Bilateral stimulation panel opens over the right of the video, so you keep the patient's face — and their eyes — in view.

What you see

• A small live preview, What the patient sees.
• The photosensitivity notice, before any set starts: “The dot moves smoothly and never flashes. Even so, if the patient has photosensitive epilepsy or visual discomfort, use auditory mode.”
• Mode, path, speed, size, colour and tactile (see The stimulus settings).
• Start set, Pause, Resume and New set, and a Passes counter that goes back to zero with each new set. Speed can be changed mid-set: the dot carries on from where it is.
• Once a set is paused, the SUD, VOC and note for it (see Rating each set).
• Close and stop the stimulation: closing the panel stops it for both of you.

What your patient sees

While a set is up the stimulus takes the place of the video tiles — the dot needs the full width — and the conversation carries on underneath. The dot and the tones are drawn and generated on the patient's own device from the settings you send: nothing is screen-shared, so the motion does not stutter, and the tones stay truly left and right.

• In auditory mode or both, they are asked: “Use headphones to hear the tones in each ear”.
• If the browser holds the sound back — Safari does until there has been a tap — an Enable sound button appears.
• A large Stop button, and the Escape key, stop the set at any moment. You see: “The patient stopped the stimulation.” The set is paused at the passes reached, and you resume it when you are ready.

If the patient joins or reconnects midway, their screen asks for the current state and picks the set up where it is. If your updates are not reaching them, the panel says so: “The patient may not be seeing the stimulation. Check the connection.”

In person: the board

Much EMDR happens in the consulting room. Outside a call, choosing the tool from a session's tools opens that session's board in a new tab; from the docks it first creates a new in-person EMDR session, then opens its board. The board is laid out for the work, in four parts:

• Where the patient sees it — three outputs, each saying whether it is live (below).
• The set — its phase (Ready, Running, Paused, Stopped by the patient), a large pass counter, the preview and large controls: start, pause, Continue this set, a new set, Stop. Space starts or pauses.
• The paused set's rating inline, with large SUD and VOC scales, and the session's sets so far with the SUD curve.
• The stimulus settings beside them. On a phone they come right after the set, before the history.

Where the patient sees it

The patient's window has a Stop button too, and opening it mid-set catches up with the running set. Closing the board takes the stimulus down on every screen: a set is never left running without a way to stop it.

Finish saves any pending ratings, stops the set on every screen and takes you to the session, on its EMDR tab.

Sharing the board by link

For a patient who is not in the room — you are talking by phone or on another platform — On their device opens the share dialog: “For a patient who is not in the room: they open the link on their phone, tablet or computer and see the stimulation — no account, no camera, no microphone. You can keep talking by phone or on another platform.” Copy the link, send it by WhatsApp or use your device's own share sheet.

• The board tells you when they arrive: “Waiting for the patient to open the link…” becomes “Patient connected: they'll see every set you start.”
• They see a waiting screen, then every set you start, with a Stop button that pauses the set on your board.
• “The link only works on this session's day and stops working if the session is cancelled.” It opens within a day of the session's date.
• Messages go through a mailbox on Alchely's own server, checked about once a second, so a start or a stop can take up to a second to reach the other side. No media server is involved.
• If your board stops checking in for a few seconds — the tab is closed, the connection drops — the patient's device takes the set down by itself.

The stimulus settings

Tactile, with game controllers

Turn on Tactile vibration (patient's controllers) and the patient's screen asks them to “Connect a game controller and press any of its buttons”. With one controller its left and right motors alternate; with two, they hold one in each hand. Your panel says which it is — for example “The patient has 2 controllers: one in each hand.”

Rating each set

When you pause a set, the panel — or the board — offers its rating: “Ask the patient and mark what they answer.”

Each set is also stored with its passes, speed, mode and whether tactile was on. Save set saves it at once, but you do not have to: “What you choose is saved on its own when you move on to the next set or finish.” The same happens if you stop the set, close the panel or the call ends.

Ratings are recorded on individual sessions only. On a couple's or group session the stimulation works, and the board says so: “This is not an individual session: the stimulation works, but SUD and VOC are not recorded.” The patient never sees the rating inputs, and no rating or note travels to their screen.

The session's EMDR tab

On an individual session, with the tool adopted, the session page has an EMDR tab: EMDR – Sets in this session.

• A summary: the number of sets, First → last SUD and Final VOC.
• Two charts: SUD by set (disturbance, 0–10 · lower is better) and VOC by set (positive belief, 1–7 · higher is better).
• A table with each set: Set, Passes, Stimulation, SUD, VOC, Note and Time. A set saved by mistake is removed from here.

With no sets yet, the tab explains how to record them and offers Open EMDR board.

The EMDR 8 phases template and Augmented Memory

Alongside the existing EMDR note template there is EMDR 8 phases: the standard eight-phase reprocessing protocol, with the set-by-set course of SUD during desensitisation. The original EMDR template is untouched, so sessions already using it keep their fields. Its sections:

1. History & Preparation
2. Target Memory
3. Negative Cognition
4. Positive Cognition
5. Initial VOC & SUD
6. Desensitization (set by set)
7. Installation
8. Body Scan Results
9. Closure & Grounding
10. Re-evaluation & Next Steps
11. Safety Observations

If you have adopted Augmented Memory, when it drafts or reformats the note it is handed the session's sets — notes anonymised — as the authoritative SUD and VOC values, rather than guessing them from the transcript.

Privacy and export

• The sets belong to the session: deleting the session, or erasing the patient, erases them.
• Your export of a patient lists every individual session's sets in full.
• The export a patient makes from their portal carries only the SUD and VOC of each set — never your notes.
• The stimulation itself stores nothing: what travels to the patient's screen is settings and a number.

Safety

The dot moves continuously, slowing into each edge and speeding through the middle. It never flashes and never changes brightness, and speed is held between 20 and 70 cycles per minute — well under the flash rates that photosensitivity guidance warns about. Even so, with photosensitive epilepsy or visual discomfort, use Auditory mode.

Problems