By TherapyNearMe.com.au — immediate appointments Australia‑wide
New and “unusual” therapies range from well‑supported (e.g., rTMS) to promising but still experimental (e.g., psychedelics‑assisted psychotherapy, stellate ganglion block, floatation‑REST). This guide summarises what they are, the evidence, potential risks, costs and how to choose safely — so you can have a meaningful conversation with your GP or psychologist. Nothing here replaces medical advice.
What counts as “unusual” — and why that matters for outcomes
When we say unusual, we mean approaches that sit outside standard first‑line care (e.g., CBT, interpersonal therapy, SSRIs/SNRIs) yet have peer‑reviewed evidence for certain conditions. Some are now mainstream in Australia (e.g., repetitive transcranial magnetic stimulation, rTMS), while others remain adjunctive, niche or investigational (e.g., transcutaneous vagus‑nerve stimulation, psychedelics‑assisted therapy, floatation‑REST). Evidence quality and availability vary widely (Mitchell et al., 2021; Goodwin et al., 2022; Lam et al., 2016).
How to read this guide: For each therapy you’ll see What it is, Evidence snapshot, Who it helps, Risks & access in Australia, and Questions to ask a provider.
A quick evidence map (at a glance)
| Therapy | Typical target symptoms/conditions | Evidence snapshot |
|---|---|---|
| rTMS | Treatment‑resistant depression (TRD) | Strong, multiple RCTs and meta‑analyses; Medicare‑rebated in Australia since Nov 2021 (Department of Health, 2021; Blumberger et al., 2018). |
| tDCS | Depression; some anxiety | Mixed; modest effects; protocol matters (Brunoni et al., 2017; Moffa et al., 2020). |
| tVNS (non‑invasive vagus‑nerve stimulation) | Depression, anxiety | Emerging; small‑to‑moderate effects in early trials (Wang et al., 2022). |
| Bright light therapy / circadian scheduling | Seasonal affective disorder; some nonseasonal depression | Good for seasonal depression; useful adjunct for circadian issues (Lam et al., 2016; Cochrane, 2019). |
| Ketamine / esketamine (with psychotherapy) | TRD, acute suicidality | Rapid but transient effects; requires careful screening and integration (Bahji et al., 2021; TGA/Spravato PI). |
| Psychedelics‑assisted psychotherapy (MDMA, psilocybin) | PTSD (MDMA); TRD (psilocybin) | Phase‑2/3 RCTs promising; from 1 July 2023 psychiatrists authorised by the TGA may prescribe in tightly controlled settings (TGA, 2023a; Mitchell et al., 2021; Goodwin et al., 2022). |
| Stellate ganglion block (SGB) | PTSD hyperarousal | Mixed; some improvement in RCTs; still investigational (Rae Olmsted et al., 2019). |
| VR exposure therapy (VRET) | Phobias, social anxiety, PTSD | Comparable to in‑vivo exposure in meta‑analyses (Carl et al., 2019). |
| Neurofeedback (EEG‑NF) | ADHD; anxiety/depression (adjunct) | Conflicting evidence; blinded outcomes often null (Cortese et al., 2016; Chiu et al., 2022). |
| HRV biofeedback / slow‑breathing | Anxiety, stress, insomnia | Consistent small‑to‑moderate benefits; home‑friendly (Goessl et al., 2017; Lehrer et al., 2020). |
| Floatation‑REST | Anxiety, stress, pain | Early RCTs on safety/feasibility; short‑term anxiolysis (Feinstein et al., 2018; Khalsa et al., 2023). |
| Forest bathing (Shinrin‑yoku) | Stress, anxiety, mood | Meta‑analyses show reductions in anxiety/depression; heterogeneity high (Kotera et al., 2022). |
| Art & music therapy | Depression, trauma, severe mental illness | Useful adjuncts; evidence base moderate (Aalbers et al., 2017; Uttley et al., 2015). |
| Animal‑/equine‑assisted therapy | PTSD, anxiety, dementia (adjunct) | Mixed; many small studies; consider as adjunct (O’Haire, 2017; Sardeli et al., 2024). |
1) Repetitive transcranial magnetic stimulation (rTMS)
What it is. Non‑invasive magnetic pulses stimulate targeted brain networks implicated in mood regulation. Delivered as daily sessions over 4–6 weeks.
