Trauma therapy online across NZ, including EMDR and trauma-focused CBT

What is psychological trauma?

Psychological trauma is the lasting impact of an event, or a series of events, that overwhelmed your ability to cope at the time. It can follow a single incident such as a crash or assault, or repeated experiences such as abuse or violence at home. Trauma-focused therapies, including trauma-focused CBT and EMDR, are recommended by international guidelines.

Single-incident and complex trauma

Trauma isn't one thing. Psychologists often distinguish between two broad patterns, and the difference matters for how therapy is planned.

Single-incident trauma follows one event with a clear beginning and end: a car crash on the way home from work, an assault, a sudden death, a serious accident on a farm or building site, a frightening birth, a house fire or a flood. Life was one way before and different afterwards. Many people recover in the weeks that follow with support from the people around them. For others the memory keeps intruding months or years later, and that is when treatment helps.

Complex trauma describes repeated or prolonged experiences, often beginning in childhood or inside a relationship that was hard to leave: ongoing abuse, neglect, family violence, years of bullying, or a controlling partner. The World Health Organization's ICD-11 now recognises complex PTSD as a diagnosis in its own right. It includes the core features of PTSD plus three further difficulties: trouble managing emotions, a persistently negative view of yourself (shame, worthlessness, feeling defective) and difficulty trusting or feeling close to other people.

You don't need to know which pattern fits you, and you don't need a diagnosis to book. Your psychologist will help you make sense of what you've been through and what it has left behind. For more detail on diagnosis and treatment, see our PTSD and complex PTSD page.

How trauma shows up day to day

Trauma rarely announces itself as "trauma". More often it shows up as reactions that feel out of proportion to what is happening now.

• Re-experiencing. The smell of smoke takes you straight back to the fire. A particular stretch of State Highway 1 makes your hands sweat on the wheel. A dream wakes you at 3am with your heart pounding. It can feel as though the event is happening again rather than being remembered.
• Avoidance. You take the long way round so you never pass that intersection. You've stopped going to the beach, the gym, the whānau gathering. You stay busy so there is never a quiet moment for the memory to surface, and you change the subject when anyone asks.
• A body that won't stand down. You sit with your back to the wall in cafés. You jump when someone comes up behind you at the supermarket. You scan every room for the exits. Sleep is light and broken, and you are exhausted by lunchtime.
• Changes in mood and beliefs. "It was my fault." "I can't trust anyone." "Nowhere is safe." Numbness at your child's birthday party. Irritability that flares at your partner over nothing. A sense of being permanently damaged or different from everyone else.

None of this is weakness. It is what a nervous system does when it has learned, through hard experience, that danger can arrive without warning. Therapy works with that learning directly.

How trauma-focused therapy works

Guidelines from the UK's National Institute for Health and Care Excellence (NICE), the International Society for Traumatic Stress Studies (ISTSS) and the World Health Organization point the same way: the psychological treatments with the strongest evidence for post-traumatic stress are trauma-focused. They work directly with the memory of what happened and the meaning it has taken on, rather than only managing symptoms around the edges.

Trauma-focused CBT is an umbrella term for several structured therapies, including cognitive processing therapy, cognitive therapy for PTSD and prolonged exposure. They differ in emphasis but share a logic. Traumatic memories tend to be stored in a fragmented, "still happening" form, and avoidance stops them being filed away as something that is over. In therapy you first learn skills to steady yourself, then approach the memory gradually in a safe, structured way, and examine the beliefs that formed around it ("I should have done something", "I'm not safe anywhere"). As the memory is processed, it loses its charge.

EMDR (eye movement desensitisation and reprocessing) reaches a similar destination by a different route. While you hold a brief part of the memory in mind, your psychologist guides you through sets of side-to-side eye movements or taps. Many people find they can process a memory without describing it in detail. Our EMDR therapy page explains the eight phases and the evidence.

NICE recommends both approaches for adults with PTSD, and ISTSS gives its strongest recommendation to trauma-focused CBT, cognitive processing therapy, cognitive therapy, prolonged exposure and EMDR. Which you use depends on what suits you, what you have been through and your psychologist's training. Some Mindwell psychologists offer both EMDR and CBT-based trauma work, so you don't need to choose before you start.

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Pacing and stabilisation: you set the speed

The most common fear people bring to trauma therapy is that they will be made to relive everything, all at once, with a stranger. That is not how good trauma therapy works.

