- Telephone and online counselling is provided using a team- based approach;
- Therapeutic planning is in place for regular clients;
- Service provision is informed by evidence about best practice approaches to trauma recovery;
- Counselling is delivered using a stage- based framework for recovery alongside an intersectional, feminist view of sexual, domestic and family violence.
The information on this page is for health professionals.
If you are not a health professional and would like to speak to a counsellor, you can reach us by telephone or online:
Evidence-based best practice trauma specialist counselling
All calls to our services are answered by experienced trauma-specialist counsellors. Counsellors offer non-judgmental support alongside therapeutic strategies or goals in managing the impact of trauma. They also provide appropriate referral pathways.
An individual’s response to the violence they have experienced is unique.
However, general patterns or stages have been identified that represent common impacts and a trajectory towards recovery.
Our counsellors use this evidence-based framework to inform their counselling approach when working with clients.
Rape & Domestic Violence Services Australia follows the guidelines set out by the Australian Centre for Post-traumatic Mental Health (2013). The guidelines offer a framework for providing counselling services for people experiencing trauma resulting from sexual, domestic or family violence. The trauma can be a recent or past experience.
Alongside this stage-based framework, counsellors are free to draw from their preferred evidence-based counselling models. These may include cognitive behavioural therapy, cognitive processing therapy, narrative therapy, schema, somatic, dialectical behaviour therapy or others.
The internal and external safety of clients, staff and anyone else affected by violence is always our first priority and safety planning occurs at every stage.
Aboriginal and Torres Strait Islander communities
Counsellors at Rape & Domestic Violence Services Australia understand the legacy of intergenerational trauma arising out of institutionalised racism and abuse of indigenous people. We take this into account in providing our services.
Rape & Domestic Violence Services Australia acknowledges the impact of colonisation on Aboriginal society and culture and the negative history of relationships between Aboriginal people and welfare agencies.
We acknowledge the impact this has on the safety and accessibility of services.
Our approach in detail
The stage- based framework in use at Rape & Domestic Violence Services Australia has been developed through the amalgamation of Herman's stage-based recovery model and the transtheoretical model of change.
Rape & Domestic Violence Services Australia identify four important stages of recovery for clients. Approaches and interventions are tailored to the individual's stage and particular circumstances:
Stage one: contemplation and preparation for safety
Telephone and online counselling services often experience a higher number of presentations by clients in the 'contemplation and preparation for safety' stage than face to face services.
For clients in the 'contemplation and preparation for safety' stage, common concerns are raised around confidentiality. Other questions include the cause of the violence and concerns about possible repercussions if attempts are made to establish safety.
Offering an anonymous support service responds to the unique needs of clients who have experienced sexual, domestic, and family violence. It also provides an earlier opportunity for help-seeking and reaches a greater number of people.
Stage two: safety and stabilisation
For most clients, once external safety has been established, attention should turn to internal safety. For other clients, the risks arising from internal threats to safety are the primary concerns. Many clients who have been subjected to repeated or prolonged violence develop ways of coping with the impacts of their experiences that threaten their wellbeing.
There are common presenting issues for clients in this stage that may include a high level of active trauma symptoms. These may include: fluctuating levels of confidence about decisions to establish safety; self-harm and suicidal ideation and action; substance abuse; risk- taking behaviours; dissociation; increases in subjection to violence; anxiety; depression; and affected dysregulation.
The focus of work in this stage is on developing skills to manage these effects and cope with stress. This includes psychoeducation around managing arousal of the nervous system through breathing, relaxation, somatic exercises, mindfulness, grounding, containment and ventilation. Further work focuses on understanding the impacts of the violence they experienced and locating blame with the offender.
Stage three: trauma processing
Many people who have experienced sexual, domestic or family violence will not require any further treatment once they have achieved safety and stabilisation.
If, however, clients continue to avoid traumatic memories (for example by self-medicating) and/or continue to be overwhelmed by them, controlled and predictable exposure to the traumatic past can assist with gaining mastery (Van der Kolk, McFarlane and Weisaeth, 2007).
Processing trauma is an individual process and will look different for each person. The general goal in processing trauma is to improve quality of life and move away from the adaptive survival responses that are no longer helpful.
In the context of a safe therapeutic relationship, processing trauma involves looking at words, emotions and somatic experiences, and integrating the story of violence and trauma into the context of the individual as a whole person. Building on the skills that support safety and stabilisation, the individual works towards being in control of their life and their choices, rather than feeling overwhelmed by their trauma.
This work is undertaken face to face in our Community Based Counselling Service or via referral to Victims Services. Clients who undertake this work will undergo assessment for suitability and readiness.
