Sean Friedman

Psychodynamic and Behavioural Therapist

Helping with making sense and making changes.Sea Point Cape Town

I am personally of the view — from time in my own therapy, working as a psychologist, and of working with mental health professionals in a number of areas (in academia, centres, institutions, and trainings) — that there is no 'cure' for the human condition, that life is going to be very painful and difficult at times, and that no one really has it all together.I have also been strongly convinced through my own personal process, the cumulative and available evidence, and the observed and described effects of psychotherapy, that beyond the treatment of acute issues, psychotherapy assists greater self-awareness, self-understanding, and self-acceptance. We will always have certain vulnerabilities and challenges, but knowing and being able to work with our flaws, and to keep showing up for what matters in life — all the same — is a kind of wonderful outcome.In addition, I have a badly behaved orange cat that may-or-may-not make an appearance in the therapy room; a love for reading and movement; and an appreciation for the strange and curious.

Trauma Specific Work

Prior to my MA in Counselling Psychology, I worked with refugees, migrants, and those affected by violence via the Trauma Centre as well as Lifeline in Cape Town from 2014-2016. The complex effects of trauma — especially repeated trauma — has been clearly recognised, and working with complex histories and presentations became a special interest of mine.During my MA, I continued to focus on complex-trauma (C-PTSD) and the effects that it tends to engender. For my research, I investigated factors that contribute to resilience and post-traumatic growth, and how these may be enhanced.

Developmental and Educational Placements

From 2018, I began training in Acceptance and Commitment Therapy, an approach that emphasises identifying what is most important to a person, and developing specific skills to get on with doing what matters, even in the face of fear, anxiety, despondency, or pain.At the same time, I spent several years in education. Working with children, adolescents, and adults through both schooling and tertiary level systems. I worked with behavioural challenges, identity formation, and engaged in lecturing and mentorship. How we best learn, develop, and grow (when safe to make mistakes, in contexts of trust and support, and given appropriate challenge) has come to greatly influence my understandings of psychotherapy as one such learning context.

Masters Training and Supervisions

I chose the Community Counselling Masters training program at the University of the Witwatersrand for its skeptical and critical approach to pathology: while training was comprehensive, it maintained a careful consideration of philosophical issues with diagnosis, and a recognition of the contextual and systemic factors that influence our lives. As such, I take care to differentiate between problems which are amenable to personal change, as well as those that are external from ourselves and require mitigating their effects. Sometimes other people/society/finances really are the problem.My clinical supervision during my masters was primarily psychodynamic, while during my internship I worked with short-term models with clear goals and outcomes.

Registrations

Independent Practice Counselling Psychologist | PS 0159018
Health Professionals Council of South Africa

Training & Membership Groups

Cape Town Psychoanalytic Society. 2024
Association for Contextual Behavioural Therapy. 2018 - 2024
ACT Peer Supervision. 2020 | 2024.

Placements

Acceptance and Commitment & Psychodynamic Psychotherapist. UWC. 2023.
Intern Psychologist. Phelopeppa Community Health Train. 2022.
Narrative, Brief, & Psychodynamic Psychotherapist. Health Sciences, WITS. 2022.
Person-centered Counsellor. Lifeline. 2015-2016.
Narrative & Solution-focussed Therapist. The Trauma Centre. 2014-2015.

Trainer Experiences

Advanced Training in ACT & Mindfulness-based Interventions. Facilitator. 2021 - 2022.
Counselling Skills Trainer. Lifeline. 2016.

Course Specialisations

ACT for OCD, Emotional Regulation, Anxiety, and Perfectionism. 2022.
Focussed Acceptance and Commitment Therapy, 2021.
Foundations in Acceptance and Commitment Therapy, 2021.

Academic Qualifications

Masters Community Counselling Psychology. WITS. Cum Laude
Honours Psychology. UNISA. Cum Laude
Postgraduate Certificate of Education. UNISA. Cum Laude
Psychology, Sociology, History, Classics. Undergraduate. UCT. Not at all Cum Laude

Competency and Scope of Practice

I am trained to diagnose, assess, and treat across the range of mental health disorders as well as difficulties and problems that are subclinical.I work with school age children, adolescents, and adults of all ages. However, I work considerably with younger adults (under 35).Although I do work with transient psychotic and other states, I work best with people who are generally able to function without frequent periods of hospitalisation.Similarly, I am not experienced with working with disabling forms of schizophrenia, life-threatening stages of anorexia, or severe addictions. These will best be addressed by qualified professionals in collaboration who specialise in these areas.

Special Interests

I work considerably with trauma and its effects. I work to integrate and make meaning of experiences of childhood and sexual abuse, neglect, physical and sexual violence, and profound loss and change to reestablish trust with others and self.I am also drawn to existential / philosophical concerns, and issues of identity and purpose. I focus on pragmatic approaches to fostering meaning and connection in career, relational, and sometimes difficult contexts while working with neurological (eg ADHD), personality, gender, and cultural differences.I am especially interested in the following areas and their interactions with one another:Recurrent and Chronic Mood and Identity Disturbances
Overwhelm, Panic Attacks, Social Anxiety, and OCD
Complex Trauma and Healing the Relationship with the Self & Others
Gender and Relationship Issues of Young Men and Women
Assessment and Treatment of Adult and Childhood ADD/ADHD
Developmental Concerns: Career / Purpose / Spirituality / Relationships

Approach

Therapeutically, I work collaboratively and contextually, meaning I understanding the therapeutic relationship to be co-constructed between us, and together we will explore and consider issues of importance, as well as the contexts that support or worsen them.My training in critical, psychodynamic, and behavioural models has given me some useful 'maps' in understanding problems in context of their histories, as well as how to realistically effect change. While I will bring a number of theoretical understandings and evidence-based approaches that may be applied, the choices and directions to follow are ultimately at the discretion of the person with whom I am working.Difficulties often manifest differently according to developmental period, gender, and culture. I take care to diagnose carefully given these and other considerations.