Evidence snapshot. Multiple RCTs and meta‑analyses show efficacy in treatment‑resistant depression; theta‑burst protocols can be as effective as standard high‑frequency rTMS with shorter sessions (Blumberger et al., 2018).
Australia access & cost. Medicare‑rebated since 1 Nov 2021 under MBS items 14216, 14217, 14219, 14220 when eligibility criteria are met (Department of Health, 2021).
Risks. Headache, scalp discomfort; rare seizure risk.
Questions to ask. Which protocol? How many sessions? How will response be measured (e.g., PHQ‑9)?
2) Transcranial direct‑current stimulation (tDCS)
What it is. Low‑amplitude electrical current modulates cortical excitability via scalp electrodes.
Evidence snapshot. Mixed results: meta‑analyses suggest small‑to‑moderate improvements for depression, with best outcomes under supervised, protocol‑adherent courses and when combined with psychotherapy/antidepressants (Brunoni et al., 2017; Moffa et al., 2020).
Risks. Skin irritation, transient dizziness.
Good fit for. People unable to tolerate medications; as an adjunct.
3) Transcutaneous vagus‑nerve stimulation (tVNS)
What it is. Ear‑ or neck‑worn devices stimulate the auricular/cervical vagus branches.
Evidence snapshot. Early meta‑analyses indicate promising but heterogeneous effects for depression/anxiety (Wang et al., 2022).
Risks. Skin irritation, tingling; avoid with certain cardiac conditions or implanted devices.
4) Bright light therapy & circadian scheduling
What it is. Timed exposure to 10,000‑lux light boxes and sleep‑wake regularity to stabilise circadian rhythms.
Evidence snapshot. Effective for seasonal affective disorder; augmented benefits seen for some nonseasonal depression (Lam et al., 2016).
Risks. Eye strain, headache; screen for bipolar disorder given risk of hypomania.
Practical tip. Morning light + consistent sleep/wake + outdoor daylight breaks.
5) Ketamine / esketamine (with psychotherapy)
What it is. NMDA‑receptor modulation produces rapid antidepressant effects; delivered as IV ketamine or intranasal esketamine with monitoring.
Evidence snapshot. Meta‑analyses support rapid symptom reduction in TRD and acute suicidality, though effects can be transient without maintenance and integration (Bahji et al., 2021).
Risks. Dissociation, blood‑pressure spikes, misuse potential. Requires medical screening and structured psychotherapy.
6) Psychedelics‑assisted psychotherapy (MDMA for PTSD; psilocybin for TRD)
What it is. Time‑limited psychotherapy augmented by a dosing session with MDMA or psilocybin under strict protocols.
Evidence snapshot. Phase‑3 data for MDMA‑assisted therapy in PTSD show clinically meaningful benefits versus therapy plus placebo (Mitchell et al., 2021; 2023). Psilocybin shows dose‑related improvements in TRD in phase‑2/2b trials (Goodwin et al., 2022).
Australia access. From 1 July 2023, authorised psychiatrists may prescribe MDMA for PTSD and psilocybin for TRD via the TGA Authorised Prescriber pathway; access remains tightly controlled and costly (TGA, 2023a; 2023b).
Caveat. International regulators (e.g., the US FDA advisory committee in 2024) expressed concerns about evidence quality and safety; policy is evolving (FDA PDAC, 2024).
Risks. Psychological distress during sessions, cardiovascular effects, drug interactions; careful screening and aftercare are essential.
7) Stellate ganglion block (SGB)
What it is. An anaesthetist injects local anaesthetic near the stellate ganglion to dampen sympathetic hyperarousal.
