Romie Nottage, LMFT

Romie Nottage is a Licensed Marriage and Family Therapist (LMFT) with 8 years of clinical experience who brings a humanistic, client-centered perspective to work with stress, anxiety, addictions, relationship challenges, trauma, and depression. She developed her practice in community mental health settings, supporting people experiencing homelessness, incarceration, and substance use, and has worked primarily in San Francisco, California. Her training in complex trauma shapes a compassionate approach that prioritizes connection and individualized care.

Romie views therapy as a collaborative process and tailors each plan to the person in front of her. She blends expressive and narrative methods with evidence-based tools, often incorporating Gestalt techniques and Attachment Theory to understand relational patterns. She regularly uses Internal Family Systems (IFS) to explore internal parts and Cognitive Behavioral Therapy (CBT) to address thinking and behavior patterns. Her overall orientation is humanistic, focused on self-discovery and growth.

Romie also developed a modality called Transformative Recovery through Evolutionary Exploration, or T.R.E.E. Work. Created while supporting men re-entering society after long-term incarceration and coping with opiate dependence, T.R.E.E. Work combines multiple clinical orientations with the aim of cultivating self-identity and fostering restorative change. Romie is now offering private practice services and shapes care to meet each client's unique needs.

Integrative Approaches for Online Therapeutic Care

Internal Family Systems (IFS) helps people notice and relate to the different parts of themselves - for example protective parts and wounded parts - and supports developing a compassionate inner leader. This approach can be useful for exploring identity, internal conflict, and the effects of trauma.

Cognitive Behavioral Therapy (CBT) focuses on identifying unhelpful thoughts and patterns and learning practical strategies to shift those patterns. CBT is structured and skill-oriented, often used to address anxiety, depression, and stress by teaching tools for coping and problem solving.

Gestalt-informed techniques emphasize present-moment awareness and experiential exercises that help clients understand how feelings and relational patterns show up in behavior. These methods support insight and emotional processing in the therapy room.

Finding the right combination of methods is part of the therapeutic process. Romie collaborates with each client to determine which approaches best match their needs, goals, and preferences, and adjusts the plan as work progresses.

Online therapy offers flexibility and accessibility through video calls, phone sessions, live chat, and text-based messaging. These options make it easier to fit therapy into daily life and allow clients to engage with licensed professionals and therapists in formats that feel most comfortable and practical for them.