What to expect from treatment
Safety is crucial in any human relationship, but even more so when addressing complex (relational) trauma. Therapy for complex trauma primarily involves reconnecting with aspects of yourself that have previously felt unsafe or suppressed. This process unfolds at a pace that is comfortable for you and may involve emotions, sensations, awareness, or thoughts.
A trauma-trained therapist uses a combination of body-based (somatic), emotion-based (affective), and thinking-based (cognitive) approaches to help you reconnect with your inner self. As you grow to know yourself better, you’ll gradually regain trust in yourself, a vital step for individuals who have been conditioned to perceive the world and people as inherently unsafe.
With the support of a trauma-informed therapist, you can develop better skills in noticing, understanding, and managing your sensations, emotions, and thoughts in a way that works for you. This process leads to establishing a sense of Inner Safety.
Once Inner Safety is achieved, Outer Safety becomes more accessible. This contributes to more fulfilling relationships and reduces the likelihood of retraumatization.
You and your therapist will work together to create a “safe-enough” therapeutic space. In this relatively controlled and professional environment, you can safely explore and learn new ways of engaging with both yourself and the world around you.
“If you can’t fly, then run.
If you can’t run, then walk.
If you can’t walk, then crawl.
But whatever you do you have to keep moving forward.”
Martin Luther King Jr.
How long will treatment take?
The duration of trauma treatment is difficult to predict and varies from person to person. It depends on how your specific trauma has affected you, what you’re ready to address, and what areas you wish to focus on in therapy. It also factors in the resources you have available—time, money, energy, or even something as simple as fuel for your car.
When resources are limited, therapy may focus more on establishing safety, building support systems, psychoeducation, and acquiring practical skills rather than trauma debriefing. Premature trauma processing can be destabilizing or retraumatizing without proper safeguards in place.
Trauma treatment is often more extensive than other mental health treatments. Given that trauma often develops over years and affects individuals for decades, healing is unlikely to occur in just a few sessions.
Funding for trauma treatment
Below, we outline various funding options for trauma treatment, along with useful links for more detailed explanations. You’ll also find helpful tips to make navigating your options easier. Since the information can be a bit overwhelming, consider reviewing it in small sections or with the support of someone you trust.
In the sections below, we cover a range of funding options that you may wish to explore when considering trauma treatment.
Where we could, we added helpful weblinks that explain the service better than we can; and here and there we also added a few helpful tips that may help ease the process of navigating all your options.
The information covered in these sections is fairly detailed, and you may want to read it in small bites or with a support person, if you find it a bit overwhelming at first.
(If you come across any information that has become outdated before we do, please feel free to drop us a line via the Contact Us form in the website footer at the bottom of the page!)
Mental Health Care Plan
To be eligible to receive a rebate on mental health services under Medicare’s Better Access initiative, a person must be referred by their GP (or psychiatrist, paediatrician or consultant physician) to consult with a clinical psychologist; generalist psychologist; certain occupational therapists; and appropriately trained social workers (collectively referred to as ‘allied health services’).
Services from psychologists in other areas of specialisation as well as counsellors and psychotherapists without accredited tertiary qualifications, are not usually eligible for a Mental Health Care Plan rebate.
You need to book in a session with your GP to obtain a Mental Health Care Plan referral. Be sure to advise the practice that you are requiring a Mental Health Care Plan, as most GPs want to set aside more than the standard appointment time for those consultations.
It is not a requirement from Medicare that your referral must be to a specific practitioner. A referral may still be valid even though it is addressed to a practice or simply, for example, ‘Dear Psychologist’.
If you are eligible for a Mental Health Care Plan referral, you are entitled to a rebate for 6-10 individual and/or group mental-health consultations per calendar year. As part of the government’s response to the Covid pandemic, it is possible to claim an additional 10 sessions per calendar year – increasing the number of sessions that will be rebated under Medicare to 20. These additional 10 sessions will be available until at least June 30th, 2022. You do not need to claim these rebates in consecutive consultations, and many people spread it out over the course of their treatment to ease the financial burden on their regular budget. Just let your therapist know when you want to do this, as many nowadays process your claim for a rebate on your behalf at the end of every session.
