Information for clients about how I work

Psychotherapeutic orientation
Schema therapy is an evidence-based treatment approach that integrates relational/ interpersonal, process experiential, emotion focused and cognitive-behavioural approaches to psychotherapy. For more information about how schema therapy works please consult the Schema Therapy Institute of South Africa website.

Services

Individual psychotherapy

Individual therapy is a useful treatment for depression, anxiety, relationship difficulties, academic pressures, bipolar disorders, processing traumatic events and personality disorders.

Couple psychotherapy

Couple therapy is a conjoint therapy with both partners.

It is useful to overcome relationship difficulties, improve intimate relationships and plan for separation and divorce.

Couple therapy is also useful for adults considering adoption and going through the screening and placement process and parenting adopted children.

Family and parenting psychotherapy

Family therapy addresses behavioural and emotional difficulties and focuses on how to manage family relationships. It aims to support the family to help the child who is struggling. This is useful when families are going through particular stresses or parents have concerns about children’s behavioural or emotional difficulties.

It can also be useful when children are undergoing medical treatment, and for families going through bereavement. Family therapy is particularly useful for adoptive families.

Parent therapy is useful for those parenting adopted children. It can also be useful create and maintain parenting plans after separation.

Group therapy

Supportive group therapy is offered to adoptive parents.

Fees
For a 50 min session of individual therapy, couple or family therapy, I charge R1250 per session. Group therapy (90 min) is R300 per session per person.

Appointments and session times
Individual, couple and family sessions are between 50 and 60 minutes. Group therapy is between 75 and 90 min.

Your session begins at the stated appointment time. So, if you have an appointment at 11h30 your appointment will run from 11h30-12h20. This is your time and I will not normally keep you waiting except in very unusual circumstances. Even if you arrive late, your appointment will end at the end of the agreed time so that I am ready to start the next client’s appointment on time.

Please take steps to ensure you arrive close to your appointment time as there is no waiting area and you will not be able to be seen before the start of the appointed time.

I normally see clients weekly at a set time for several weeks or months. This means that you will be offered an appointment time on a specific day at a specific time which will be reserved for you until you formally terminate the sessions. Where you cannot come at the usual time, I may be able to accommodate you at another time by arrangement, but options will be limited. Please note that changing your regular appointment time does impact on the therapeutic work we are able to.

If you prefer to come less often (e.g. once every two weeks), you are welcome to discuss this.

Annual leave
My annual leave usually coincides with school holidays. I take one week after the first and third term, two weeks in the June holidays and four weeks over December/January. Please click here for current leave dates. If you need additional support during times that I am on leave, please discuss this with me so that we can arrange alternative support during this time.

Venue for therapy
Sessions normally take place at my office in Newlands. By prior arrangement, I can make hospital, clinic or school visits (where these are allowed by the institution concerned). In such cases I charge for my travel time by the hour at the same hourly rate that you pay for the session. I also provide consultations via the internet (see section below) or by telephone. If you are claiming from a Medical Scheme you will need to check whether these remote sessions are covered. For internet or telephonic sessions, fees are the same as those for sessions at my office. I usually use the platform called Skype or Zoom and you will be provided with the information you need on how to use this.

Internet sessions
There are additional security concerns if you have consultations via the internet as internet communication is not completely secure. Even highly secure systems like internet banking sites get hacked from time to time. The email system itself is widely recognized not to be very secure. At the same time, with such a mass of information flowing over the internet, the probability is low that someone would try to eavesdrop on a meeting that is taking place using one of the online systems. For applications that provide for face to face meetings and conferences (for example, Skype or Zoom) there is some variability with respect to the security levels. Please look at the security policy of the medium used. If you elect to have therapy over the internet, you are accepting the security limitations of the communication system used. I cannot be held responsible for any security breaches.

Loan of resources
I sometimes lend clients various resources to assist them in their therapy. These include books or DVDs. When I lend these resources, it is your responsibility to return them. If they are not returned when requested or within three months, you will be billed for the cost of replacing the item(s) plus an administrative charge.

Accounts
Payment is expected at the end of each session. Payment can be made in cash, via credit card, Snapscan or EFT. Please pay fees to the following bank account: Jean Luyt – Clinical Psychologist, First National Bank, Rondebosch Branch (201 509), Gold Business Account; Account Number: 62764724409. Statements will be issued at the end of the week.

All sessions not cancelled 24 hours in advance will be charged at the full rate and will not be covered by your medical aid scheme.

If your account is not paid timeously, you will no longer be able to continue in therapy until such payment is made. Any unpaid account will be handed over to a debt collection agency for recovery of debt after 60 days. If I have to send an account to an attorney for collection, the person responsible for the account will be liable to pay the legal costs involved.

Third party payments
If your account will be paid for by a third party, like your parents, or where you are not the main member on the medical aid, I will have to get explicit permission from them to claim from the medical aid or send them an invoice. If this is the case, please provide me with an email address to which I can send the necessary consent form. Payment by a third party will not impact on confidentiality of the consent of the sessions, but they will be informed about when you attend sessions and if you miss a booked session. It will be your responsibility to discuss with the person paying the account how you will handle appointments missed without adequate notice.

Medical aid schemes
I submit all invoices directly to a Medical aid scheme if you are a member of one. Please inform me if you prefer me not to do this.

