Couples Psychotherapists in Cape Town

Couples counselling works with two people, and with what happens between them. It does not treat one of them.

Both partners usually attend ¹. Couples counselling works on repeated arguments, an affair, sex, money, parenting, or a decision about separating.

It does not rule on who is right. It is not for married couples alone. Ask a practitioner which approach they use.

If you are afraid of your partner, say so to the practitioner before any joint session is booked. Ask to be seen on your own first. The support numbers at the top of this page are for that situation.

Everyone on this page describes their work as psychotherapy. A psychotherapist works through talking with you about your thoughts, feelings and behaviours.

Psychotherapy usually runs longer than counselling and aims for clinical change. It works on patterns that repeat rather than on one current problem.

A psychotherapist trains in psychological treatment rather than in medicine. What that training covers, and which approach a practitioner uses, differ between practitioners. Ask which approach a psychotherapist trained in, and how long they usually work.

Groote Schuur Hospital - Psychiatry Outpatient Services. Phone +27 21 404 9111. Western Cape public hospitals charge on a means-tested scale. Patients in the lowest band pay nothing for specialist outpatient visits. Public patients are accepted by referral from a district or secondary service. Each specialty has its own eligibility criteria.

Usually. Partners are almost always seen together¹. Couples sessions require safety.

Some practitioners will see one partner alone where the other will not attend. Ask what a practitioner does when one person is unwilling.

No. Couples counselling is for people in a relationship, married or not, of any gender, living together or not. The same practitioners work with couples deciding whether to separate, and with couples who have already separated and are parenting together. Say which of those describes you at first contact.

No. The work is with what happens between two people rather than with a verdict on either of them. Effective work with couples needs its own theories and methods, drawn from research on relationships. Ask a practitioner how they handle it when you disagree in the room.

Yes, and many practitioners offer it. Couples therapy by video shows few significant differences from face-to-face sessions². Symptom reduction, engagement and the therapeutic alliance are comparable.

Sitting in the same room at home suits some couples and not others. Ask what a practitioner offers.

Yes. It is preventive work with a relationship that is not in difficulty.

One trial followed engaged and newly married couples for three years. Those given no programme separated at a higher rate than those completing any of the three offered. A single relationship awareness session did as well as the two skills courses³.

Reviewers are cautious about how long such effects hold⁴.

Each practitioner sets their own fee. Our guide to what therapy costs in South Africa sets out the usual ranges; ask each practitioner what a couples session costs.

Most South African listings state an arrangement rather than an amount: a sliding scale, insurance accepted, a cash practice, or an invitation to enquire⁵.

Lower-fee couples services exist. FAMSA Outeniqua in George sees individuals, couples and families, free of charge for people who cannot afford a fee⁶. The UNIBS unit at the University of the Free State offers marital and family counselling in Bloemfontein⁷. The University Psychology Clinic at Nelson Mandela University in Port Elizabeth offers couples, marital and family therapy, delivered by supervised trainees⁸.

Where a practitioner states a fee on their listing, that figure is their own. Ask before the first session. Ask too whether the fee runs per session or per person in the room.

Practice differs on what comes first. Some approaches open with a formal assessment that combines joint and individual meetings. Others use no set assessment stage¹.

In the first meeting you usually talk about why you are coming now, how each of you sees the problem, and what each of you wants changed.

Before you start, ask the practitioner these questions.

• Does the practitioner see each partner alone?
• What does the practitioner do with what one partner tells them in private?
• How will you know the work has finished?

Your scheme decides, and the answer differs by scheme and by option. The Council for Medical Schemes regulates South African medical schemes, and publishes the difference between a medical scheme and a health insurance policy⁹.

A claim depends on the practitioner's registration category and on how the practitioner invoices a session with two people.

Ask your scheme whether that category is claimable on your option, and ask the practitioner what they can invoice.

There is no threshold you have to cross first. Relationship distress is one of the commonest reasons adults seek psychotherapy at all¹⁰.

Distress between partners travels. It is associated with mood, anxiety and substance-use difficulties in the partners themselves, and with difficulties for children in the household¹.

Couples come with a repeating argument, with an affair, with a decision about whether to stay together, and with none of those. You do not have to agree on the problem before you make contact.

South Africa has no separate register for the title psychotherapist. A psychotherapist must register with the Health Professions Council of South Africa (HPCSA), most often as a psychologist or a psychiatrist. Regulations still in force (R993 of 2008) place the use of any psychotherapeutic method within the scope of psychology. You can check a name on the HPCSA iRegister.