Evidence snapshot. One RCT in active‑duty military showed modest improvements in PTSD symptoms over sham; replication and long‑term data are needed (Rae Olmsted et al., 2019).
Risks. Invasive procedure risks (bleeding, nerve injury); choose experienced clinicians.
8) Virtual‑reality exposure therapy (VRET)
What it is. Therapist‑guided exposure in VR to feared cues (flying, social settings, trauma cues).
Evidence snapshot. Meta‑analyses indicate VRET is comparable to in‑vivo exposure for anxiety disorders and can be more acceptable to some clients (Carl et al., 2019).
Risks. Cybersickness; ensure therapist is trained in exposure therapy.
9) Neurofeedback (EEG‑NF)
What it is. Real‑time EEG feedback to train attention/arousal patterns.
Evidence snapshot. Findings are mixed: when outcomes are blinded, effects on core ADHD symptoms can be small or non‑significant; some meta‑analyses report gains in attention measures (Cortese et al., 2016; Chiu et al., 2022).
Bottom line. Consider as an adjunct, not a replacement for guideline‑supported care.
10) Heart‑rate‑variability (HRV) biofeedback & slow breathing
What it is. Breathing at your personal resonance frequency (~6 breaths/min) with feedback to boost vagal tone.
Evidence snapshot. Systematic reviews show small‑to‑moderate reductions in anxiety and stress and improvements in sleep and emotion regulation (Goessl et al., 2017; Lehrer et al., 2020; Saito et al., 2024).
Practical tip. 10–20 minutes/day, 4–5 days/week, plus daily light exercise and regular sleep.
11) Floatation‑REST (sensory reduction)
What it is. Warm, buoyant, Epsom‑salt water in a quiet pod reduces exteroceptive input.
Evidence snapshot. Open‑label trials show acute anxiolytic effects; a recent RCT supports safety/feasibility with signals for symptom reduction vs. chair‑REST comparators (Feinstein et al., 2018; Khalsa et al., 2023).
Risks. Claustrophobia, ear/skin irritation; avoid with certain medical conditions.
12) Forest bathing (Shinrin‑yoku)
What it is. Guided immersion in natural settings with mindful attention.
Evidence snapshot. Meta‑analyses report reductions in anxiety and depressive symptoms vs. urban controls, though heterogeneity is high and long‑term data are limited (Kotera et al., 2022).
Practical tip. Combine with gentle walking and phone‑free time.
13) Art and music therapy
What they are. Structured creative therapies delivered by trained therapists to process emotion, trauma and identity through nonverbal channels.
Evidence snapshot. Cochrane and other reviews suggest adjunctive benefits for depression and quality of life; strongest in combination with standard care (Aalbers et al., 2017; Uttley et al., 2015).
Access. Ask about qualifications (e.g., ANZACATA‑registered art therapists; Registered Music Therapists in Australia).
14) Animal‑ and equine‑assisted therapies
What they are. Goal‑directed interactions with trained animals, often adjunctive to psychotherapy.
Evidence snapshot. Studies in PTSD, anxiety and dementia are encouraging but mixed; many trials are small or non‑randomised. Consider these as wellbeing adjuncts rather than stand‑alone treatments (O’Haire, 2017; Sardeli et al., 2024).
Risks. Allergies, safety and infection control; always verify animal welfare standards.
How to choose safely (and avoid hype)
1) Start with foundations. Sleep, movement, social connection and evidence‑based psychotherapy/medication remain core for most conditions.
2) Verify credentials. Search the AHPRA register for psychologists and psychiatrists; ask about formal training for specific modalities.
3) Ask for outcome monitoring. PHQ‑9, GAD‑7, PCL‑5, WSAS — results should guide treatment, not marketing.
4) Understand costs and access. In Australia, rTMS may be Medicare‑rebated if criteria are met; psychedelics‑assisted therapy currently involves high out‑of‑pocket costs.
5) Red flags. Claims of guaranteed cures; skipping assessment; discouraging standard care; lack of safety protocols; no informed consent.