Clinical Modalities

I have trained, and continue to further my training in several approaches, most notably Psychodynamic Psychotherapy and Acceptance and Commitment Therapy. I use these in tandem to help people to better understand themselves, clarify what is most important in their lives, own their choices and space in the world, and develop skills and life strategies that enable and support the taking of action that aligns to their values and goals.I draw on best practices and the research literature in utilising techniques from Dialectical Behavioural Therapy (DBT), Exposure and Response Prevention (ERP), and other cognitive-behavioural approaches when indicated for specific difficulties.

The Importance of Accurate Diagnosis

A difficulty (such as trouble concentrating on studies or work) could be due to stress, anxiety, or depression; neurological characteristics (ie ADD / ADHD, or dyslexia); or situational and environmental concerns.An accurate diagnosis can be immensely helpful, while inaccurate diagnosis can lead to misapplied and ineffective treatments.Comprehensive assessments include a thorough history taking of the issue, careful selection of specific tests, scoring, and finally holistic interpretation with practical recommendations. This process takes several weeks from time of intake to the final report.

Psycho-Educational Assessments

Attention Deficit Hyperactivity Disorder, Specific Learning Disabilities (ie Dyslexia, Dyscalculia), Neurocognitive (ie short/long term memory functioning)Cognitive, academic, and socio-emotional functioning are assessed to determine difficulties in work/study, determine eligibility for accommodations, and provide recommendations for assistance.

Career Assessments

Person-to-environment, contextual, and adaptive considerations. Constraints, opportunities, and the changing workplace informed. Strengths, areas of development, potential problems, and possible solutions outlined.Personality, interests, values, needs, purpose, capabilities, and skills are considered to provide guidance in career and work choices.

Diagnostic Assessments

Multiple forms and systems of diagnosis utilised and combined holistically for self understanding & recommendations. Psychodynamic, DSM/ICD, and ACT informed.Differential diagnosis, considerations of history, patterns, personality, strengths, and vulnerabilities. Skill identification and treatment recommendations.

Frequently Asked Questions

What are the Fees & Billing Structure?

My fee is charged per session, according to a pre-agreed upon session length. Typically we would meet once per week for a contracted period, or on an ongoing basis depending on your goals. In some cases, we may initially meet more than once per week.I do see a limited number of in-need patients at a reduced rate. If affordability is an issue, for acute difficulties, we can work out an appropriate treatment and payment plan.

Do you accept Medical Insurance & PMB’s?

My fees are line with medical aid rates, though there may be a copayment depending on your provider and plan. Please contact your medical aid if uncertain of your coverage.Importantly, a number of conditions are recognised as Prescribed Minimum Benefits, or PMB's. These by law, are covered by medical aids including hospital plans. Dependent on the diagnosis, a number of sessions may be covered in full. I will assist with diagnosis and application for PMB's when indicated.

What are Cognitive and Behavioural Therapies?

There are a number of cognitive and behavioural therapies and models. These approaches work primarily with thoughts and behaviours directly.I personally have resonated with Acceptance and Commitment Therapy which falls under the umbrella of what is often referred to as 'Third Wave CBT', along with Dialectical Behavioural Therapy (DBT), and Mindfulness-Based CBT (among others). There is a good evidence base for this approach, and it allows me to flexibly draw on a variety of other CBT techniques as appropriate.The distinguishing feature of these 'third-wave' approaches is that there is a reduced emphasis on challenging irrational thinking, and a greater recognition in the utility of learning to care less about thoughts, tolerate difficult emotions, and focus on living in accordance with ones values while taking action towards what matters despite difficulty.

What is Psychodynamic Psychotherapy?

Psychodynamic or Psychoanalytic Psychotherapy involves an emphasis on the therapeutic relationship, along with developing greater self-awareness, self-acceptance, and flexibility in making and owning choices.There is good evidence that the effects from psychodynamic therapy are longer-lasting than short-term interventions or the effects of medication.

What is the Length of Therapy?

This does depend on the presenting concern and your goals.In our initial session, we will determine the appropriateness of therapy for your concern, the treatment options, and their possible lengths before contracting to work together.For acute issues and clear goals, such as depressive episodes, panic attacks, phobic symptoms, adjustment difficulties, or relational concerns, brief therapy (anywhere from 4 to 12 sessions) may be adequate.When difficulties have been long-standing and recurring, when shorter-term therapy has been attempted before (but was unsuccessful), or when there are multiple and complex issues and histories, longer-term therapy is likely to be indicated.

Do you prescribe Medication?

As a psychologist, I do not prescribe medication. However, I do work collaboratively with other professionals that I trust.Medication has been shown to be effective for a number of problems. Sometimes temporary and short-term use will be adequate, for other difficulties chronic medication may be needed.For some conditions, a combination of medication and therapy together may be most effective. Medication may work faster in the alleviation of symptoms, while psychotherapy is more effective at longer-term outcomes and preventing remission.If indicated, this is something that we will discuss as one treatment possibility. I work holistically, and recognise this as one of many changes that can be made including exercise, diet, meaningful work, hobbies, and good functioning relationships. I understand medication to be effective when it enhances these areas.

Contact

Please check my about, services, and FAQ first to get an idea of my approach and the kinds of work that I do.If interested in booking a psychotherapeutic session or assessment, please feel free to WhatsApp me directly and I will get back to you within business hours.

Alternatively, use the below form to make an email enquiry.

+2776 7222 123
2 Rhine Road, Sea Point
Cape Town

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