This post is about How to Find a Good Trauma Therapist on the Northern Beaches of Sydney, and Online.

Have you ever felt like the well-intentioned advice to start your trauma recovery and mental health journey by getting a diagnosis or a Mental Health Care Plan with a GP just doesn’t quite hit the mark? You’re not alone! The majority of women that I have seen over the last 22+ years, have been looking for a more individualised, holistic and trauma-informed approach to their health and wellbeing.  

Many trauma experts and women looking for trauma treatment have raised concerns about being diagnosed with a mental health disorder or disorders such as ADHD without considering and assessing for trauma. Former South Pacific Private Program Director and Trauma Warriors Trauma Therapist, Andrea Szasz talks about this confusion in her article in the Guardian, Is it ADHD or Nervous System Dysregulation?

Concerns have persisted for several years regarding the excessive reliance on the Diagnostic and Statistical Manual of Mental Disorders (DSM) for diagnosing commonplace issues, including those related to grief and loss, as well as more enduring challenges such as trauma. Often these concerns are medicated under the umbrella of anxiety or depression.

Master Psychotherapist, Irvin Yalom writes about diagnosis,

“Avoid diagnosis, it is counterproductive in the everyday psychotherapy. Why? Therapy is an unfolding where the therapist gets to know the client over time…a diagnosis is limiting and can act as a self-fulfilling prophecy.”

Yalom is essentially talking about pathologisation, I wrote an article about this over a decade ago, which can be found here and I also address GP referrals in my article, What Your Dr Doesn’t Tell You About How to Find a Therapist. Additionally, Mad in America is an excellent online publication that actively challenges the conventional medical model.

By providing practical guidance, this blog on How to Find a Good Trauma Therapist on the Northern Beaches, aims to empower you to make informed choices regarding your trauma recovery and mental health support, encouraging a shift towards therapists and therapeutic practices that prioritise the understanding and healing of attachment, complex and developmental trauma.

What’s The Difference Between a Counsellor, Psychotherapist, Social Worker and Psychologist? 

You’ve likely come across psychologists, who are often the go-to referral through a Mental Health Care Plan, with Mental Health Social Workers being another potential resource. You might be wondering, however, ‘Why isn’t my counsellor or psychotherapist of choice and counsellors or psychotherapists in general included in these plans?’ Straight up – it’s a matter of politics and policy, and the Psychotherapy and Counselling Federation of Australia (PACFA) is actively working towards having their tertiary qualified workforce of counsellors and psychotherapists included. 

Psychologists, social workers, counsellors and psychotherapists all provide psychological interventions and care. Psychologists have a medical model / diagnosis orientated approach and social workers have a social model orientated approach. Counsellors and psychotherapists, spend the whole 4 years specifically focusing on counselling. You will often find that psychologists and social workers go on to train in counselling as they feel their primary degree didn’t provide them with specific counselling skills. It is important to choose someone with specific counselling or psychotherapy training and then trauma training as a speciality.

Whilst the therapeutic relationship is central to all modalities, psychotherapists take it one step further and they use the (attachment) therapeutic relationship to recover the dissociated parts and to restructure the psyche (we often use the analogy of a house – the basement (the past), the ground floor (the present moment/here and now) and the loft (the potential/future)). A psychotherapist helps rebuild the foundations from the basement up.

Trauma Counselling & Psychotherapy Directories

In Australia, numerous databases provide an excellent starting point for discovering a tertiary-qualified, trauma-savvy counsellor or psychotherapist specialising in complex trauma. I’ve compiled a list below: 

• The Psychotherapy and Counselling Federation of Australia
• The Australian Register of Counsellors and Psychotherapists
• Psychology Today (look for counsellor or psychotherapist in the title section)
• The Blue Knot Foundation
• The National Redress Trauma Support

Take your time to explore the counsellor and psychotherapist profiles and ponder the questions outlined in this guide. While the guide offers comprehensive insights, it’s completely normal to feel a bit overwhelmed. Take your time with the process—you deserve the highest quality care available.

*What to Look for When Trying to Find a Good Trauma Therapist on the Northern Beaches of Sydney, and Online*

When embarking on the search for a good trauma therapist on the Northern Beaches of Sydney, and online, it’s good to consider several factors before the initial session. If you haven’t found answers to these questions beforehand, fret not; you can always bring them up in your initial session.

Do I need a Female, Male or Non-Binary Trauma Therapist? 

Selecting the right therapist involves personal considerations, and for women, there might be unique aspects to factor in. If you’re a woman who has experienced trauma, especially of a sensitive nature like sexual abuse, you will find it beneficial to choose a therapist based on your comfort level and preferences. For instance, some women may feel more at ease discussing certain issues with a female therapist due to shared experiences or a perceived understanding of specific challenges. There are many services by women, for women, for this reason. 