Stage four: connection and reintegration
Connection work continues when clients find that the impacts and reactions related to their trauma experiences are largely manageable (Herman, 1997). This means that they are not frequently troubled by re-experiencing, avoidance or arousal symptoms and able to place their experiences of abuse in the past.
People with complex trauma histories commonly experience difficulties with the interpersonal skills that are required to connect with others. Developing these skills can take time and be difficult. Effective and assertive communication, social interaction and interpersonal problem-solving during counselling is beneficial. (Cloitre, Scarvalone & Difede, 1997).
Safe connection is a key ingredient in recovering from interpersonal violence and should be explored throughout all stages of trauma recovery work. Where necessary, this work may continue with an increased focus on reintegration when the client has gained some mastery over re-experiencing, avoidance or arousal symptoms.
Intersectional feminist approach
Culturally responsive trauma models recognise that a client may hold intersecting identities where social and political structures influence a person’s vulnerability to, experience of, and recovery from experiences of violence (Bryant-Davis 2019).
There is recognition that trauma experiences exist outside an individual’s thoughts, feelings and behaviour. This can help to explain how social inequality impact the individual. This extends from gender to include sexual orientation, ethnicity, religious and cultural identities and displacement, socio- economic status, migration status, disabilities, family structure and more.
Our counsellors explore relevant factors with clients to fully understand their context, and set goals for counselling that make sense for the individual.
As Rape & Domestic Violence Services Australia provides counselling in various modalities, clients often contact the service in the earlier trauma processing stages and may move between stages and modalities. Flexibility and adaptability provides clients with choice and consistency in the support available. It also provides the opportunity to maintain connection with one service over time.
Approximately 70% of callers to our telephone and online counselling services contact between one and three times. For others, we become a regular part of their care and support team.
As we provide our service using a team-based approach, it is important for regular callers that a plan is documented to ensure proper communication across the team. This also ensures that the client does not have to repeat their story and their preferences at each contact.
Where clients contact the service six or more times, our counselling team undertake a therapeutic planning process which incorporates:
- The client's stated preferences, counselling goals and wishes. Where clients are able to, they will be invited to engage in a formal planning discussion. When this is not possible, this may be done via a review of records from counselling calls and clinical reflection;
- The counsellor's assessment taking into account the client's stated trauma impacts, strengths, psychosocial circumstances and stage of trauma recovery;
- Consultation with the clinical lead team;
- Consultation with client's other support services where consent has been obtained to do so.
Working with complex trauma
Rape & Domestic Violence Services Australia understands that individuals who have experienced prolonged or repeated episodes of sexual, domestic or family violence experience a range of impacts.
These impacts can include unhelpful beliefs about themselves, the world and other people, internalising disorders (anxiety and depression), dissociation, difficulty managing emotions, difficulty with relationships and difficulty engaging in their community. This experience is what is referred to as 'complex trauma'.
Rape & Domestic Violence Services Australia understands that these behaviours represent efforts that individuals have had to make in order to survive the cumulative effects of violence and disrupted early attachments. Our counsellors work with individuals to recognise and understand these behaviours as responses to their experiences of violence and abuse.
Many clients with complex trauma have difficulty maintaining consistent engagement with services and supports. Some clients have expressed to us that they tolerate the anonymity and distance of telephone counselling better than face to face counselling.
We work with these clients to build skills in maintaining connection and managing distress and other impacts. We have found that this sustained connection can lead to change in a client's preparedness to engage in face to face counselling or other support.
Team based approach
Rape & Domestic Violence Services Australia offers a team based approach to telephone and online counselling. This means that each time a client makes contact with the service, they could be speaking to any one of our counsellors. It is necessary for clients who contact our services regularly to have in place a robust therapeutic plan to ensure consistency in our approach. This ensures the client is not expected to repeat their story and makes sure their needs and wishes are respected.
Clients with complex needs who contact frequently or who are experiencing a trans- crisis may be allocated to a clinical lead supervisor who will hold oversight of the client's therapeutic plan. The supervisor will direct the team in the approach to any dilemmas in the client's care. The supervisor who holds this role will review the file regularly and update the client's therapeutic plan to ensure consistency across the team.
Clients who might benefit from individual counselling are identified by counsellors and supervisors in negotiation with the client. Individual counselling at Rape & Domestic Violence Services Australia consists of regular, booked telephone or online counselling appointments with a specific counsellor.
The timing, duration and content of these appointments will be determined by the counsellor and client according to a specific set of agreed goals. The counsellor may do some case coordination and/ or liaison with other involved agencies in developing and attending to these counselling goals.
Clinical care networking
Where clients have complex needs or where we require more information about their needs and supports, we may initiate a clinical care network (CCN).
Clinical care networks are undertaken only with the clear consent of a client. They involve a process of liaison and/or advocacy with other services, therapists or supporters.