You will need to arrange a return visit to your doctor after six sessions, to have your referral reviewed and for your doctor to decide whether you meet the eligibility criteria for four more sessions. If you do not attend this review session, you will not be able to claim further Medicare rebates. In addition, in order to be eligible for the additional 10 sessions, you will need to return to your GP for a further review.
All health professionals set their own fees (and for those listed in the COTWA directory, you can find the fees in their profile). Some may bulk-bill (and you can search for those clinicians on the COTWA directory); and others may require an out-of-pocket gap payment.
The specified scope of treatment under the referral, as well as the actual rebate amount per session differ between the various allied-health disciplines, so it would be wise to check this with your therapist beforehand.
You may claim a rebate from either Medicare or your private health fund for any particular session, but not both.
CLICK HERE for more information about health care plans from Health Direct
A word of caution
If you are concerned that a Mental Health Care Plan referral for trauma treatment on your permanent health record may affect your future work options; and/or future insurance needs (such as Death and Total Disability insurance, Professional Indemnity insurance, Income Protection insurance and others), you may want to ask your GP about your options.
Enhanced Primary Care Plan
Sometimes, at their sole discretion, some GPs may also prepare a Chronic Disease Management plan for their patients with complex needs. (Confusingly, some people still refer to this arrangement by its earlier name, Enhanced Primary Care (EPC) plan; or a GP Management plan and/or Team Care Arrangement). It is up to your GP to decide whether you may be eligible for a maximum of five more sessions, at a smaller rebate, with a registered allied health service provider(s) (such as your trauma clinician) to assist with the management of your chronic difficulties.
CLICK HERE for more information and FAQ’s about Enhanced Primary Care Plan referrals
Some aspects of mental health care may be covered on private health insurance.
Outpatient Treatment
Depending on your health insurance and your policy, you may be able to claim a small rebate on out-of-hospital mental-health treatment. As this varies from health insurance to health insurance and for the cover you have, you should contact your individual health fund and verify what you have covered before engaging with a provider. Be aware that some health insurers only cover psychotherapy if you engage with a clinical psychologist.
Also, you are only allowed to claim a rebate from either Medicare or your private health fund for any particular session, not both at the same time.
Then, it may be wise to also plan for difficult periods in your healing journey.
Some hospitals offer really helpful day-programs for people with a history of complex trauma, that you may want to access as a psychiatric outpatient.
In-Patient Treatment
Sometimes, even effective trauma treatment may require a short or longer in-patient hospital admission, while you find your equilibrium again.
For this reason, you may want to make sure that your private health insurance policy also covers at least minimal cover for psychiatry and/or hospitalisation – even if you might really prefer to not use it.
Psychiatric services (and drug and alcohol rehabilitation) only require a two-month waiting period, not the usual 12-month waiting period. This is true even if the condition is pre-existing. In some cases, you may even be able to obtain an exemption from this waiting period and retroactively upgrade your hospital cover.
A once-per-lifetime exemption applies to upgrading your private health insurance to cover psychiatric care in a private hospital, without having to serve a waiting period first.
You may need to specifically request ‘the mental-health waiver’ when upgrading your cover, but it is worth asking your insurer first before utilising this once-off mental health waiver as some health insurers don’t have this waiting period.
For more information about accessing the exemption, please contact your health fund directly. For general information about this exemption, see the Department Of Health website.
If you were to ever require an urgent psychiatric admission but are not currently under the care of a psychiatrist, your GP (or Emergency Department physician) may simply send a referral to the clinic of your choice, addressed to ‘Dear Psychiatrist’. You will then be allocated to a doctor who can admit you as soon as possible. If you wanted to see a particular psychiatrist, this is also possible but may delay the admission process somewhat.
If you’re expecting a hospital admission at some point, it would be wise to contact your health fund, your hospital, and your doctor before things become too overwhelming to still think straight, to find out how much will be covered, how much you will have to pay, and any other expenses (your health fund or Medicare will cover a portion of the Medicare Benefits Schedule fee, but the remainder may be at your own expense).
Financial Questions to Ask your Doctor
We also recommend that you make a list of the questions that you may want to ask your doctor beforehand – maybe save it on your phone, under a name you’ll remember when flustered, so it is always nearby?