When unusual therapies make sense
- After two adequate antidepressant trials + psychotherapy without sufficient response (TRD).
- When avoidance blocks exposure work, VRET can help people get started.
- When physiological arousal dominates, HRV biofeedback or tVNS may reduce reactivity so therapy sticks.
- If you prefer non‑pharmacological options, discuss rTMS or structured light therapy with your treating team.
How TherapyNearMe.com.au can help
- Matched care. We’ll pair you with a psychologist experienced in your goals and discuss whether an unusual therapy belongs in your plan.
- Australia‑wide access. Immediate appointments via Telehealth and in‑person.
- Coordination. We work with your GP/psychiatrist if you’re exploring rTMS, ketamine/esketamine or TGA‑authorised psychedelic programmes.
Call 1800 NEAR ME or book online at TherapyNearMe.com.au.
FAQs
Is rTMS covered by Medicare? Often, yes — for eligible patients under item numbers 14216/14217/14219/14220 (Department of Health, 2021).
Are psychedelics legal treatment now? In tightly controlled settings: from 1 July 2023, TGA‑authorised psychiatrists may prescribe MDMA for PTSD and psilocybin for TRD (TGA, 2023a; 2023b). Access is limited and expensive.
Can I do these instead of therapy or medication? Generally no — they are best seen as adjuncts to guideline‑supported care.
Do I need a referral? For many services, yes. Speak with your GP and your psychologist.
References
Aalbers, S., Fusar‑Poli, L., Freeman, R.E., Spreen, M., Ket, J.C.F., Vink, A. & Gold, C. (2017) Music therapy for depression. Cochrane Database of Systematic Reviews, (11), CD004517.
Bahji, A., Vazquez, G.H., Zarate, C.A., Jr. & Frey, B.N. (2021) Ketamine for treatment‑resistant depression: a systematic review and meta‑analysis. Journal of Affective Disorders, 278, 93–102.
Blumberger, D.M., Vila‑Rodriguez, F., Thorpe, K.E., Feffer, K., Noda, Y., Giacobbe, P. et al. (2018) Randomized noninferiority trial of theta‑burst vs high‑frequency rTMS for depression. New England Journal of Medicine, 378(7), 600–601.
Brunoni, A.R., Moffa, A.H., Fregni, F., Palm, U., Padberg, F., Blumberger, D. et al. (2017) Trial of electrical direct‑current therapy vs sertraline in major depression. New England Journal of Medicine, 376, 2523–2533.
Carl, E., Stein, A.T., Levihn‑Coon, A., Pogue, J.R., Rothbaum, B., Emmelkamp, P. et al. (2019) Virtual reality exposure therapy for anxiety disorders: a meta‑analysis of randomized controlled trials. Journal of Anxiety Disorders, 61, 27–36.
Chiu, H‑J., Sun, C‑K., Fan, H‑Y., Tzang, R‑F., Wang, M‑Y., Cheng, Y‑C. et al. (2022) Surface EEG neurofeedback improves sustained attention in ADHD: a meta‑analysis. Child and Adolescent Psychiatry and Mental Health, 16, 104.
Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R.W. et al. (2016) Neurofeedback for ADHD: meta‑analysis of randomized controlled trials with blinded outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 55(6), 444–455.
Feinstein, J.S., Khalsa, S.S., Yeh, H., Wohlrab, C., Simmons, W.K., Stein, M.B. & Paulus, M.P. (2018) Examining the short‑term anxiolytic and antidepressant effect of Floatation‑REST. PLOS ONE, 13(2), e0190292.
FDA Psychopharmacologic Drugs Advisory Committee (2024) Meeting briefing: MDMA‑assisted therapy for PTSD — vote and discussion summary. (Context note reflecting evolving regulatory views.)
Goodwin, G.M., Aaronson, S.T., Alvarez, O., Arden, P.C., Baker, A., Bennett, J.C. et al. (2022) Single‑dose psilocybin for treatment‑resistant depression. New England Journal of Medicine, 387(18), 1637–1648.
