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Major Depressive Disorder MDD is a leading cause of disability worldwide. Researchers are evaluating a culturally and methodologically adapted Eye Movement Desensitization and Reprocessing EMDR therapy protocol specifically developed for treating MDD in Pakistan. This study also aims to compare the effectiveness of delivering EMDR therapy through both in-person and online methods, addressing the lack of research on EMDR adaptations and online therapy effectiveness in this region. The study involves two groups of participants receiving adapted EMDR therapy. One group will attend 12 to 13 weekly face-to-face sessions with a psychotherapist in a clinical setting. The other group will receive 12 to 13 weekly online sessions using BilateralBase software, conducted by a psychotherapist remotely. Patients are randomly assigned to either treatment mode as part of a randomized controlled trial. Participants will be adults aged 20 to 50 with symptoms of Major Depressive Disorder, ideally without recent psychotherapy or medication treatment. The study will monitor participants over six months, assessing changes in depressive symptoms. Researchers will use both qualitative and quantitative methods to evaluate treatment fidelity, cultural adaptation, and comparative efficacy between the two delivery methods. The total participation involves weekly sessions and follow-up assessments to measure outcomes.