That way, you can whip it out when you don’t have much else to say on a particular day, and get the answers you need before things get hairy. It is always good to know one has ‘options’, or in the absence of that, to start thinking of Plan B!
Here are some questions we think are worth asking:
- Do you have a ‘no gap’ or ‘known gap’ agreement with my health fund? (this is really helpful to limit the potential cost of an admission)
- If they don’t, ask What would be the ‘gap’ on my medical services while admitted during a hospital stay? (be prepared for it that you may have to ask both your doctor and your health fund before you have the full answer)
- What kind of out-of-pocket expenses could I incur during a hospital stay? (for example, some psychiatric and other medical consultations and check-ups can only be claimed through Medicare)
- Will there be any excesses and/or co-payments? (some health insurance policies require you to pay an excess or co-payment for admissions to hospital, which you will need to pay directly to the hospital)
- Can I please have a written quote of expected and potential expenses that I may incur? (be sure to request the quote at the start of your treatment!)
The NDIS provides support to eligible people with intellectual, physical, sensory, cognitive and psychosocial disability, to help them get the support they need “to live an ordinary life” with the aim of improving their skills and independence over time.
Increasingly, the long-term and often debilitating psychosocial implications of complex trauma are being recognised by the NDIS. If your symptoms are considered “permanent” (i.e. likely to be lifelong, even if it waxes and wanes) and “significant” (i.e. so that it has a substantial impact on your ability to complete everyday activities on your worst days), you may be eligible for funded support from the NDIS.
This could go towards help with daily personal activities; transport; to enable participation in community, social, economic and daily life activities; workplace help, to allow you successfully get or keep employment in the open or supported labour market; some therapeutic supports (including behaviour support); and help with household tasks to allow you maintain your home environment; and more.
You may not feel that you have a “disability” that is “significant” and “likely to be permanent or lifelong”, and indeed that perspective does not fit with most survivors’ views of recovery from complex trauma. Bear in mind that these are just terms used by the NDIS, and that words do not need to define you.
With an NDIS plan, however, you can choose the services that will support you to live a meaningful life, which fits with your definition of recovery.
The ReImagine Today website is a good place to start for an introduction to the NDIS and its eligibility criteria; an explanation of the nature and evidence required for psychosocial disabilities; and describing the application process for accessing the NDIS in 6 Steps to people living with mental health conditions.
Your service providers do not need to be registered with the NDIS to be able to provide a service to you under the NDIS. CLICK HERE for an explaination of what that means and what the implications are.
Also, if you don’t want to work through an agency to source a support worker that meets your needs, you may find it helpful to post a job description/request on the WA Families and Support Workers Job Network Facebook page.
CLICK HERE for more information about how the NDIS Planning Service works
If your condition is a result of a criminal act in WA, you may be entitled to Criminal Injuries Compensation. This scheme is administrated by the WA Department of Justice. It is designed so that you can apply directly, and a great deal of information on this scheme including application forms and application guides is available.
Maximum compensation amounts are dependent on the date of the incident/s. If you prefer the support of a legal expert to assist in considering your eligibility and with the application process, you should be aware that there is nothing built into this scheme to cover legal costs, therefore these costs will need to be deducted from what you are awarded. You may be eligible for support from a free legal service like a Community Legal Centre, Legal Aid, or Aboriginal Legal Service of WA. If you have not done so already, you MAY be required to report the incidents to the WA Police. Currently, fully completed CIC applications are taking around 2 years to be assessed.
If your condition is a result of childhood sexual abuse in an institutional context, you may be eligible for compensation under the National Redress Scheme. This scheme is administrated by the Commonwealth Government and compensation payments are funded by the liable institution. It is designed so that you can apply directly, and there is a great deal of information on the scheme including which institutions have opted in, eligibility, application forms and guidelines on their website.
If you prefer the support of a legal expert in considering your eligibility and with the application process, you should be aware that there is nothing built into this scheme to cover legal costs, therefore these costs will need to be deducted from what you are awarded. You may be eligible for support from a free legal service like a Community Legal Centre, Legal Aid, or Aboriginal Legal Service of WA. In addition, there are some excellent FREE services who specialise in NRS applications, particularly Knowmore. If you have previously received other compensation for this abuse, it will have compound interest applied and be deducted from your award.
