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 and treatment.

Clinical training and supervision

Prior to my clinical training, I completed a trauma focussed qualifying internship with The Trauma Centre for Survivors of Violence & Torture in Woodstock in 2014. I continued to work in crisis counseling and education, and with adolescents and children in particular.During this time, I was drawn to the behaviorist tradition for its rigorous and precise emphasis on measurable change. It is the basis of such methods as ERP for OCD, and I took an interest in the underlying philosophical and scientific particulars of 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 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 often 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 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 approaches.

Registrations and Professional Development

I am registered both as an Independent Practice Counseling 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 am 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 crucial — and what a psychologist is trained to do — is to take careful account of a person's unique history, context, capacities, and personality in determining an appropriate treatment that can offer the best chance of success.Psychodynamic psychotherapy is concerned with an in-depth understanding of the internal 'dynamics' at work in a person: one's 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 am trained in and integrate such methods as Exposure and Response Prevention (ERP for OCD) and 3rd wave CBT techniques for anxiety and panic disorders.

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 for out of psychotherapy. You can ask me anything about how I work.Typically, three initial sessions are required 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 either outright or in a new form.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 extreme cases of serious and imminent risk of harm to self or others.

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 (PMB's) 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. Significant holiday breaks can be arranged in advance.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?

Yes, but only in very particular situations. If you are reasonably within range of my practice, therapy will likely be offered exclusively in-person.

If you would to arrange, please let me know a little about yourself and what you are looking for via the form below.The initial assessment sessions are typically arranged relatively quickly, but please keep in mind that it may take a while to secure an ongoing time if we do decide to continue.

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Sea Point | Cape Town
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Terms of Service

A NOTE ON BOUNDARIESTo maintain the integrity of the therapeutic process, it is important to establish appropriate boundaries. This is known as the therapeutic 'frame' and is essential to ensuring safety in a process that by its nature brings up much emotional vulnerability.The psychotherapeutic relationship is an unusual and asymmetric one. Patients are asked to talk openly as to whatever comes to their minds, and to share the most intimate of feelings, thoughts, and experiences. This is a very vulnerable and precious process, and confidentiality, consistency, and clear boundaries are of paramount importance.The frame protects the patient and the therapy, and makes the work possible. As such, it is taken extremely seriously — and any alternations to the frame are considered carefully under case supervision. This leads to a degree of inflexibility, but this inflexibility is due to taking seriously the care of my patients.This resulting structure is intentional, researched, and proven to be effective. This structure also allows for extensive freedom: patients are billed and are responsible for settling their accounts on time, but aside from this there is complete freedom to be difficult, resistant, and express anything whatsoever. It remains my responsibility to work through all of this carefully and continue to provide the treatment.

BASIC PROCESSI will ask you to do your best to freely express yourself, and to say whatever comes to your mind. This might sound easy, but it quickly becomes very difficult. That is normal and natural, it happens more with some things than others, and we call this 'resistance'.Resistance is not a problem. It allows you to get to know your mind and what may be difficult to think about.I will ask questions about how you feel, about your thoughts and relationships, about the content of your dreams, and about other intimate aspects of your life. You are free to ask me anything, or to talk about anything.If you don't want to talk about something, I might ask why that is, but you don't have to talk about something if it feels too much for you.Sometimes I might share a technique or an exercise, but this is not very often. Sometimes we might think through something practical, or consider some ideas, or talk through a plan for something.Many feelings do come up during the therapeutic process, both good and bad towards the therapist. This is perfectly okay and in the natural course of treatment. This is called 'transference' and is one of the most effective ways in which things may be worked through in therapy.I may from time to time ask about thoughts and feelings that come up towards me, or things that I notice in regards to our relationship — as well as any feelings and thoughts around therapy and the sessions.All of this leads to a special kind of closeness, and precisely because of this and to allow it to develop, there are strict prohibitions.We cannot spend time outside of sessions casually, and no 'dual-roles' can be entertained (i.e. I will not able to hire, supervise, or spend time with you in some capacity other than the therapeutic one within our arranged sessions).At times, we might cross-over, especially in a city such as Cape Town. In such situations, you are free to greet or ignore me. I will not divulge to anyone the nature of our relationship either way.Aside from such culturally appropriate things such as a handshake on meeting, or helping one up from a fall, physical touch is not permitted.I make a living from my work, and my billing covers this. I cannot accept any other financial gains or gifts. Similarly, I cannot provide financially for my patients. In certain circumstances, I may provide a fee reduction but this will be carefully discussed and considered.

