Trauma related difficulties
Psychological support for trauma related difficulties
Difficult experiences can continue to affect how someone feels, thinks, relates to others and responds to situations long after the event itself. Sometimes the connection is obvious. At other times, people mainly notice anxiety, difficulty trusting others, sleep problems, avoidance or a sense of being constantly on guard.
You do not need to be certain that what happened “counts” as trauma before seeking support. You also do not need to describe everything that happened in detail. We can begin with how your experiences are affecting you now.
Saturdays: In person in BlackburnWednesdays & Thursdays: Telehealth, including after hours
Particular clinical experience
Della has training and clinical experience in trauma informed psychological practice and working with adults experiencing trauma related difficulties. She is also undertaking doctoral research in trauma informed practice, with a particular focus on how people are interviewed and supported following difficult experiences.
What this may look like
- Avoiding places, people, conversations or reminders
- Difficult memories arriving when you do not expect them
- Feeling constantly on guard or finding it difficult to relax
- Changes in your sense of safety or trust
- Anxiety that can be difficult to make sense of
- Disturbed sleep or nightmares
- Difficulty with trust, closeness or relationships
- Strong emotional or physical reactions that feel difficult to understand
- Feeling disconnected, numb or different from how you used to feel
Not everyone who goes through a difficult experience develops these difficulties, and people notice different things.
What is PTSD?
Post traumatic stress disorder, or PTSD, is a recognised mental health condition that can develop after exposure to traumatic experiences. Not everyone who experiences trauma develops PTSD.
PTSD can involve intrusive memories, avoidance, changes in mood or thinking, and feeling persistently alert to danger. A diagnosis depends on the pattern, duration and impact of symptoms. Experiencing a difficult event on its own does not establish a diagnosis.
Another way of understanding PTSD
One way of understanding PTSD is as a psychological injury that can develop when the mind and body continue responding as though danger is still present after the event has passed. This does not mean someone is weak or has failed to cope.
PTSD is treatable. Australian clinical guidelines recommend trauma focused psychological therapies for adults with PTSD, and effective treatments are available.
How therapy can help
We usually begin by understanding what is happening now and how your responses may have developed. Reactions such as avoidance, staying alert to danger or trying not to think about what happened may have made sense at one point, even if they are now making everyday life harder.
From there, therapy may involve developing ways to manage distress, understanding recurring patterns, working with avoidance where it has narrowed your life, and addressing sleep, anxiety or relationship difficulties when they are part of the picture.
For some people, directly working with traumatic memories may become useful. This does not mean being pushed to tell the whole story before you are ready. We discuss the options, the reasons for using them and whether they make sense for you.
The work is collaborative. We discuss what we are doing, why we are doing it and what feels manageable enough to work with.
Experience across different contexts
Trauma does not happen outside a person's history or culture. Della has clinical experience working with adults affected by war, persecution, displacement, migration and intergenerational trauma, including people whose family histories continue to influence how they understand safety, relationships and themselves.
This experience informs a trauma informed approach that considers the person's individual experience alongside their family, cultural and historical context.
Written Exposure Therapy for PTSD
Della is trained to provide Written Exposure Therapy, or WET, for suitable adults experiencing PTSD. WET is a brief, structured trauma focused psychological treatment.
Much of the trauma focused work is completed through writing during the session, so you do not need to give the psychologist a detailed verbal account. The standard WET protocol involves five sessions and does not require between session therapy homework.
This format may appeal to people who:
- prefer a shorter and clearly structured treatment
- find extensive between session homework difficult to manage
- would prefer not to give a detailed verbal account of the traumatic experience to the psychologist
- want to understand exactly what the treatment will involve from the beginning
WET is not necessarily the right treatment for everyone. We first consider your symptoms, circumstances, safety, preferences and treatment goals before deciding whether it is an appropriate option.
What does the research say?
Written Exposure Therapy has been evaluated in several randomised clinical trials. Research has found reductions in PTSD symptoms, and trials have found WET to be noninferior to longer trauma focused treatments including Cognitive Processing Therapy and Prolonged Exposure Therapy.
WET also requires fewer sessions and does not include between session therapy assignments in the standard protocol.
Pacing and choice
You do not need to arrive ready to discuss every detail of what happened. We start by understanding what is affecting you now and what you would like to change.
Trauma focused work can sometimes feel difficult, so it is important that you understand what we are doing and why. If a particular approach does not seem appropriate, we can discuss other options.
Practicalities
Sessions are 50 minutes.
Luma Psychology is an outpatient private psychology service for adults aged 18 and over. It may not be suitable for people who currently require crisis intervention, intensive mental health support or coordinated multidisciplinary care.
Young people aged 15–17 are also welcome to enquire; each request is considered individually. If you are aged 15–17, or enquiring on behalf of someone in this age group, please book a free 15-minute phone consultation with Della to discuss whether Luma Psychology is a suitable fit.
Della does not provide medico legal, forensic or court reports.
Related areas
- Anxiety & overthinking
- Sleep & insomnia
- Chronic pain & health changes
- The impact of difficult past experiences
About the psychologist
Della Zhang is a Registered Psychologist working with adults in Melbourne and via Telehealth.
References and further information
- Phelps, A. J., et al. (2022). Australian guidelines for the prevention and treatment of posttraumatic stress disorder: Updates in the third edition. Australian & New Zealand Journal of Psychiatry, 56(3), 230–247.
- Sloan, D. M., Marx, B. P., Lee, D. J., & Resick, P. A. (2018). A brief exposure based treatment vs cognitive processing therapy for posttraumatic stress disorder: A randomized noninferiority clinical trial. JAMA Psychiatry, 75(3), 233–239.
- Sloan, D. M., Marx, B. P., Acierno, R., et al. (2023). Written Exposure Therapy vs Prolonged Exposure Therapy in the treatment of posttraumatic stress disorder: A randomized clinical trial. JAMA Psychiatry, 80(11), 1093–1100.
In person appointments are available in Blackburn on Saturdays, at 213 Canterbury Road, Blackburn VIC 3130. Telehealth is available on Wednesdays and Thursdays, including after hours.
Thinking about making an appointment?
You don’t need to have everything figured out before reaching out. Tell me a little about what you’re looking for and I’ll contact you about the next step.
Want to talk first? You are welcome to to ask a couple of questions.