You should understand that by accepting an NRS offer of compensation, you will be required to sign a deed relinquishing your right to pursue further compensation from the institution/s through other avenues.
Currently, fully completed NRS applications are taking around 1 year to be assessed.
Legal reform in WA (as of 1 July 2018) means that survivors of childhood sexual abuse are no longer statute barred via time limitations from pursuing compensation through the courts from liable parties (institutions and individuals). At this point, the reform does NOT apply to survivors of other forms of abuse.
Although it is a court process, it is extremely unlikely that you will be required to give evidence in a courtroom setting.
You should be able to receive cost-free or obligation-free advice from a reputable personal injury law firm with regard to your potential claim. WA firms are subject to more stringent legislation and guidelines around costs than firms operating out of some other states.
If you have already received an award under the National Redress Scheme, you will have signed a deed relinquishing the institution from further compensation claims.
Currently, to progress a civil claim to the point of a potential advance payment for psychological services or to full settlement, can take 1-3 years or longer.
You can receive free or low-cost services and support for any mental health condition for you or your family, if you are a current or former member of the Australian Defence Force (ADF) (including reservists) and you have had at least one day of continuous full-time service.
There is no need to establish that your difficulties were caused by your service.
More information on the options that are available to support your mental health and wellbeing, and how to access services, is available from the DVA website
People with a history of complex trauma (which is also sometimes called Complex Post Traumatic Stress Disorder, or C-PTSD) are sometimes more susceptible to developing Post Traumatic Stress Disorder (PTSD) after experiencing or witnessing a single traumatic event later in life.
If such a traumatic event occurs while you are working or acting in the scope of your employment, treatment for your PTSD symptoms may be covered by workers’ compensation.
Also, if you could convincingly demonstrate that your symptoms of complex trauma got aggravated, accelerated, exacerbated, or deteriorated AND that work was a significant contributing factor to that, then your pre-existing C-PTSD symptoms may also be covered by Workers Compensation.
A mental health condition is no less serious than a physical injury and must be addressed in the same manner. Psychological injury or mental injury can include a whole range of difficulties that all interfere with your life, and significantly affect how you feel, think, behave and interact with others. This FACT SHEET covers a lot of questions about psychological injuries.
If you think you might have a psychological injury, please discuss this with your GP as soon as possible. Delaying seeking help can increase your symptoms of anxiety; make your treatment take longer; and also compromise your right to file a workers’ compensation claim.
If a workers compensation claim is approved, you may be compensated for lost wages, medical expenses, and associated costs while you are unable to work; and eligible for targeted trauma treatment for this most recent condition (which may directly or indirectly also benefit your longer-term complex-trauma difficulties).
The Clinical Framework for the Delivery of Health Services (Clinical Framework) is an evidence-based guide used by WorkCover to support health-care practitioners delivering services to people with compensable injuries.
It outlines five principles shown to deliver optimal recovery and return to work outcomes for those who qualify for workers compensation. You may want to keyword search this document (try ‘psychol’ or a variation of that) to see how it may apply to your circumstances.
Based on these principles, your treatment with a trauma specialist would need to demonstrate:
- How the effectiveness of your treatment is measured and demonstrated
- How a biopsychosocial approach was adopted for your treatment
- How you are being empowered to manage your injury
- Which goals were implemented to focus on optimising function, participation, and return to work
- How your treatment is based on best available research evidence.
Contact WorkCover WA to see how to access services and what you are entitled to:
Phone 1300 794 744 (toll free) or call (08) 9388 5555
There are very limited circumstances under which you may be able to access your superannuation early. This allows people with an acute or chronic mental illness to withdraw a limited amount of their super for unpaid expenses, if they have no other means of paying for the expense. Your doctor and/or treating clinician will be required to substantiate the claim that your condition is acute or chronic, and/or that the treatment you require is not readily available in the public health system. They will also be required to provide a quote for treatment over the course of the next 12 months.
Be aware that the super you withdraw is paid and taxed as a normal super lump sum.
You may find THIS LINK a helpful starting point to navigate this process.