Addiction Counselling Services in South Africa

After the initial assessment of a patient’s needs, a mental health professional will design a personalised treatment plan for the patient. This plan can then be executed during various types of therapy sessions, including the following:

Group sessions: In this setting a number of patients with similar disorders meet, discuss and share their problems and solutions with each other.

Family therapy: The patient and one or more family members attend a session in the presence of a therapist, in order to address issues peculiar to the family’s particular situation.

One-on-one counselling: A therapy session involving a meeting between a single patient and a single therapist, without any other person being present during the meeting.

The Purpose of Individual Counselling

The purpose of a one-on-one counselling session (also known as individual counselling) is to create an opportunity where a therapist and a patient can deal with issues related to a disorder, in a private, confidential setting. Every individual is unique and one-on-one therapy sessions offer specific advantages, including:

  • The patient is ensured of more confidentiality than in a group.
  • The patient receives the full and undivided attention of the therapist.
  • The patient does not have to listen to irrelevant issues of other patients.
  • It is easier to explore personal issues and to develop individual solutions.
  • It is more suitable than a group setting for patients who are introverted or shy.
  • Groups allow “lazy” patients to fade into the background and avoid accountability.
  • The patient may find it easier to disclose information that might be embarrassing.
  • Appointments can be arranged for a time that is most convenient for both parties.
  • Therapy sessions can be paced according to the needs and capacity of the patient.
  • Therapists can more easily spot co-occurring disorders due to the intimacy involved.
  • It allows for the formation of a trusting relationship between counsellor and patient.
  • The client is able to be themselves, with the benefit of not being judged by others.
  • Therapy sessions can be arranged at short notice, as there are no other parties involved.

The Therapeutic Alliance

The “therapeutic alliance”, which is the working relationship between therapists and patients, is stronger in individual counselling. Research has consistently shown that this is a vital component of successful therapeutic intervention.

There are hundreds of different therapy directions, each with their own designation, but most directions fall within one or more of the following psychotherapeutic traditions, each of which contains different branches and variants of therapy:

Psychodynamic / psychoanalytic therapy: emphasizes unconscious conflicts with roots in childhood and the relationships one had with close caregivers. In its classic form, Freudian psychoanalysis is a protracted process that extends over several years, with the client gradually building insights into the causes of his or her own feelings and behaviour. Has since branched out into several different directions and treatment variants, which are practised in more short-term treatment courses and are based on various further developments of Freud's thoughts and / or more modern additions, such as attachment theory. "Psychodynamic therapy" is a broad term that encompasses all therapy directions within this tradition, while the term psychoanalysis especially used on therapy that closely follows the Freudian tradition (classical Freudian psychoanalysis is less prevalent today).

Cognitive Therapy / Cognitive Behavior Therapy: emphasizes current issues and the patterns of thought that maintain them. Has a results-oriented approach that works with a defined psychological problem, as a general rule in short-term courses, where you closely follow the progress that is made in relation to the problem. In addition to working with thought patterns, cognitive behavioural therapy incorporates learning principles and techniques from behavioural therapy (see behaviourism), a form of therapy that emerged prior to the cognitive approach, but is now rarely practised in pure form in psychotherapeutic courses.

Humanistic/experiential therapy: emphasizes experiencing and expressing suppressed feelings, reactions and potentials, focusing on an equal relationship between therapist and client, as well as an empowering attitude with the therapist (humanistic psychology). The humanist approach was initially referred to as the third way because it was based on an alternative to both psychoanalysis and behavioural approaches that were more scientific. Experiential psychotherapy has its roots in therapy, and Carl Roger's client-centered method. Emotion-focused therapy is a recent example of a therapy direction within this tradition.

Existential therapy: emphasizes enabling the client to stay true to himself, his own values ​​and his own beliefs. The goal is to find meaning and take responsibility for your own life. Existential therapy was founded by Ludwig Binswanger and Viktor Frankl. Existential therapy emphasizes that man is existence and not exclusively heritage and environment. Existential therapy, therefore, has a philosophical basis and is based on existential philosophy, phenomenology and existential phenomenology. Existential therapy is grounded in the world of human experience and rests on a clear emphasis on freedom, choice and responsibility.

Systemic therapy: emphasizes relationships and the implicit agreements that occur between people. Consider psychological problems as something that is inherent in the whole system's interaction (for example, the way a particular family functions) rather than something that is related to the person who exhibits the symptoms. Originally developed in family and couples therapy, but can also be practised as individual therapy. See also narrative therapy.

Body-oriented psychotherapy: Therapy forms where the conversation is combined with attention to and work with the client's body. See, for example, sensory therapy. Body-oriented psychotherapy forms may have many different sources of inspiration, but the historically most important figure for establishing the tradition is Wilhelm Reich, who was originally a student of Freud (with whom Reich later broke). Body-oriented psychotherapy forms are less prevalent / recognized than the other main traditions, including due to historical/cultural reasons (psychotherapy has traditionally been the main focus of conversation ).

In addition to these main traditions, there are a number of more alternative approaches that are considered evidence based and are not recognized in established treatment systems on par with the traditions above. These include, for example, NLP ("neurolinguistic programming") as well as approaches that combine psychotherapy / psychology with spiritual practices and new age inspired philosophy.