On the other hand, transference dynamics, where past relationships with significant figures like parents can influence the therapeutic relationship, might also be a consideration. You might start with a female therapist and decide another time to have therapy with a male therapist. Some therapies work by internalising the love and care of the therapist in the form of a good mother/good father representation.

It’s essential to recognise that therapy is a deeply personal journey, and choosing according to the sex of a therapist, depends on your individual comfort, needs, and the dynamics you feel will be most conducive to your healing process. Exploring these considerations openly with potential therapists can contribute to finding the right fit for your unique circumstances and experiences.

Is the Therapist Trauma Informed and Experienced in Working with C-PTSD? 

When seeking a therapist, prioritise those with specialised training and credentials in trauma. You will usually find this information on the therapist’s website. Trauma comes in various forms, such as attachment trauma, complex trauma, developmental trauma, and single-incident trauma. It’s crucial to choose a therapist with trauma-informed training and care, indicating a profound understanding of the complexities linked to prolonged and pervasive trauma. Beyond general knowledge about trauma, focus on therapists trained to work specifically with trauma. Additionally, consider whether the therapist specialises in individual, couples, or family trauma.

What is the Trauma Therapist’s Duration of Practice? 

Assess how long the therapist has been in practice. While experience doesn’t guarantee effectiveness, a seasoned therapist will have encountered a variety of cases and developed refined skills through many years of practice-based evidence and continued professional development. 

What is the Therapist’s Therapeutic Approach? 

It is important to have at least a basic understanding of the therapist’s theoretical approach to therapy and trauma. Psychodynamic, somatic, and working with parts, subpersonalities and Internal Family Systems for example, are common approaches. Here is a link to Trauma Warriors, The Best Therapy for Trauma & CPTSD – see which one (or more) you align with most.

Does the Therapist Work Collaboratively? 

Seek a trauma therapist who emphasises a collaborative and empowering approach. Therapy for complex trauma often involves active collaboration between the therapist and the client, promoting agency and self-discovery.

Trauma counsellors and psychotherapists are adept at collaborating with other health professionals, such as your GP, psychiatrist, dietitian, body worker and more. Psychotherapists undergo training in severe psychopathology, often through psychiatric placements, equipping them with the skills to effectively communicate about these concerns. This collaborative approach ensures a comprehensive and well-coordinated effort to address your trauma and mental health needs.

Does the Trauma Therapist Have Lived Experience? 

You might prefer to look for a therapist who has lived experience with trauma and any other mental health concerns that you may have. If the therapist does have lived experience, it is important that they seek regular clinical supervision and have worked through their trauma history in their long-term depth psychotherapy. This is important and I speak about why in greater depth in my blog, Why Your Therapist Should Be in Therapy. A therapist with lived experience brings a depth of experience that equates to added empathy and understanding to the therapeutic relationship – a recovered therapist can also offer a deep sense of hope to your recovery process. 

Was the Therapist Referred? 

When seeking recommendations for a trauma therapist, you can turn to reliable sources such as friends, family, or healthcare professionals. Referrals offer valuable firsthand insights into a therapist’s approach and effectiveness. It’s worth noting that many therapists may choose not to work with friends or family members, which should not be a cause for alarm if you find yourself in this situation – it is actually in your best interests to have someone just for you! It’s essential to understand that not every therapist-client pairing is optimal, and not every therapy modality suits everyone. Therefore, if a referral doesn’t materialise or doesn’t result in a suitable match, it’s important not to take it personally. Acknowledging the individualised nature of therapy and recognising that finding the right fit may require exploration and consideration can help in the search for an effective therapeutic relationship.

Have You Read Client Reviews and Testimonials? 

The guidelines regarding testimonials for therapists vary across different boards, with some prohibiting them altogether. In cases where testimonials are permitted, they are often expected to be unsolicited. When assessing online reviews and testimonials, it is important to scrutinise the dates of the feedback and identify consistencies across reviews. Additionally, consider therapeutic factors, such as the impact of positive or negative transference from previous clients onto the therapist. It’s essential to be mindful of the potential biases in reviews. Reviews may be selectively chosen, and in some instances, negative feedback might be posted when the person posting wasn’t even a client – this could be due to various reasons, such as the therapist lacking availability in their schedule or deeming the therapeutic fit as incompatible. Due to confidentiality, therapists are not allowed to respond to positive or negative reviews. Therefore, approaching client reviews with a discerning eye and considering contextual factors is crucial for a more accurate evaluation.

Is the Trauma Therapist’s Online Presence Ethical? 

It’s important to assess the therapist’s online presence, social media posts and participation in discussion groups. Unfortunately, there are many Facebook groups where admins allow de-identified client discussion. I believe this to be unethical. I would personally state to the therapist that you do not give them permission to seek consultation about your case online. If the therapist is sharing client information online, this goes against their ethical code regarding confidentiality. The therapist should abide by and provide you with a privacy agreement.

