S ea n Fr iedm an
Psychodynamic & behavioural psychologist
Online |
| Sea Point Cape Town⋆༺𓆩☠︎︎𓆪༻⋆
I am a psychologist in private practice with a special interest in the assessment and treatment of traumatic stress, anxiety (OCD, panic, social), and depressive disorders.
My training in critical, psychodynamic, and behavioural models has provided me with useful frameworks to think of difficulties in the context of their histories as well as possibilities of change when applicable.
Clinical training and supervision
Prior to my qualifying clinical training, I completed my counseling internship with The Trauma Centre for Survivors of Violence & Torture in Woodstock in 2014. I continued with work in crisis counseling and education, and with adolescents and children in behavioral development.During this time, I was drawn to the behaviorist tradition for its rigorous and precise approach to measurable change. It is the basis of such methods as ERP for OCD, and I took a special interest in the underlying philosophical and scientific particulars in how, why, and when these methods do (and do not) work.For my MA, I attended the postgraduate training program at the University of the Witwatersrand which emphasized recognition of the contextual and systemic factors in diagnosis and treatment. During this integrative program, I received extensive supervision and training in psychodynamic psychotherapy.In contrast to the behaviorist tradition, the psychoanalytic / psychodynamic tradition is concerned with personal subjectivity, the unconscious (parts of self and experience that we are not aware of that influence us greatly nonetheless), and the meanings and gains within symptoms. It takes longer, is more uncertain, is relationally mediated, and importantly has been shown to be highly effective — with improvement continuing following the cessation of therapy.This last point is particularly important, as therapies that are very good for reducing symptoms do not necessarily lead to lasting change, and symptoms generally return leading to the 'top-up' model (as in needing to return to therapy periodically for symptom reduction).I personally see value in initial symptom reduction, while continuing psychotherapy to treat the underlying 'causes'. This is much more complex than I have laid out here, but I hope it gives an understanding as to the value of different methods.
Registrations and Professional Development
I am registered both as an Independent Practice Counselling Psychologist with the Health Professions Council of South Africa, as well as a Chartered Psychologist with the
Health and Care Professions Council in the United Kingdom.I am member of the South African Psychoanalytic Iziko, a society concerned with continued and advanced training in the psychodynamic / psychoanalytic approach, a member of the SAPI college, and engaged in ongoing supervision and my own training analysis.
Competency and scope of practice
I am trained to diagnose, assess, and treat a wide range of mental health disorders, as well as subclinical difficulties and challenges. My training was additionally oriented beyond the treatment of disorder, towards personal growth and self-understanding.I work with chronic and acute forms of anxiety, depression, and trauma sequela, while addressing existential and pragmatic issues.While I do work with transient psychotic states and other similar conditions, I work best with individuals who are generally able to function without frequent hospitalizations.
Clinical modalities
There are a number of therapy approaches, models, and methods. What is important — and what a psychologist is trained to do — is to take careful account of a person's unique history, context, capacities, and personality when selecting an appropriate approach that can offer the best chance of a successful treatment.Psychodynamic psychotherapy is concerned with an in-depth understanding of the internal 'dynamics' at work in a person: the conflicting feelings, thoughts, desires, and experiences — and how these interact with one another. This approach takes time, works through the therapeutic relationship, and has the most robust evidence for what we might think of as 'cure', or addressing the root of one's difficulties.Cognitive and behavioural approaches work with thoughts and behaviours directly. They are essentially 'educative' in that they teach skills and aim to develop particular abilities. They are very well supported by the evidence at symptom reduction, and are often extremely helpful for many more pragmatic issues.I draw on best practices and the research literature in selecting methods as appropriate and aim to understand what is that I am applying and why. I have completed training and integrate such methods as Exposure and Response Prevention (ERP for OCD), and mindfulness-based and somatic approaches to anxiety and panic disorders as appropriate.
Frequently Asked Questions
What about ABCDEFG therapy?