Goessl, V.C., Curtiss, J.E. & Hofmann, S.G. (2017) The effect of HRV biofeedback training on stress and anxiety: a meta‑analysis. Psychological Medicine, 47(15), 2578–2586.
Khalsa, S.S., Feinstein, J.S., de la Salle, S., Kettner, H. & Paulus, M.P. (2023) A randomised controlled safety and feasibility trial of floatation‑REST in anxiety and depression. PLOS ONE, 18(7), e0286899.
Kotera, Y., Richardson, M. & Sheffield, D. (2022) Effects of Shinrin‑yoku (forest bathing) and nature therapy on mental health: a systematic review and meta‑analysis. International Journal of Mental Health and Addiction, 20(1), 337–361.
Lam, R.W., Levitt, A.J., Levitan, R.D., Enns, M.W., Morehouse, R., Michalak, E.E. & Tam, E.M. (2016) Efficacy of light therapy for nonseasonal major depressive disorder. JAMA Psychiatry, 73(1), 56–63.
Lehrer, P., Kaur, K., Sharma, A., Shah, K., Huseby, R., Bhavsar, J. & Zhang, Y. (2020) Heart‑rate‑variability biofeedback improves emotional and physical health: a systematic review and meta‑analysis. Applied Psychophysiology and Biofeedback, 45, 109–129.
Moffa, A.H., Martin, D., Alonzo, A., Bennabi, D., Blumberger, D.M., Bensenor, I.M. et al. (2020) Efficacy and acceptability of tDCS for MDD: an updated meta‑analysis of randomized sham‑controlled trials. Biological Psychiatry, 87(7), 641–651.
Mitchell, J.M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker‑Guilbert, K. et al. (2021) MDMA‑assisted therapy for severe PTSD: a randomized, double‑blind, placebo‑controlled phase 3 study. Nature Medicine, 27, 1025–1033.
— Mitchell, J.M., et al. (2023) MDMA‑assisted therapy for moderate‑to‑severe PTSD: confirmatory phase 3 results. Nature Medicine, 29, 1–12.
Rae Olmsted, K.L., Bartoszek, M., Mulvaney, S., McLean, B., Young, R., D’Andrea, E. & McLean, J.C. (2019) Effect of stellate ganglion block on PTSD symptoms: a randomized clinical trial. JAMA Psychiatry, 76(5), 484–493.
Sardeli, A., Fradelos, E.C., Keramaris, N., Tsaras, K., Tzavella, F., Zoumpouli, E., & Papathanasiou, I.V. (2024) Equine‑assisted services for veterans with PTSD: a systematic review. BMC Psychiatry, 24, 544.
Therapeutic Goods Administration — TGA (2023a) Change to classification of psilocybin and MDMA to enable prescribing by authorised psychiatrists.
Therapeutic Goods Administration — TGA (2023b) Accessing MDMA and psilocybin as an authorised psychiatrist (guidance).
Department of Health and Aged Care (2021) Listing of rTMS on the Medicare Benefits Schedule: Fact sheet (MBS items 14216, 14217, 14219, 14220).
Uttley, L., Scope, A., Stevenson, M., Rawdin, A., Sutton, A., Steven, A. et al. (2015) Systematic review and economic evaluation of art therapy for non‑psychotic mental health disorders. Health Technology Assessment, 19(18).
Wang, Z., Fang, J., Luo, H., Xu, Y., & Wang, C. (2022) Transcutaneous auricular vagus nerve stimulation for depression and anxiety: a systematic review and meta‑analysis. Neuroscience & Biobehavioral Reviews, 136, 104631.
Australian policy references
Office of Drug Control (2023) Regulation of MDMA and psilocybin (Schedule 8).
MBS Online (2021–2025) rTMS explanatory notes and item descriptors (14216, 14217, 14219, 14220).
Important: This article is for general education only. Always discuss options with your GP and treating team. If you or someone you know is in crisis, contact Lifeline 13 11 14, 000 in an emergency, or your local acute care team.
