S ea n Fr iedm an

Psychodynamic & behavioural Psychologist

Online |
| Sea Point Cape Town⋆༺𓆩☠︎︎𓆪༻⋆

I am a psychologist in private practice with 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.

Differentiating and treating complex trauma (cPTSD)

The effects of chronic and repeated trauma shares and mimics aspects of personality disorders (i.e. borderline personality disorder) but these are distinct and require different treatments. As such I take a special interest in untangling complex symptoms for accurate diagnosis, and in facilitating appropriate treatment.I work with patients to integrate and contain experiences of childhood abuse, neglect, and repeated physical and/or sexual violence to facilitate the reestablishment of trust with self and others.

Severe anxiety, panic, and paradoxical problems

Severe anxiety and panic are paradoxical problems in that many well-meaning, natural, and even apparently common-sense solutions usually end up making them worse.For example, adrenal stimulation can be experienced negatively (as anxiety), leading to efforts to reduce or eliminate it. When this happens, we start to 'flag' it as dangerous or as a problem to be solved, becoming more alert to it and, ironically, increasing it (as adrenaline is then released in response to perceived danger). At the same time, positive experiences of this stimulation (i.e. as excitement) decrease.In cases where the cycle begins to accelerate, it can rapidly increase the sense of danger and produce panic. Once this has happened, it is difficult to change as a strong association between the sensations of stimulation and danger is created.I use a behavioral approach to effectively address these and other similar dynamics and mitigate symptoms in the immediate term, before attending to underlying contributing dynamics in order to maintain gains and prevent remission.

Chronic and recurring depression and lack of vitality

Chronic and recurring depressions likely have multiple intersecting pathways including genetic and environmental influences. When longstanding, these can greatly affect self-esteem and motivation. 'Good' periods are likely to be experienced with anxiety and anticipation for a coming 'bad' period, and moments of inspiration and excitement can come to be experienced with suspicion and distrust.I work with patients to disentangle the confluence of factors that are keeping them stuck and to experiment with making shifts to bring about significant and lasting change.

Masculinities, gender dynamics, identity

Culturally, many changes have produced new possibilities and ways of being, along with uncertainties, confused expectations, and sometimes harshly punishing and unforgiving contexts. While some constrictive double binds have been challenged, others have emerged in new and unacknowledged ways.I take a special interest in helping to acknowledge, voice, and facilitate self-acceptance and understanding, as well as communication — in identity, relationship, sexuality, and subjectivity. I see value in both traditional and newly constructed ways of being and take a non-prescriptive approach to these developments and challenges.

Registrations

Independent Practice Counselling Psychologist
Health Professionals Council of South Africa
HPCSA PS0159018Chartered Psychologist
Health and Care Professions Council United Kingdom
HCPC PYL046126

Clinical training and supervision

I attended the postgraduate training program at the University of the Witwatersrand which maintained a strong recognition of contextual and systemic factors in approaches to diagnosis and treatment.I was supervised extensively in acceptance and commitment therapy (ACT) and psychoanalytic psychotherapy. The first is a behavioral approach that can be very effective for bringing about change quickly. The second is attuned towards understanding oneself and facilitating less obvious though more fundamental changes to one's experience.

Trauma specific experience

Before my advanced clinical training, I worked in trauma-specific counselling with individuals affected by extreme violence and torture at the Trauma Centre in Cape Town.During my postgraduate training, I focused on complex trauma (cPTSD) its symptoms and effects, and took a special interest in differentiating it from other similar and overlapping difficulties (as seen in borderline personality disorder, autism, and attentional difficulties).My thesis explored internal and environmental factors that contributed to resilience and post-traumatic growth in children who had endured extreme circumstance and violence, and yet were able to cope and eventually thrive.

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.Similarly, disabling forms of schizophrenia, life-threatening eating disorders, and severe, dangerous addictions are best addressed by professionals in collaboration with a team.

Clinical modalities

There are a number of therapy approaches, models, and intervention strategies. I am trained in both short and long term models. What is important — and what a psychologist is trained to do — is to carefully understand difficulties and goals in context, and to select treatment approaches that will be likely to work in consideration of a person's history, personality, and situation.Psychodynamic psychotherapy is concerned with an in-depth understanding of the internal 'dynamics' at work in a person: all the conflicting feelings, thoughts, desires, past experiences — and how these interact with one another. Whether using shorter or longer term approaches, this understanding is essential as the same tools or interventions will not work for different people, and in some cases can make things worse.Cognitive and behavioural approaches work with thoughts and behaviours directly, providing challenges and shaping skills to teach emotional regulation, planning, solution finding, and other 'tools' as needed.I draw on best practices and the research literature in utilising various techniques as appropriate, and have been trained in Exposure and Response Prevention (ERP for OCD), Behaviour Modification (for ADD/ADHD), and Behavioural Activation (for depression).

