If you or your children are not safe, get help now. Visit a nearby emergency service, hospital, or police station immediately. The lines listed below are family and gender-based-violence lines.
Crisis numbers in South Africa
- Gender-Based Violence Command Centre: Tel: 0800 428 428 | SMS: send the word help to 31531, published for people with disabilities
- LifeLine Gender Violence Helpline: Tel: 0800 150 150 | WhatsApp: 0800 150 150
- Childline South Africa: Tel: 116
- All crisis lines in South Africa
What couples counselling is, and what it is not
In couples counselling the relationship is the client. Both partners come, and the counsellor works with what happens between you, not with who started it.
Approaches generally share similar features 1. An active style, attention to the patterns that keep a difficulty going, and an alliance with both partners at once.
You do not have to agree about why you are there. Relationship distress is a common reason adults look for therapy 2.
How does a session with two people work?
Both partners usually attend. Sessions run about an hour, most often weekly, and most approaches expect months of work rather than a single conversation 1.
A psychologist must say at the outset who the client is and how they will use what you say 3. Ask in your first email how the practitioner handles a private call or message from one of you.
No one model beats the rest for relationship distress 2. Ask how a practitioner works, and whether it fits the way the two of you talk.
Who is qualified to do this work?
Couples work is not a separate registration in South Africa. Check that the person is registered at all, then ask what experience they have of working with two people. Read the registration category on each listing before you write.
Clinical, counselling and educational psychologists and registered counsellors are separate HPCSA categories with different scopes. The Council's register search shows which one a person holds 4. A registered counsellor's scope is supportive and routine work, and referring on a client who needs more advanced assessment 5.
Social workers register with the South African Council for Social Service Professions instead 6. Practising without registration is a criminal offence here 7.
Titles you will see include Clinical Psychologist, Counselling Psychologist and Educational Psychologist. Search the register by name at Health Professions Council of South Africa (HPCSA). A current entry is that body's own published record of the person.
What a couples session costs
A South African couples listing carries a fee arrangement, not a price, and the commonest is "please enquire" 8. You will have to ask. Ask the session length and the fee for two people, often a longer session.
Our guide gives the ranges people are quoted here 9.
A psychologist must give you the fee as part of informed consent, as early as is feasible 3.
Medical aid attaches to a diagnosed condition and to your scheme's rules. Ask the practitioner what they can claim, and your scheme what it pays, before the first session.
Across South Africa: R1,100 to R1,900 for an individual session with a psychologist, per our South Africa fee guide. Those are advertised prices, not official rates.
Is couples counselling the right first step?
Joint sessions are not always the right first appointment. A careful practitioner screens before agreeing to see you together. The usual reasons are moderate to severe aggression between partners, active alcohol or other substance misuse, a continuing affair, and psychotic symptoms 1. Individual or specialist treatment comes first.
If one of you is afraid of the other, that is a safety question first. Going alone is a sensible beginning, not a sign you have given up on the relationship.
Couples counselling across South Africa
Filter by the language you would rather argue in. After English, Afrikaans is the commonest home language among South African practitioners who work with couples. isiZulu, Sesotho, seTswana and isiXhosa all appear 8.
The mix is local, not national. Cape Town's couples practitioners record far more Afrikaans than isiZulu, and Durban's the reverse.
Krugersdorp has 7 therapists listed on TherapyRoute who work with couples.
Frequently Asked Questions
Is premarital counselling a different thing?
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 courses10.
Reviewers are cautious about how long such effects hold11.
Can couples therapy be done online?
Practitioners who work by video say so on their listing.
Psychotherapy delivered live by video reaches outcomes close to in-person work, across therapies in general12. Couples work by video shows few significant differences from meeting in a room13. Engagement and the therapeutic alliance are comparable.
Ask whether both of you may join from separate places. That matters if one of you works away.
What does marriage counselling cost in South Africa?
Four things move a fee. The practitioner's registration category, their experience, the session length, and whether you meet in a room or online.
Lower-fee couples services exist. FAMSA Outeniqua in George sees individuals, couples and families, free of charge for people who cannot afford a fee14. The UNIBS unit at the University of the Free State offers marital and family counselling in Bloemfontein15. The University Psychology Clinic at Nelson Mandela University in Port Elizabeth offers couples, marital and family therapy, delivered by supervised trainees16.
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.
What happens in a marriage counselling session?
The practitioner works with what happens between you, not with one person's account of it.
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.
A first meeting normally covers three things. Why you are coming now, how each of you sees the problem, and what each of you wants changed.
Ask before you start whether the practitioner sees each partner alone. Ask how you will know the work is done.
Will a medical aid pay for marriage counselling?
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 policy17.
Two things affect a claim. The practitioner's registration category, and how a session with two people is invoiced.
Ask your scheme whether that category is claimable on your option, and ask the practitioner what they can invoice.
When should we go for marriage counselling?
There is no threshold you have to cross first. Relationship distress is one of the commonest reasons adults seek psychotherapy at all2.
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.
If the problem is safety rather than the relationship
Where there is violence, control or fear at home, the first call is not to a counsellor.
The Gender-Based Violence Command Centre answers at any hour. Call 0800 428 428, or dial *120*7867# free from a mobile and ask to be called back 18.
For a child, call Childline South Africa on 116. Their own line, 0800 55 555, is free from every network and answered at all hours 19.
For a protection order under the Domestic Violence Act, go to the magistrates court nearest to where you live or work. Anyone who is being abused may apply, and a minor may apply unassisted. The court takes these applications outside court hours, at weekends and on public holidays. It costs nothing 20.
Of the 7 who say how they work, 6 offer online sessions (86%).
Couples work here is offered by psychologists and counsellors.
Couples sessions here are offered in English, isiZulu, seTswana and Sesotho.
Nearby places and related listings
- Every therapist listed in Krugersdorp (11)
- Marriage counsellors by city, the marriage counsellors page, not tied to a place
- South Africa: Marriage counselling by city
References
[4] Health Professions Council of South Africa, register search.
[6] South African Council for Social Service Professions, find a professional.
[8] TherapyRoute's own records.
[9] TherapyRoute, How much does therapy cost in South Africa.
[14] FAMSA Outeniqua, George.
[16] University Psychology Clinic (UCLIN), Nelson Mandela University.
[17] Council for Medical Schemes.
[18] South African Government, government call centres and help lines.
[19] Childline South Africa.
[20] Department of Justice and Constitutional Development, domestic violence protection order.
Real choice. Authentic, independent, clinician-led care.
TherapyRoute is a clinician-led directory that champions independent practitioners who answer to you and their professional ethics. We don't take commissions, sell your data, or assign therapists by algorithm. You browse, compare, and choose.
Vincenzo (Enzo) Sinisi, Clinical Psychologist (HPCSA), Psychoanalyst (IPA/SAPA), Group Analyst (IGA)


