General Information for Clients

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1. Assessment and Psychotherapy

The nature of your difficulties will determine what form of psychotherapy would be most appropriate. A thorough assessment is therefore needed to determine the nature of the problems and the best way to address them.

Assessment and Evaluation: The first two sessions focus on an assessment of your problems and concerns, for which I will need detailed background information. I may ask you to complete a time line and some sets of questionnaires. After that I will share with you my formulation of the problems. We will then agree on goals you may want to work towards.

Assessments may include assessment of Depression, Anxiety, Bi-Polar disorder, ADHD, ADD, Dissociation, Psychosis, Family functioning, etc. as it seems appropriate.

2. Individual And Couples Psychotherapy

I offer all of the above therapies which are based on my training and experience  in Narrative Therapy, Schema Therapy, Cognitive Behaviour Therapy and Systemic Therapy, Family therapy. All these approaches are integrative in that they draw from a variety of interventions which can be tailored to address specific problems of each individual. If you would like to know more, please visit the Therapeutic Models section on my website: www.lenemalan.co.za. I will discuss with you my formulation of your problem/s and what research indicates as the most appropriate treatment method.

Psychotherapy:The number of sessions you may need will depend on whether you want to resolve some specific issue or if you want to address broader and more long standing issues in your life. Specific problems may be resolved in about 6 sessions; some problems call for 10 to 25 sessions. In this case you will have to do some reading and actively monitor and change thinking and behaviour patterns.

In less structured therapy sessions may be more open ended and exploratory, depending on your needs. Your progress will be evaluated at regular intervals and you are encouraged to express any concerns you may have about your progress.

 Review, maintenance and follow-up: Regardless of how many sessions you have had, the final session/s will be structured to provide a review and maintenance plan. You may want to come for some booster sessions after a few weeks or months to discuss any difficulties to maintain your progress.

Often clients find that changes occurring in their feelings or behaviour could have an impact on relationships with family or friends. If this happens to you, please bring this to your session to enable us to decide how best to deal with the situation.

You are at any time welcome to ask me questions about the therapeutic approach I’m using, questions I’m asking or any other concerns you may have.

Online Psychotherapeutic Services

I have been providing online services over several years to clients locally and Internationally. For some this may be an unusual way of establishing a therapeutic relationship. However, longstanding clients have given continuously positive feedback about the advantages and benefits they have experienced using this modality to engage in a process of personal growth.

During this current phase of the Corona virus Pandemic and the restrictions it imposes on all of us, and keeping everybody’s health and well-being in mind, it also allows clients to continue with therapy, with the option to revert back to one-on-one therapy at a later stage, when the pandemic has been contained.

1. For general information about my services, therapeutic approaches and practice, please visit www.lenemalan.co.za.

2. Online options.
I use Zoom for online sessions, as the audio and visual quality is the best option in my opinion. I also believe the confidentiality aspect with Zoom is more satisfactory than other options.
However, if clients prefer to use Skype, it is also an option.
WhatsApp calls or video could be used under certain circumstances. It is particularly good for quick communications, such as setting up or changing appointments. However, WhatsApp video and sound quality are often not satisfactory.

System requirements
The quality of sessions depends on the quality of access to Internet. The best connection is offered by a speed of 10mbpm, but 4 mbpm may also be acceptable. At lower speed, the quality of the picture and sound could fluctuate and interfere with the quality of the session.

3. Setting up meetings.
Dates and time for meetings are arranged beforehand by e mail. Before the session I send clients an invitation to the meeting by URL link by e-mail. Just click on the link, which will take you to the meeting. To further ensure good sound, you may need a headset with a mic.
You could also connect by using a local number, in which case there will not be a picture available, only sound.

4. Meeting room requirements.
Confidentiality during the session and no unexpected interruptions is essential. A quiet room with good lighting will enhance the quality of the session. A calm and quiet environment is also essential. You are welcome to enjoy a cup of tea or coffee during out meeting. Please prepare this before our meeting to save time for our discussion.

5. Confidentiality.
Every effort is being made from my side to ensure confidentiality during sessions and with regards to correspondence. Clients however will be aware that 100% confidentiality cannot be guaranteed and must accept that from the client’s side arrangements for sessions and e-mail communication should be made to ensure confidentiality as best as is possible.

6. I am often asked if the expenses could be claimed from Medical Aid Funds. Whilst I claim from Medical Aids Funds for clients in South Africa, I do not provide this service for clients who are member of Medical Aid Funds/Insurance out – with South Africa. The client is responsible to find out what the requirements would be to claim from his/her medical aid fund and to submit claims.
In my experience, some funds may require a recommendation or diagnosis from a psychiatrist. A Psychological report may also be requested, which could be provided at a fixed fee.

