EMDR or CBT? Understanding the Differences and How to Choose

When people look for therapy to help with anxiety, trauma or low mood, two names often appear: EMDR and CBT. Both are evidence-based, effective and widely used in the UK, yet they work in different ways. Understanding what each approach offers can help you decide which might suit you best.

How CBT works

Cognitive Behavioural Therapy (CBT) focuses on the relationship between thoughts, emotions and behaviours. It helps you notice unhelpful thinking patterns and experiment with new responses. For example, if you tend to think “I can’t cope,” CBT might help you examine that belief, test it in small steps, and develop more balanced alternatives. It is structured, active and collaborative, with practical strategies you can use between sessions. CBT is particularly effective for anxiety, depression, phobias and panic.

How EMDR works

EMDR, or Eye Movement Desensitisation and Reprocessing, helps the brain process distressing memories or experiences that remain emotionally charged. During sessions, your therapist guides you to recall parts of the memory while you follow gentle eye movements or other forms of bilateral stimulation. This allows the brain to integrate the memory in a healthier way, reducing emotional intensity. EMDR is best known for treating trauma, but it can also help with anxiety, health-related distress, and feelings of being stuck or on edge.

The key differences

• Focus: CBT works mainly with current thoughts and behaviours. EMDR works with how past experiences affect you in the present.
• Talking vs processing: CBT involves structured discussion and cognitive exercises. EMDR is less verbal and relies on the brain’s natural processing mechanisms.
• Homework: CBT often includes practice tasks between sessions. EMDR focuses more on in-session processing, with less formal homework.
• Speed and depth: Some people notice changes quickly with EMDR, while others prefer CBT’s step-by-step structure. Both can be adapted to your pace and comfort.

Combining the two

Many therapists integrate CBT and EMDR, especially when clients have both trauma and ongoing anxiety or depression. CBT offers skills to manage daily stress, while EMDR addresses the root causes that keep certain feelings locked in. This combination can be particularly effective in private practice, allowing therapy to remain flexible and individualised.

Choosing the right fit

If you prefer a structured, goal-oriented approach with clear strategies, CBT might feel right. If your distress feels rooted in past experiences or physical sensations you cannot shift, EMDR may be more suitable. It is also common to use both, either sequentially or together, depending on what feels most supportive. The most important factor is the therapeutic relationship and your sense of safety with your therapist. Together, you can decide which approach will help you move forward most effectively.

Moving ahead with confidence

Both CBT and EMDR are evidence-based and transformative. Whether you want to understand your patterns or process what has felt too heavy to face alone, the right therapy can help you rediscover calm, strength and choice in your life.