Is the Trauma Therapist a Member of a National Federation or Association? 

Choose a trauma therapist who is registered with a reputable counselling association such as the Psychotherapy and Counsellors Federation of Australia (PACFA), PACFA is equivalent to the New Zealand Association of Psychotherapists (NZAP) and the United Kingdom Council for Psychotherapy (UKCP). When counsellors and psychotherapists have membership in such associations, it indicates that they have a minimum standard of counselling or psychotherapy training, they attend at least 10 hours of clinical supervision and 20+ hours of continued professional development a year. A trauma therapist is likely to do all of their CPD in trauma related workshops. You will usually find this information on the therapist’s website on their bio page. 

Is Your Therapist a Member of a Trauma Database?

A therapist listed in trauma-specific databases as mentioned above, like the Blue Knot Foundation or the Trauma Support Directory demonstrates a commitment to working with trauma survivors and staying informed about trauma-related issues. It also means they have likely participated in further trauma training. 

Is Therapy Accessible? 

It is important to consider the practical aspects, such as the trauma therapist’s location, availability and scheduling options. Accessibility can impact your ability to attend sessions regularly. In saying that, many people travel across town, on a weekly basis for the right therapist. Many therapists are also offering online and hybrid options now which might look like, in person twice a month, and online twice a month.

Is the Therapy Consistent? 

The therapeutic process has the potential to become the cornerstone of your week, sometimes you might want to extend to two or three sessions a week. It serves as a stabilising environment, a still point amid life’s chaos. The regularity of sessions is crucial, providing a dependable holding framework. The effectiveness of therapy involves maintaining a consistent appointment time that aligns with your schedule. Trauma therapists, in particular, often recommend weekly sessions. This consistency is vital, especially for individuals dealing with disorganised attachment injuries arising from chaotic early childhood experiences. The weekly rhythm serves as a stabilising force, creating a reliable and supportive container for the therapeutic process. Your therapist will discuss this with you in the first session. It is important that the timing is right as therapy is a big commitment to yourself. 

Are the Fees Transparent & Sustainable? 

Most good trauma therapists on the Northern Beaches prioritise transparency by displaying their fees on their website. Initially, understanding the cost of therapy can be challenging. However, individuals who have overcome early childhood attachment, developmental, and complex trauma often emphasise the invaluable nature of the recovery process and come to see it as an investment in themselves. Depth psychotherapy, supported by a wealth of evidence, demonstrates long-term efficacy, and effective therapy has the potential to profoundly transform your life. Engaging in therapy is ultimately a commitment to your well-being but it does need to be sustainable.

*Reflections for the First Session*

First and foremost, your initial trauma therapy session is primarily about establishing a connection with the therapist. Strive to be yourself as much as possible. Therapists understand that opening up can be challenging, especially if you have a history of trauma. It’s entirely normal to feel anxious during your first therapy session. Reflecting on the following questions after the initial session can be beneficial.

The Therapeutic Alliance

Research indicates that the relationship you build with your therapist serves as the cornerstone of your recovery. If you’ve experienced early childhood trauma, the very term relationship might evoke anxiety or fear. Trained trauma psychotherapists and counsellors acknowledge this, making it a priority to alleviate any apprehensions you may have. It’s crucial to select a therapist with whom you sense safety, trust, and connection. A strong rapport significantly enhances the effectiveness of the therapeutic process. Some individuals can instantly discern if a therapist is the right fit, while for others, especially those with a history of trauma and trust issues, it may take a bit more time. In recovery treatment centres, a common recommendation is to give a new approach at least 6 weeks. This principle often applies when acquainting yourself with a new therapist. I typically recommend participating in 6 sessions, followed by a review. By the end of this period, you’ll likely have a good sense of whether the therapist aligns with your needs or not.

Ask Questions

During your initial session with a trauma therapist, which typically lasts between 50 to 90 minutes, much of the time will be dedicated to the therapist asking you about your reasons for seeking therapy and what has led you there. Most therapists actively encourage you to pose questions, and they often reserve ample time at the end of the session for any additional inquiries you may have. Don’t hesitate to inquire about the trauma therapist’s experience, their approach to trauma, and any success stories (while keeping in mind that therapists adhere to strict client confidentiality). As mentioned elsewhere in this article, you may also want to explore whether the therapist has lived experience and has undergone their own therapy. These conversations are instrumental in assessing their suitability for meeting your specific needs.

Is the Trauma Therapist Culturally Competent?

Ensure that the therapist possesses cultural competence, demonstrating respect and understanding of your background and cultural identity. This is particularly crucial for individuals from diverse cultural or marginalised communities, including those who have experienced domestic violence, war-related trauma, individuals with disabilities, or those from First Nations or LGBTQI+ communities.