There are over 400 therapies with various acronyms, and each year more are developed (and trademarked).However, there are a limited number of well established and proven methods, underlying factors and processes at work. I aim to understand and provide treatment in careful consideration of these and the person with which I am working.
What happens in the first session?
We talk about what brought you here, your history, and what you hope to change. You can ask me anything about how I work.Typically, three initial sessions are requires in order to properly assess the appropriateness of the treatment. By the end of this initial period, we will have a shared sense of whether and how to continue.If another treatment or professional is more appropriate I will let you know my reasoning, and will provide an appropriate referral when able.
How long will therapy take?
Symptoms typically reduce substantially within several months of treatment, or 16-20 sessions. For some pragmatic difficulties this may be enough.However, symptom-reduction does not mean that the underlying issues have been resolved. They tend to return.The approach that aims to address underlying causes, usually sees an initial symptom reduction, before symptom exacerbation (as in they get worse or heighten). The exacerbation allows for the working through of them.There is no timeline to this approach, but typically between 6 months and 2 years substantial work is completed.Often when therapy is found to be fruitful, and when this has led to an increased quality of life, people may decide to continue treatment with a shift in focus from their initial complaints.
How often will we meet?
I work at minimum once weekly, and that is the usual frequency at which we would begin.For some, more frequent work may be necessary or desirable. Frequency increases the intensity of the treatment which is often (but not always) useful.
Is what I say confidential?
Yes. What you share stays between us, is legally and professionally protected, and cannot be divulged.Limited legal and ethical exceptions apply only in cases of serious and imminent risk of harm to yourself or others, and certain child-protection situations. Even in these most extreme exceptions, only the most limited and impersonal information can be shared to ensure safety.
What will it cost and can I claim from medical aid?
My 2026 local session rate is R1550.
My 2027 local session rate is R1620.Some medical aids cover part of the cost depending on your plan. Check your benefits and any limits.For certain conditions, there are prescribed minimum benefits from all South African medical aids — but this is subject to specific diagnosis.
What if I need to cancel or reschedule?
For the initial sessions, 48 hour notice (excl. weekends and public holidays) is required or the session will be charged in full.If the decision is made to continue treatment, an exclusive recurring weekly time is reserved which is billed regardless of attendance for the period in which we have decided to work. This excludes public holidays, and holiday periods that roughly conform to the SA school calendar.Treatment may be ended at any time, regardless of reason or any prior commitment, subject to a 72 hour notice as regards to billing for the final session.
Do you offer online sessions?
Only in very particular situations. If you are in Cape Town, it likely will be offered exclusively in-person.
Contact
If you would to arrange, please let me know a little about yourself and what you are looking for via the form below.Typically we would meet for up to three initial sessions for a history taking and assessment, and to determine our fit for working together. We will then discuss treatments options and their rationale, as well as whether to continue or whether a referral is more appropriate.The initial sessions are typically arranged relatively quickly, but please do keep in mind that it may take a while to secure an ongoing time if deciding to continue.
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Sea Point | Cape Town
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Terms of Service
LIMITS OF CONFIDENTIALITYPsychotherapy is a deeply personal process, and maintaining the confidentiality of our sessions is of utmost importance. Please be aware of the following.While all sessions and communications are confidential, certain circumstances may necessitate contacting your supplied emergency contacts, or in the most extreme cases legal or social services.If your life or another person's life is in imminent danger.
If there is evidence of danger to a child or vulnerable adult.
If prenatal use of dangerous controlled substances is disclosed.Parents or guardians of non-emancipated minor clients (under the age of 12) are entitled to access their children's records. However, over this age, regardless of who is responsible for the account (e.g. a parent or workplace), confidentiality is always completely protected and fully maintained. No records or personal updates can be disclosed without explicit written consent.