7. Please also note the following requirements with regards to provision of clinical/psychotherapeutic services:

7.1 Client support:
Availability of an appointed person in case of emergency:
Contact details of an appointed person need to be available to provide client support, within the client’s workplace, or a friend or family member, in case of an emergency or should the client need extra support in between session.

7.2 Medical support.
Access to a medical doctor should be available should medical intervention be required, or medication be recommended to a client.

7.3 Serious mental health/psychiatric problems.
Lastly, it would not be appropriate to work online with a client who has serious mental health problems, such as suicide risk or psychosis. Those clients would be advised to seek Psychiatric intervention in the first instance and one-on-one therapeutic opportunity.

8. Registration requirements.
Please take note that I am registered as a practicing Clinical Psychologist in South Africa.

I hope this document would answer your questions regarding Online sessions, but please feel free to contact me if you need more information.

3. Fees, Accounts And Length Of Sessions

My fees are in line with the Department of Health’s Reference Price list (RPL) for Psychology and Medical Schemes. For member of Medical Aid Funds, invoices are sent directly to your Medical Aid. Payment of your account is however ultimately your responsibility.

For private clients, a slightly reduced fee is offered and agreed upon before commencement of therapy

Sessions are normally 60 minutes. In the case of crisis management I will discuss with you beforehand if longer sessions are indicated. At times it might be appropriate to have shorter sessions of 30 or 45 minutes. In these cases I charge a fee based on the hourly rate

Missed sessions will be charged unless cancelled with 24 hour notice.

Your sessions will normally be 60 minutes. If you arrive late your session will end at the end of the hour you were booked for.

Telephone contact up to 15 minutes at no charge and normal fee prorate from 20 minutes or more.
Face to face sessions are offered at 4 Herold street, Stellenbosch. Online sessions are with Zoom. Please se separate section with information regarding Online sessions

Medical aid fund clients’ accounts are sent weekly to medical aid funds by PRAC-Admin Medical Bureau Services (Pty) Ltd which manages my practice administration.

Private clients pay on the day of your session by EFT or by prior agreed arrangement.

If you have difficulty with payments, please discuss this with me. I may offer sessions at a reduced cost or spread the payments over a longer period on a no interest basis.

4. Your Right To Privacy And Confidentiality

The rights of clients are summarised in the National Patient’s Rights Charter which can be down loaded from http://hpcsa.co.za/conduct generic ethical rules.php.– select booklet 3. The following are aspects relating to your rights as a client seeking psychological assessment and/or psychotherapy.

Disclosing personal information: As part of the assessment and psychotherapy process I will ask you to disclose personal information of the kind which you may normally keep to yourself. The effectiveness of the process depends on you making these personal disclosures. However, note that you have the right to the privacy of all information of yourself and you are free to not disclose any information you don’t want to disclose. If this poses a problem for psychotherapy I will discuss this with you. Also, if you question the relevancy of any questions express this so that I can explain why I’m asking the questions

E-mail communications:  e-mail is a useful way of communicating and is usually used for making appointments, sending accounts and sending and receiving documents which are part of the therapy process. However, it is not fully secure and may be intercepted by third parties. Although most people are comfortable with using emails, you should please express your concerns about your personal information by using e mails so that we can explore alternative methods of sharing documents such as Dropbox or iCloud.  Please indicate on the agreement form the method of communication you prefer before we start your sessions.

Please refer to section regarding Internet/online sessions

Legal limits of confidentiality: the content of discussions during assessment and psychotherapy is confidential and will not be discussed with any other person without your consent. The following are exceptions:

  1. The court may issue an order that compels a psychologist to reveal information disclosed in therapy and in some cases, in terms of Acts of Parliament, a psychologist may have an statutory duty to disclose confidential information.
  2. Where a psychologist believe that a client is at risk for seriously harming him/herself or any other person they are ethically bound to act to prevent this or to protect third parties
  3. Medical aids require a diagnosis to be recorded on the account t in the form of a numerical code from the International Classification of diseases. (ICD10). The verbal form of the diagnoses e.g. Major Depression does not appear which means that anyone with access to your account could read this and know what your diagnosis is.
  4. I may share some of your information during supervision with my supervisor. Supervision ensures that a psychologist maintain professional standards and maintain a balanced perspective. I will not discuss any information with a colleague who knows you personally.
  5. I may present a paper at a conference and use examples from my practice. No identification information is included to protect the confidentiality of clients.

All these principles also apply to minors (children and n adolescents).When treating a minor, I will regularly inform parents or guardians about his/her therapeutic progress. I will however not disclose content of sessions without the consent of the minor. Exceptions may occur where sections 2.1, 2.2 and 2.3 apply. Please discuss with me concerns you may have in this regard.

Please do not hesitate at any stage to discuss any questions or concerns you may have.

Contact Lené

Contact Lené to schedule a session, for information, or to ask a question.

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