Did the Trauma Therapist Take a Comprehensive Assessment?

A good complex trauma therapist conducts a thorough initial assessment to understand the specific aspects of your trauma history and its impact on your life. This assessment guides the development of a personalised working hypothesis and treatment plan. Many therapists take a longer first session of 90 minutes to allow enough time for a thorough assessment. In psychotherapy, it is not uncommon for the initial assessment to take place over several sessions. 

Did the Trauma Therapist Explain the Contract Clearly Including Boundaries and Ethics?

The contract (or informed consent) and the therapeutic frame are the first steps in creating safety for you as a new client. The therapist should take a good amount of time to explain how therapy works. A physical copy of the contract discussing confidentiality, cancellations, attendance, holidays, privacy, CovidSafety etc should be given in the first session so you can make an informed decision about whether it will be the right therapy for you. 

Regular Clinical Supervision

If the trauma therapist is registered with a Psychotherapy & Counselling Federation or Association, they will engage in clinical supervision. Ensuring your therapist is on the PACFA/ARCAP Register is crucial for this reason. In the initial session, where therapists discuss the clinical contract and boundaries, most practitioners will touch upon supervision, given the confidentiality and supervision rules. A proficient therapist actively participates in monthly clinical supervision throughout their career, fostering their professional growth for years to come.

Continued Professional Development (CPD)

If the trauma therapist is registered with a Psychotherapy & Counselling Federation or Association, they actively engage in continued professional development (CPD). Trauma therapists often focus their CPD on trauma training, ensuring they stay informed about the latest research, interventions, and ethical considerations in the field. CPD is crucial for maintaining up-to-date expertise and providing high-quality care. The therapist will usually mention this in the first session.

Has the Trauma Counsellor or Psychotherapist Had Their Own Personal Therapy? 

Seek a trauma therapist with a substantial background in having had their own depth psychotherapy. Ideally, therapists should have completed a minimum of 160 hours of weekly counselling or psychotherapy during their training, in line with the expectations of the PACFA College of Psychotherapy, as well as international associations such as NZAP and the UKCP. Engaging in continuous personal therapy throughout their careers, as recommended by Yalom, ensures that the therapeutic space remains focused on your needs rather than the therapist’s.

*Considerations for the first 1-6 sessions*

Here are some considerations as you progress through the first few sessions and into open ended trauma therapy. 

Trust Your Instincts

For individuals who’ve endured early childhood trauma, trusting your instincts can be a challenging journey, particularly if you’ve faced gaslighting or the neglect of your feelings and needs, perhaps from a narcissistic parent. If, after the initial sessions, you sense discomfort or a mismatch with the therapist, it’s entirely acceptable to discuss your concerns, explore other therapists, and, if necessary, conclude the therapy. A skilled trauma therapist will respond without defensiveness.

How Do I Tell the Trauma Therapist They aren’t a Good Fit for Me? 

Good trauma therapists have invested years in their own personal therapy and clinical supervision, recognising that they may not be the perfect match for everyone. The recommendation is to acknowledge when the therapist doesn’t feel like the right fit. Understanding the challenges associated with endings, especially for those with early childhood attachment, developmental and complex trauma, is crucial. Opting for an ending session might seem challenging compared to emailing or ghosting, but it is a step towards assertiveness and avoiding potential feelings of shame. It’s essential to note that you don’t owe the therapist an ending session though; it’s a choice made for your growth, not the therapist’s.

Committing to Ongoing Trauma Therapy

Congratulations on completing the initial six sessions and considering a review for continued, open-ended trauma therapy. Taking this step requires courage and a profound commitment to your long-term well-being. It’s normal for this decision to feel unfamiliar, especially if you’ve experienced neglect in your history. Participating in therapy is an act of self-care, representing your dedication to showing up for yourself. Through this ongoing process, the therapist facilitates the growth of internal resources, nurturing the younger parts that may have been forced into hiding due to early childhood and developmental trauma.

Referring You to Another Professional

In some cases, if the trauma therapist has concerns about whether they are the most suitable fit for your specific needs, they might recommend you to another good trauma therapist on the Northern Beaches with more expertise or a different therapeutic modality. It’s crucial not to take this referral personally, especially if you have a history of feeling like you are either not enough or too much. Therapists may refer clients for various reasons, often linked to their own training or specific capabilities. Understanding that these referrals are made with your best interests in mind can help navigate this aspect of the therapeutic process.

Conclusion

Navigating the journey to find a good trauma therapist on the Northern Beaches of Sydney, and online, involves careful consideration. The traditional route of relying solely on GPs for mental health support has limitations, prompting the need for a more informed exploration of available therapeutic options. This blog post aims to empower individuals by providing guidance on selecting trauma-specific counsellors or psychotherapists who adopt a holistic, trauma-informed approach.

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