Romie Nottage , LMFT

Romie Nottage is a Licensed Marriage and Family Therapist (LMFT) practicing in California with eight years of experience in community mental health. She has devoted much of her career to working with people facing homelessness, incarceration, and substance use, and has practiced primarily in San Francisco. That community-oriented work has deeply shaped her perspective as a clinician and as a person.

After eight years in community mental health, she recently launched a private practice to focus on individualized care informed by her training in complex trauma. Romie approaches therapy as a collaborative process - the therapeutic relationship guides how she supports each person, and she adapts her style so treatment fits the individual rather than forcing a single method.

Her practice blends expressive and narrative techniques with more structured interventions. She frequently integrates Gestalt work and Attachment Theory to ground relationships, draws on Internal Family Systems (IFS) to explore internal parts, and uses Cognitive Behavioral Therapy (CBT) for skills-based changes. Overall she situates her work within a humanistic orientation that honors each person’s experience.

Romie also developed a personalized modality called Transformative Recovery through Evolutionary Exploration - T.R.E.E. Work - a blend of clinical approaches designed to cultivate self-identity. T.R.E.E. Work originated during her work with men re-entering society after long periods of incarceration who were coping with opiate dependence, and she has since adapted it for people seeking restorative, identity-focused change. She welcomes opportunities to support growth in ways that feel authentic and tailored to each person.

Integrating therapeutic approaches for online care

Romie commonly uses Internal Family Systems (IFS) and Cognitive Behavioral Therapy (CBT) in her work. IFS helps people explore the different parts of themselves - for example protective or wounded parts - and supports self-leadership and inner understanding, which can be helpful for trauma, addiction, and relationship struggles. CBT focuses on identifying and shifting unhelpful thoughts and behaviors, offering practical tools for managing anxiety, depression, and stress.

She also brings her own T.R.E.E. Work - Transformative Recovery through Evolutionary Exploration - which blends techniques from several orientations to help people cultivate a clearer sense of self. Finding the right approach is viewed as a collaborative process; Romie works with clients to identify which methods align with their needs, goals, and preferences, and adjusts the plan as the therapeutic relationship develops.

Online therapy with Romie can take place by video call, phone session, live chat, or text-based messaging, offering flexibility for different schedules and comfort levels. These options make it easier to access consistent care from licensed professionals without extensive travel, and allow therapists to tailor session format to what best supports each person.