Short version: if its not broken then its fine.

Longer version:

Balanced is complicated. The end result is the desire to make all things viable across all fields, but in order reach the same destination the path doesn't need to be the same. There is a certain amount of give and take when playing to the pros/cons of any class/cabal/etc in the situations they are put into.

It is a super time consuming and potentially difficult thing for any healer to counter raid any cabal for their item at any level, so do we adjust all retrievals based on that? No, because that is stupid.

Yes Tremblefist can do some annoying things. Most of the classes who find the things Tremblefist can afflict them with however have an easier time in counter raiding vs the standard cabals. The classes that tend to be less bothered by Tremble tend to find it slightly more tedious to retrieve vs other locations. In that regard, it *is* balanced.