• nikkialister

A guide to Counselling in SA

I am the proud mom of two beautiful daughters; my eldest will be 20 at the end of May! When she was a baby I remember the “in thing” was to take one’s baby to the Paediatrician for every cough and sniffle. I remember receiving a letter in the post (yes that’s how long ago it was) from our Paediatrician at the time asking parents to please reserve appointments for serious matters or on the advice or referral from a GP or nursing sister.

I wanted to take some time in this post to introduce a whole community to you, which you may not be aware of. I am honoured to be a part of this community, which I have found to be passionate, caring and so incredibly helpful. I also wanted to take time to map out the mental health landscape in South Africa, so that you can see where each people helping speciality fits into our communities. I am hoping that with increasing understanding that people will have a better idea of where to go for the help that they need.

I am writing this post about the private health care sector of South Africa. I am taking time to learn more about how people can access state help but unfortunately the need far outstrips the available resources. I hope sometime in the near future to write a post about ways to access state help.

By way of illustration, I will use the example of a sick child. When it comes to mental health concerns, loss or grief, relationships challenges or parenting struggles, it seems as if most people are only aware of psychologists as sources of help. This is similar to parents of the early 2000s taking their children to a Paediatrician for day to day health concerns. There is a whole network of GP’s and nursing sisters qualified and experienced to help in many ways, who are also trained to know when to refer something they are not able to help with.

The same example can be used to understand counselling in South Africa. There are different types of professionals available to help. Each has what we call a “scope of practice” to guide them. This outlines the areas in which the practitioner is able to help according to their education, training and experience. Should a client require interventions outside of this scope of practice, the professional is required to refer them to another more suitable professional.

In South African there are various avenues to access mental health support. Most people are aware of practitioners registered with HPCSA (Health Practitioners Council of South Africa). These include Psychiatrists, Psychologists and HPCSA Registered Counsellors.

1. A Psychiatrist is a medical doctor who specialises in the diagnosis and treatment of mental illness. Their focus is often on the use of medication as treatment. 2. A Psychologist is also a professional trained to diagnose and treat mental illness, however, treatment is centred on different types of therapeutic interventions. Examples are psychotherapy, cognitive behavioural therapy, client-centred therapy, narrative therapy etc. 3. A Registered Counsellor is able to screen clients for mental illness and also offer therapeutic interventions but with a more limited scope of practice to a psychologist. HPCSA registered professionals generally offer high-quality mental health support but unfortunately due to strict entry requirements their numbers are incredibly low and large amounts are in private practice, inaccessible to the majority of the population. Even those who are able to pay for their services are required to wait for long periods of time for an appointment. Other lesser-known avenues of support include telephone counselling through organisations such as Lifeline and SADAG, support groups such as Alcoholics Anonymous, Grief Share, Pastoral counselling offered through various churches and also counsellors affiliated with counselling organisations such as ASCHP (Association for Supportive Counsellors and Holistic Practitioners) for example.

My counselling community is affiliated with ASCHP, who is a professional body recognised by SAQA (South African Qualifications Authority). They provide screening of qualifications and experience for entry, professional guidelines, a scope of practice as well as ethical accountability to their members. Depending on the level of registration the counsellor will have recognised qualifications, usually a psychology degree and relevant experience. For more detailed information visit

I believe that ASCHP counsellors provide a useful and cost-effective service to those who require counselling support. The passionate community of ASCHP counsellors that I am proud to be a part of will endeavour to help you or your loved ones to the best of our abilities within our scope of practice and should the time come, we will lovingly refer you to someone better equipped to help you.

There is a tremendous need in South Africa for counselling support, with an array of competent professionals willing and able to help according to the need. I hope that this post has been helpful in helping you to understand where your need may fit into the counselling landscape of South Africa.

I am a counsellor working in private practice based on the East Rand of Johannesburg and also on-line. Please contact me for more information or to make an appointment. A directory of counsellors from across SA can be found at

Thanks for reading, please feel free to contact me with any comments or questions. I would love to hear from you.



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