ONLINE SESSIONSOnline sessions are generally restricted to when someone resides outside of Cape Town.In some particular circumstances, online sessions may be considered, but not at short-notice.It is expected that patients secure a suitable and private location appropriate to the work, and dress as they would if they were attending a session in-person.Sessions cannot be recorded or transcribed without express consent, and it is expected that this is not done from the patient side either.Keep in mind that reasonable attempts are made at privacy and confidentiality, but I cannot ensure the security of systems beyond my control.

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 of cases legal or social services. This pertains to:If your life or another person's life is in imminent and serious danger.
If there is evidence of severe harm to a child or vulnerable adult.
If prenatal use of dangerous controlled substances is disclosed.Even then only the most limited and impersonal information to ensure safety can be disclosed.Parents or guardians of non-emancipated minor clients (under the age of 12) are entitled to access their children's records.For parents of minors, over the age of 12, but under the age of 18, they may know of whether sessions have been attended and of general progress. All session content however remains confidential.Medical / clinical records are required to be in safekeeping for 5 years. These records only reflect dates of attendance, notes on current functioning, significant events (such as a workplace accident), and a remark on general 'progress'. They do not contain any personal content from the sessions whatsoever, which is kept separately and wholly confidential. Technically these medical records can be subpoenaed, but the sensitive session notes cannot be.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. If invoices are requested to be shared, keep in mind that these would include identifying information, session dates, and diagnostic and treatment codes.

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. Without your explicit written consent and request, no discussion with other current or former treatment professionals is ever entertained.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 and permanently expunged 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.

COMMUNICATIONWhile I am available to respond to practical enquiries via my work email and phone line. All personal concerns or therapeutic questions are to be kept to the sessions themselves. Please limit out-of-session communications to matters such as:Confirmation of session times
Clarification of fees or payments
Other administrative mattersI 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 COVERThe patient is fully responsible for the account.My 2026 local rate is R1550.
My 2027 local rate is R1620.
My international rate is £90.I bill at month's end.The account is to be settled within the first 10 days of the new month. If this is not possible, please address with me directly at the outset.Payments are made directly to myself, either via transfer or in-person. If paying in cash, an envelope is to be used.I do not correspond with medical scheme providers on behalf of patients. I do provide invoices in accordance with medical scheme requirements for purposes of reimbursement.If an account remains unsettled I am 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.After 14 days, a reminder email will be sent.After 21 days, a second reminder email will be sent.After 30 days an account will begin to accrue interest in accordance with South African law, and services will need to be suspended until the account is settled in full.I will make reasonable attempts to accommodate with a payment plan if necessary. If the account remains unpaid, I will hand over the debt to a medical debt collections agency.

BILLING POLICYA fixed session time is exclusively allocated and reserved for the patient, and this time is billed regardless of attendance for the duration of treatment.There is no provision for cancelling, moving, or adjusting individual sessions during an ongoing treatment arrangement. Where a patient is running late, I may make contact to check in on attendance for that session. Regardless of the patient's arrival time, I will remain available to receive them for the full duration of the scheduled session.If arriving late, the session will not be extended past its usual ending time.Treatment periods exclude public holidays, as well as the majority of the SA school holidays. I will communicate in advance at the beginning of the year, and again throughout the year these exact treatment dates.In some cases, I may decide to work on certain public holidays or further into school breaks. In such situations, I defer to the patient on whether they would like to attend their session and bill accordingly.If I have decided to work on some particular public holiday, and if the patient decides they will be attending, a 48-hour notice will be sufficient for cancellation without consequence to billing.Generally, holidaying during treatment periods will be charged as per the normal billing arrangement.Significant holiday periods outside of the treatment period, may be prearranged, but this is something that must be discussed and agreed to as far in advance as possible.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 for a different session time, or to wait until one becomes available.

TERMINATION OF TREATMENTA patient may terminate treatment at any time.A 72-hour notice (exclusive of public holidays and weekends) applies to termination of the treatment arrangement.Until this required notice, sessions will continue to be billed accordingly.