FAQ

The psychology practice is located in Claremont, in the Southern Suburbs of Cape Town. The practice services areas like Claremont, Bishopscourt, Cape Town City, Constantia, Kenilworth, Newlands, Pinelands, Rondebosch, Rosebank, and Plumstead.

• Sessions are charged at medical aid rates, particularly that of Discovery Medical Aid at R1244.90 per therapeutic session (51-55 min).
• I am able to submit claims on behalf of Discovery clients. Clients with other medical aids pay me directly and are provided an invoice to independently submit to their medical aid for reimbursement.  A discounted cash rate is available at R1000 per session. Sessions can be paid via EFT within 30 days or via the card facility machine in my office. In the near future my practice will be registered with most popular medical aids and hence I will be able to claim on your behalf to your medical aid. An update will follow as soon as this is available.
• It is the client’s responsibility to enquire with their medical aid about the availability of cover for therapy sessions. In the unfortunate event that a session(s) turns out not to be covered, the client remains responsible for settling all fees pertaining to sessions attended. Clients are strongly encouraged to remain abreast of their medical aid cover status in relation to psychotherapy. It is the client’s responsibility to clarify any queries with their medical aid.
• Interest will be charged on accounts not settled within 30 days as per the Prescribed Rate of Interest Act. If an account is not paid within two months, the client’s name will be added to a list of non-payers. Should it be necessary, all attorney-, client-, collection, and tracing costs, as well as interest related to recovery of any amount owed by the client will be the responsibility of the client.

• By law, all appointments that cannot be kept must be cancelled 24 hours or more in advance. Appointments cancelled less than 24 hours in advance will be charged for.
• Should you forget an appointment or simply not show up without notifying me, you will be held liable for the account.
• Some clients are very limited in their availability to attend therapy sessions due to occupational and personal obligations. Such clients often are given a “regular” weekly time slot which tends to be the only option that can work for them. Should a client not honour an appointment and fail to notify me, they will risk losing a regular slot to another client who had been awaiting the opportunity to attend sessions at that time.

Contact details for enquiries and scheduling appointments can be found on the Contact page.

A session has a duration of 50-55 minutes.

It is not possible to give a generalised estimation of how long the therapeutic process may take for different individuals. This depends on a variety of factors, including the nature of your concerns or therapeutic goals, your personality functioning and cognition, severity of symptoms (if any), and accessibility to resources such as time, energy, and finances.

Some presenting issues may require more in-depth therapeutic work which tends to be of medium-to-long rather than short duration. This is particularly the case when there is a need to work through traumatic and distressing life experiences or when one is dealing with the management of a chronic mental illness or deep-seated problematic personality functioning.

A treatment plan is developed early in the therapy process and this should provide some indication of what the duration of the treatment might be. Therapy can however be unpredictable at times.

It is natural to feel somewhat nervous about your first session if you have not been in therapy before. 

Before I tell you more about what you can expect, let me point out that you have come to this point because at some level you desire and need something better, healthier, and more fulfilling for yourself, and possibly for some of those closest to you as well. You should also note that taking the step to enter therapy implies that you believe that the things you long for are attainable. I would also like you to realise that it takes courage to believe and to hope, and also to take the step of going into therapy. Hopefully you are able to take a moment to feel proud of yourself.

The first session is primarily spent with the following goals.

• Your presenting concerns/problems or particular goals you want to work towards in therapy.
• This often involves a process through which I need to obtain information from you as it relates to your personal history and life experiences; your experience of symptoms – if any; information about when and how a problem may have emerged; and information relating to your life in terms of developmental history, work, significant relationships, social functioning, general health, lifestyle practices, environmental conditions, etc.
• Humans are complex beings with complex life histories, and it is therefore not uncommon if all the afore-mentioned information is not obtained during the first session. It is the nature of the process that we tend to continuously discover new things as we go along.
• The goal of the first session is therefore for me to gain an understanding of what it is that brought you to therapy , both in the here-and-now and in terms of your unique personal history and tapestry of life experiences.
• Once there is an understanding of how a problem may have developed and/or factors that might be maintaining or exacerbating the problem, one can then set therapeutic goals that we will aim to achieve through a treatment plan that will subsequently be developed.
• It is also of central importance that the first session is not merely a question-and-answer “interview” encounter. Indeed, much of my focus is on ensuring that I listen to you intently and understand you and make you feel seen, valued, and affirmed, and that you may come to feel comfortable, secure, and safe in the treatment space.

Each client their context are unique. Therefore therapy in my view is not a one-size-fits-all endeavour, and I approach each client’s case in relation to their presenting concerns, personality and cognitive functioning, presence or not of deep-seated trauma or personality functioning problems, presence or not of a diagnosis and the response required to treat this, the client’s capacity to engage in therapy, and so forth. 

You can read more about some of my preferred treatment approaches on the Therapeutic Approaches page.

Clients are sometimes understandably concerned about confidentiality in therapy and whether confidentiality is absolute and guaranteed. As psychologists, we are bound by the ethical code of our profession as well as by law to maintain absolute and complete confidentiality of all information clients provide.

As a psychologist registered with the Health Professions Council of South Africa (HPCSA), I am required to obtain a client’s written consent in any event where I might be obligated to reveal any personal information, even to the people closest to a client, including a spouse, parent, romantic partner, etc.