Assessment is a normal and ongoing part of psychotherapeutic practice.Outside of this, I take a special interest in the differentiation of closely similar but distinct difficulty and disorder. For example, differentiating complex trauma and personality disorders from one another, as well as depression, anxiety, and ADHD.An accurate diagnosis can be immensely helpful, while inaccurate diagnosis can lead to misapplied treatments.For in-depth and specialist assessments please contact me to enquire further.

Frequently Asked Questions

What are the fees & billing structure?

Individual psychotherapy sessions are charged in line with medical aids rates, usually requiring a small copayment. Assessments are billed according to the number of hours needed (interviews, testing, scoring, and report writing).

Do you accept medical aid & PMB's?

Yes. The person responsible for the account pays me directly, and then submits the invoice to medical aid who reimburses the members account.A number of conditions are recognised as Prescribed Minimum Benefits (PMB's). Dependent on the diagnosis a number of sessions may be covered in addition to your usual benefits. I will assist with diagnosis and activation for these when indicated.

What is the length of therapy?

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 16 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 psychotherapy is likely to be indicated.

Do you prescribe medication?

As a psychologist, I do not prescribe medication. However, I do work collaboratively with medical doctors and specialist psychiatrists who are able to prescribe.Medications are very helpful for some people, and not at all for others. Sometimes temporary and short-term use is adequate, at other times ongoing use is important.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 kind of work that I do. Keep in mind that it may take a while to secure an initial session.If something resonates and seems like a good fit,
feel free to message me and tell me what you're looking for.

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Sea Point | Cape Town
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Current Rates: 2026

Individual Psychotherapy Sessions
Local: R1550
International: £90

Please make use of the following EFT details, with your Full Name as Reference.

S Friedman
Discovery Bank
Savings Acc.
Account Number: 18685487819
Branch Code: 679000
BIC/SWIFT: DISCZAJJXXX

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 the disclosure of information. These include, but are not limited to:If your life or another person's life is at risk.
If there is evidence or suspicion of harm to a child or vulnerable adult.
In cases where prenatal use of dangerous controlled substances is disclosed.In such situations, I may be legally or ethically required to notify appropriate authorities, including legal or social service agencies, and may attempt to contact your family where appropriate.Parents or guardians of non-emancipated minor clients are entitled to access the client's records. However, for adult clients, regardless of who is responsible for the account (e.g. a parent or workplace), confidentiality will be fully maintained. No records or personal updates will be disclosed without your explicit written consent, except where disclosure is required by law or professional obligations.

SUPERVISION | CONSULTATION | THEORISATIONAs part of standard practice and ethical responsibility, psychologists routinely engage in supervision and peer consultation with other professionals. This process is essential for maintaining objectivity and supporting the therapeutic work.At times, consultation with a third-party professional may be necessary to gain a more comprehensive understanding of the issues at hand and to facilitate continued therapeutic progress.When discussing cases with other professionals, all identifying information will be removed or altered to preserve your anonymity. Relevant aspects of your case, such as psychological dynamics, symptoms, and history, may be discussed for the purposes of supervision or consultation.At times, it may be beneficial to incorporate aspects of a case into research or theoretical exploration. Any identifying information will be fully anonymised so that you would not be recognisable from the material. I will always seek your approval before submitting or publishing any material for such purposes.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 reasonable precautions to ensure the security of your personal information, as well as the clinical notes and records I maintain. 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.Personal and identifying information, including medical records, is stored within medical billing software and may be communicated to medical scheme providers for reimbursement purposes. These systems and providers are required to comply with the Protection of Personal Information Act (POPIA).However, I encourage you to exercise discretion when communicating sensitive information via digital channels. While I take reasonable steps to secure the information I manage, I cannot guarantee the security of systems beyond my control. I recommend limiting the exchange of highly sensitive information to the sessions themselves.

COMMUNICATIONTo maintain the integrity of the therapeutic process, it is important to establish appropriate boundaries around communication. 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, as I may not be available.

RATES, PAYMENT, & MEDICAL INSURANCEPayments are made directly to me by the person responsible for the account. I ask that the account be settled within the first week of the new month – if for some reason 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, however, manage or 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 for more than one month, I am ethically obligated to cease providing 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.Click on this link to view Current Rates and banking account details.Please note: Session rates are subject to annual increases.

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 by providing at least 72 hours' notice, excluding weekends and public holidays.The 72-hour notice period applies to termination of the ongoing treatment arrangement, rather than to the cancellation or rescheduling of individual sessions. 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.