SUPERVISION | CONSULTATION | THEORISATIONAs part of standard practice and ethical responsibility, psychologists routinely engage in supervision and consultation. This process is essential for maintaining objectivity and supporting the therapeutic work.Relevant aspects such as psychological dynamics, symptoms, and history are considered, but all identifying information is removed and altered to preserve anonymity.On occasion, it may be helpful to record a session for further analysis. Such recordings may provide critical insights into the dynamics of a session. I will always obtain your express consent before recording any session. Any recordings will be used solely for the agreed purpose and securely deleted thereafter.
PRIVATE INFORMATION | POPII take precautions to ensure the security of your personal information, as well as all clinical notes and records. I utilise password-protected digital folders for session notes and secure filing cabinets for physical notes. Online forms are protected by two-factor authentication, as is my business email account. Additionally, my practice's WhatsApp account is password protected.My invoices include information such as your name, email address, and session dates. These may include a diagnostic code for medical aid purposes.While I take reasonable steps to secure my digital communications, I cannot guarantee the security of systems beyond my control. As such, please limit all highly sensitive information to the sessions themselves, as detailed in the section on boundaries.
BOUNDARIESTo maintain the integrity of the therapeutic process, it is important to establish appropriate boundaries. I am available to respond to practical enquiries via my work email and phone line. Please limit out-of-session communications to matters such as:Confirmation of session times
Clarification of fees or payments
Other administrative mattersPersonal concerns or therapeutic questions should be addressed during our sessions. I aim to remain accessible and responsive during my working hours, but please note that I may not see messages sent outside of these times until the next business day.In case of an emergency, please contact an appropriate emergency service or helpline.
RATES, PAYMENT, & MEDICAL INSURANCEPayments are made directly to me by the person responsible for the account. I bill at month's end and ask that the account be settled within the first week of the new month. If this is not possible, please address with me directly.I provide invoices in accordance with medical scheme requirements for the purposes of reimbursement and will facilitate the submission of PMB claims where applicable. I do not correspond with medical scheme providers on behalf of patients.It remains the member's responsibility to address any issues with their medical scheme provider directly. Any shortfalls, rejected claims, or other amounts not covered by the medical scheme remain the responsibility of the patient.If an account remains unsettled I am ethically obligated to suspend services where continued treatment would result in the accumulation of further debt. If necessary, I will provide a referral to public or low-cost services.For 2026, the local session rate is R1550 per session. For 2027, the session rate is R1620. Session rates are subject to annual increases from January of each year.
BILLING POLICYSessions are arranged for a particular period, and each agreed session time is reserved exclusively for the patient for the duration of that period. This reserved time forms part of the therapeutic arrangement and is therefore payable regardless of attendance, including when the patient is unable to attend due to personal commitments, travel, or other circumstances. The exceptions to this are school holidays and public holidays.There is no provision for cancelling, moving, or adjusting individual sessions during an ongoing treatment arrangement. Patients are, of course, asked to provide notice if they are going to be late or unable to attend. Where a patient is running late, I may make contact to check in. Regardless of the patient's arrival time, however, I will remain available for the full duration of the scheduled session.Similarly, session times cannot be moved or made up at another time. When arranging a regular session time, patients are therefore encouraged to consider their other commitments, including work schedules, regular interruptions, travel, and anticipated holiday periods. If a particular day or time is likely to be subject to frequent interruptions, it may be preferable to arrange a different regular session time.This structure is intentional. Psychotherapy is a treatment that requires an appropriate degree of regularity, continuity, and dedicated time. The security of a consistent and exclusively reserved session time is an important part of the therapeutic setting. The reserved time also allows me to remain available to the patient even when they are unable to attend and to continue reflecting on the therapeutic work between sessions.
Please note that medical schemes do not reimburse for unattended sessions.
TERMINATION OF TREATMENTA patient may terminate treatment at any time.A 72-hour notice period applies to termination of the treatment arrangement.. If treatment is terminated without the required notice, the final scheduled session will remain fully chargeable.While I can usually fill a session time at short notice, it would not be appropriate to replace an ongoing patient's reserved session with another patient on an ad hoc basis.
The exclusive reservation of the session time is also important to maintaining continuity and security within the therapeutic setting.