Medical aid schemes differ in the amount they contribute towards psychological services and most have a maximum amount annually. If you plan to claim from a Medical aid scheme, please find out exactly what cover it offers.

Some Medical aid schemes, or particular plans within schemes, offer additional benefits for certain chronic conditions and may pay for additional sessions on completion of an application form. Whether or not your account is submitted to a Medical aid scheme, payment of the account is ultimately your responsibility and if you are expecting the Medical aid scheme to pay but for any reason they fail to, you must arrange to pay the account yourself.

PMB (Prescribed minimum benefits) conditions
Please note that I will not apply for cover for a PMB condition until the assessment phase is complete (usually 3 sessions) and you will be responsible for paying the sessions during this assessment phase. In addition, if the Medical aid scheme approves payment for a PMB condition I reserve the right to intersperse these sessions with sessions that you cover yourself. In this way we ensure sufficient funds to cover treatment for a longer period of time. Please discuss this with me if you have any questions about this.

Confidentiality
What you talk about during the sessions is confidential. This means that I will not disclose it to another person without your permission. Records include audio recording and written notes of sessions. My notes are kept in a locked filing cabinet and audio recordings are kept on my computer in password protected files. These records are kept in line with ethical guidelines outlined by the HPCSA.

Limits to confidentiality apply in the following exceptional circumstances:
• A court may issue an order that compels a psychologist to reveal to a court information disclosed in therapy, and, in some cases, in terms of Acts of Parliament, a psychologist may have a statutory duty to disclose confidential information.
• Where psychologists believe that a client is at risk for seriously harming themselves or another person or damaging property, they are ethically bound to act to prevent this and/or to protect third parties.
• Medical aid schemes require a diagnosis to be recorded on the invoice. This is done in the form of a numerical code from the International Classification of Diseases (ICD-10). The verbal form of the diagnosis (e.g. “Major Depression”, “Bulimia Nervosa”) does not appear on the invoice, but often does appear on an application for additional benefits.

Professional situations that involve disclosure of your personal information
• Supervision: I routinely discuss some of the content of assessments and psychotherapy with trusted colleagues. This is normal clinical practice. Psychologists need to discuss their work with other psychologists to maintain professional standards, to maintain a balanced perspective, to improve their understanding, and to solve problems more effectively. This is done in the strictest confidence and with discretion without sharing identifying details of clients. On occasion I might share the audio recordings of sessions with my supervisor. My accreditation as a schema therapist also involves the evaluation of some of my sessions with International Association of Schema Therapists by means of these audio recordings.
• Training: I am involved in the training of psychologists and I sometimes use case material or sections of voice recordings from my practice to illustrate particular aspects of psychotherapy without any identifying details. This occurs under strictly professional conditions in that the psychologists or trainee psychologists understand that such material must be treated as strictly confidential and limited personal information is provided about clients that might enable them to be identified.

Informed consent
The information outlined above is important because in asking me to do the initial assessment, and then, in proceeding to have psychotherapy, you are consenting to be interviewed, to disclose personal information and to engage in the processes of psychotherapy and to pay for, or have a third party pay for such therapy. It is important that your consent is “informed consent,” that is, that it is based on my having informed you of the conditions under which the assessment and therapy occurs, of my responsibilities and of any risks involved.

Before starting the assessment, you will be asked to sign a “Client information and consent” form. In signing this you are entering into a formal contract with me and accept that you have read and understood the points made in this document. This means that it is your responsibility to read this document carefully and to raise questions about any matter mentioned here that concerns you, as well as any other concerns you may have. Of course, you are always free to raise concerns and discuss issues afterwards, if you are not happy with any aspect of this arrangement.

During or after the assessment process, I will give you information about your status with respect to diagnosis (e.g. Major Depressive Disorder, Anorexia Nervosa, Posttraumatic Stress Disorder) as well as a proposal for psychotherapy. Your consent to engage with psychotherapy is also part of a formal contract with me.

Psychotherapy will normally be based on the general principles set out in this document. It is important that you express any concerns you have about the appropriateness of the treatment approach for you or the impact of the interventions either at the beginning or at any time.

You have the right to decide whether to continue with treatment and can choose to terminate at any time. However, should you choose to terminate suddenly, please discuss this with me first, so that I can express any concerns that I may have about the risks of sudden termination or can have the opportunity to speak to you about problems you are experiencing in the therapy process of relationship with me.

Rights of minors
The Children’s Act sets out the rights of minors (children and adolescents). It specifies that no parent may unreasonably withhold consent for the treatment of a child, and that children are able to give informed consent themselves from the age of 12. In terms of this Act, it is the duty of professionals to take decisions which they believe to be in the best interests of the child. In terms of the act, when treating a minor, I can inform parents or guardians about her/his therapeutic progress but will not normally disclose information about the content of sessions without the child/adolescent’s consent. I will also get explicit consent from the parent who is agreeing to pay for the therapy.

Do not hesitate to speak to me about any aspects of the matters raised in this document that you do not fully understand or that concern you. At any stage of the process of assessment and psychotherapy, it is important that you understand what is taking place in sessions or how I believe it will benefit you. You should voice any questions or concerns you may have about any aspects of my work with you. It is important that you tell me if you feel concerned about anything I say or feel uncomfortable about anything about the process.