Every trauma-focused approach begins with a preparation phase. Your psychologist takes time to understand your history and your current life, and teaches grounding and calming skills: ways to bring yourself back to the present when a memory pulls you under, and to settle your body when it goes into alarm. For many people this preparation takes only a session or two, and memory work begins only when you and your psychologist agree you are ready.

You stay in control throughout. You have a say in which memory to start with, you can pause or stop at any point, and you are never required to share details you don't want to. Sessions usually end with time to settle, and you'll often leave with a plan for the days in between: what to do if a nightmare wakes you, who to call if things feel too much.

For complex trauma this stabilisation phase is often longer. When someone has grown up around danger, the skills for managing strong emotion, trusting another person and treating themselves with some kindness may need building before memory work makes sense. Guidelines recognise that people who have lived through multiple traumas may need a longer course of therapy. There is no prize for going fast, and a careful pace is a sign your psychologist is doing their job.

Does trauma therapy work online?

Yes. A 2021 meta-analysis pooling more than 100 studies found that psychotherapy delivered by video was no less effective than in-person treatment, with the clearest evidence for cognitive-behavioural therapies for anxiety, depression and PTSD. A Dutch programme delivering intensive EMDR and prolonged exposure entirely by video to people with PTSD and complex PTSD reported large reductions in symptoms that held at six-month follow-up, with no drop-outs and no adverse events.

There are practical advantages too. Trauma therapy asks you to approach hard material, and many people find that easier from their own lounge, with the dog on the couch and their own cup of tea, than in an unfamiliar clinic. There is no drive home while still shaky. If you live in Westport, Kaitaia or Gore, you can see a psychologist with trauma training without a day's travel.

Online trauma work does need a few things in place: a private space where you won't be interrupted for the hour, a reliable connection, and a plan for support afterwards. Your psychologist will talk these through before memory work starts and adjust the approach if your situation changes. Our guide to online therapy covers the evidence in more depth.

If your trauma is covered by ACC

Mindwell is not an ACC provider, and our sessions are self-funded. If what happened to you was sexual abuse or assault, it is worth knowing about ACC's Sensitive Claims Service before you pay for therapy. ACC funds therapy with ACC-registered providers at no cost to you, whether the abuse happened recently or decades ago, and whether or not you have reported it to the Police. You can be matched with a provider through Safe to talk (call 0800 044 334 or text 4334) or search the directory at findsupport.co.nz.

If your trauma followed a physical injury that ACC has accepted, or a sudden traumatic event at work that you experienced, saw or heard directly, ask your GP or ACC what psychological support may be available.

Some people choose to see us anyway: they want a particular psychologist or approach, or what they went through isn't something ACC covers. That is a legitimate choice, and we will be straightforward with you about the options.

Who trauma therapy suits, and when you need more than this

Trauma therapy at Mindwell suits adults anywhere in New Zealand who are safe now and want to work on what happened, whether that was last year or thirty years ago. You might be functioning well on the surface and tired of the effort it takes, or you might have reached a point where avoidance has shrunk your life more than you can accept.

Some situations need something more or different first. If you are still in a violent or unsafe relationship, safety comes before memory work, and your psychologist will help you think about that. If you are drinking or using heavily to cope, that is worth being honest about early; it changes the plan rather than ruling therapy out. If you are having thoughts of ending your life, Mindwell is not a crisis service: call 111 if you are in immediate danger, or call or text 1737 any time to talk to a trained counsellor.

What to expect at Mindwell

You book online, choosing a specific psychologist or the first available, and first sessions are typically available within 7 days. You'll receive a confirmation with your video link and a short intake form that takes about five minutes.

The first session is about getting to know you: what brings you now, what your life looks like, what you have already tried and what you want to be different. You don't have to describe the traumatic event in detail. Together you'll usually agree a plan, often weekly or fortnightly 50-minute sessions.

Sessions are $199 + GST ($228.85 incl. GST) each, paid at booking, and we provide receipts if your health insurer covers psychology. What you share is confidential under the Health Information Privacy Code 2020, within the usual limits of confidentiality. If you're unsure whether trauma therapy is right for you, use the "Ask a question" form on our homepage and we'll usually reply within one business day.

All sessions are by secure video, so trauma therapy at Mindwell is open to adults across New Zealand, including Auckland, Wellington, Christchurch, Hamilton, Tauranga and Dunedin, and to people in rural areas who would otherwise travel hours for trauma-focused care.

Related support: PTSD and complex PTSD · EMDR therapy · Relationships and attachment

Updated October 2026 · How we write our information