There are a few exceptions to what is stated above, which we refer to as the limits of confidentiality. This means that under particular rare circumstances, psychologists are obligated ethically and legally to reveal confidential information about a client to another person(s) or party. I outline below these specific situations.

• In the case of clients who are legally minors, psychologists are still obligated to respect their personal information and privacy fully and absolutely. I would however at some intervals across the duration of the treatment process need to provide the legal parent(s) or guardian with feedback on the client’s progress and psychological status. This would not happen too frequently, and the client and I would first discuss what they feel comfortable for me to reveal or not. You are entitled – even as a minor – to have particular information remain absolutely confidential and I must respect your wishes in terms of that. Should I however be of the belief that you or another person is at risk of serious harm, I would be ethically obligated to inform the relevant parent/guardian so that appropriate steps can be taken to ensure your personal safety.
• Another exception that applies is exactly as above, except that it also applies to clients who are legally of adult age. If a psychologist is of the earnest belief that a client has the intent to harm themselves or another person (e.g., by serious injury or death), it may be necessary to release information to another person(s) to facilitate the measures required to secure a client’s personal safety and wellbeing. In such a situation, however, I will first discuss the situation with the client as far as is reasonably possible.
• Clients sometimes see health professionals additional to a psychologist to manage their treatment,, e.g., a psychiatrist, general medical practitioner, social worker, etc. A psychologist may need to communicate information about your condition to another health professional when it pertains to your treatment and decisions need to be made in that regard. This would be discussed with you beforehand, and all other health professionals are bound by the same ethical codes and legal requirements of confidentiality as psychologists.
• Psychologists are obligated ethically and legally to report to the appropriate channels any case where a client is engaging in abusive, neglectful, or otherwise harmful behaviour towards a dependant, i.e., a minor, an elderly person, or an intellectually disabled person who relies on the client for their daily care and survival. Such a situation will first be discussed with the client as far as possible.
• Lastly, in rare cases, a psychologist might be forced by a court order to release personal information in relation to a client. If possible, I will always discuss this with the client and release only whatever minimal information is absolutely and unavoidably required by the court. My goal would remain to safeguard a client’s personal information to the greatest degree possible.

Hopefully the above information addresses some of the questions you may have around confidentiality. In summary, you may rest assured that complete confidentiality is the rule rather than the exception. Should any of the mentioned exceptions arise, I will always if at all possible discuss the situation with a client. These can be very sensitive matters, and my role is to explore together with the client how we can mitigate and manage the situation constructively and limit any possible harm to the fullest possible extent.

Before your first session, I will send you an informed consent form via email with all the terms and conditions related to the therapy process. This should be completed and signed by you and returned to me electronically before our first session. 

When providing consent, you legally provide your permission for the treatment to commence, meaning that you are voluntarily entering the psychotherapy treatment process as a personal choice and that you are not doing so against your will or as a result of coercion by another person.

But consent must also be informed. This means that the process which you are entering into is explained to you and understood by you in clear terms. This includes what your rights are as a client, what you may expect of me and the treatment process, and what I may expect of you. If there are any questions whatsoever about the process or information in the consent form, please do let me know so that I can resolve any questions. Consent is therefore only informed consent when a client fully understands the process they are entering into, including all the terms, conditions, and responsibilities pertaining to both parties involved.

The reality of the matter is that conducting psychotherapy from a religious viewpoint is strongly discouraged within the professional psychology community. 

It is however altogether a different matter if clients have a need to discuss their beliefs and personal experiences related to that. The aim is to provide a space where the client can discuss anything whatsoever that is of significance to them, and my task is to understand as best I can what their experiential world looks like and feels like. 

Differing religious or spiritual beliefs are, from a psychological point of view, a simple inevitability just as much as it is inevitable that we have different personalities, cultures, languages, and personal histories. I have the deepest respect and reverence for any person’s belief system. In general I tend to inwardly celebrate when people do have a faith or belief system, because I know that – if “taught” and preached responsibly – faith is among the strongest factors of psychological resiliency a person can possess. Sadly of course it can also be used as a tool for evil – but that is due to the user of the tool rather than the nature of the tool itself.

I do prefer to believe that I have the capacity for some significant measure of understanding of a client’s experiences as related to their belief system – regardless of its nature – in the same way that I have some capacity for understanding and infinite range of experiences unique to clients, but not quite something I have yet personally experienced. By the same token I am also able to understand complete and utter nihilism – either option is a result of how we personally navigate and make sense of the very complex and perplexing realities of human existence, especially in a world that looks the way ours does at times.

So in summary, as a psychologist I cannot use my belief system as a tool toward offering viewpoints or input to a client during therapy. Clients are however most welcome to share anything whatsoever in relation to their personal beliefs. In general I am very fascinated to learn about different religions and spiritualities. 

My desire for each client is that they gain as much benefit as possible from the therapy process. It can be a very unique and moving experience for both parties involved. Beyond anything else, however, I want you to feel seen, understood, and valued, and to experience the sense of security, safety, and trust needed to open oneself up in the treatment process.

Whether you are only just starting out therapy or whether the process has been ongoing, I invite you to ask anything or discuss with me anything related to the process or your experience of it. It is important that we have a relationship of trust and that you feel comfortable discussing with me anything that is troubling you.

If there are any questions you have that are not addressed here, you are very welcome to use the contact form on the Contact page to get in touch, or to email me at info@mariskapienaar.co.za.