Specialised Psychotherapy for individuals, families, couples, children, adolescents, and adults.
SYSTEMIC FAMILY & COUPLE THERAPY
Systemic family therapy is an approach to helping
people with psychological difficulties, which is
radically different from other therapies. It does not
see its work as being to cure mental illnesses that
reside within individuals, but to help people to
mobilise the strengths of their relationships so as
to make disturbing symptoms unnecessary or less
We live our lives through our relationships.
Research into what matters most to people
consistently finds that close relationships, especially
family relationships, rank higher than anything else.
Our sense of who we are is intimately associated
with our relationships – both to other people and the
contexts in which we live. When relationships do not
give us what we need, we lose our sense of comfort
and confidence about the person that we are.
When relationships go seriously wrong, powerful psychological processes come to operate. Often not in full awareness, and often with unwanted consequences.
Much psychological distress is a result of these processes. Conditions that get given labels such as depression, anxiety, and conduct disorder are very often effects of relationship problems. Conversely, when systemic family therapists see someone in psychological distress they look first for relationships that have gone awry.
How Systemic Family and Couple Therapy Works
Systemic family therapy has developed over some 50 years to the point at which we have a varied repertoire of highly effective methods that a family therapist can call on to meet the needs of clients and families. These include:
• An awareness of how family processes operate and an ability to make these apparent to the family.
• An ability to work with children in relation to their parents and vice-versa.
• Working with families to understand and productively use the influence of their family history and traditions.
• Through both conversation and action, helping family members to recognise options they have not been making use of.
• Collaborative exploration of strengths and resources of family members that they can bring to bear to support each other.
Systemic couples therapy
The London depression trial (Leff et al., 2000) used a manualised systemic couples therapy (Jones and Asen, 2000) for a randomised control trial. The systemic couples therapy was highly effective with average Beck Depression Inventory scores reduced from 25(high clinical level) to 11 (within the normal range) maintained over 2 years. So systemic couples therapy had higher compliance than CBT or medication. The authors conclude that “For this group couple therapy is much more acceptable than antidepressant drugs and is at least as efficacious, if not more so, both in the treatment and maintenance phases. It is no more expensive overall.” (Leff et al, 2000, p. 95)
André’s is not a Sexologist. However as
a Systemic Couple Psychotherapist Andre's Hub
explores sexuality and taboos
around sex. This is an educational and systemic
aproach to Andre's work. Sexuality
and the relational component of sex in a relationship
is not something new to André in his clinical work.
As a Couple Psychotherapist, André is interested in
Sexology as a study of what people do sexually and
how they feel about sexual expression in their
relationships. How people express
themselves sexually in a relationship is important to
explore in couple and individual therapy.
“I am interested in the social construction of peoples
beliefs around sex, sexuality, sexual
orientation and sexual expression. In therapy we
would discuss practical and relational ways of exploring sexuality as part of why people came for therapy.
I promote critical thinking around sexual stereotypes and expressions."
“I enjoy being open to learn and to explore sexuality with straight, gay, bi and trans people, individually and in couple therapy. I am also in writing this very aware that my position on sexual orientation is not within a category and that sexual orientation may very well be more fluent than what we want to admit to, maybe because of the social construction of what makes a man/woman, couple?
Women in my experience struggle with low desire for intimacy and little enjoyment of sex sometimes. Often, they find it hard to experience orgasm during sex or when self-pleasuring. I explore the relational dynamics to these problems in therapy. Sometimes women find sex painful and many times I have to work closely with clients GP’s to make sure the issue is not medical."
For men it’s rapid ejaculation at times. Men, in my experience say that they find it difficult to control their ejaculation and are not able to last as long as they would like to. This then is often coupled with finding it difficult to get or keep an erection. Psychological and relational reasons such as stress play a role. However, medical reasons such as diabetes or high blood pressure can also play a role.
Couples at times need to re-discover each other because they have become best friends and forgot how to be free with one another sexually. Systemic Psychotherapy is the focus of such interventions with couples. It may be that they have lost trust in each other because of infidelity. We talk about many strategies to rebuild the sexual relational connection and how to be adventurous sexually again.
Young men and women have their own issues with sex such as masturbation, premature ejaculation, wet dreams, sexual orientation, vibrators, safe sex, body image, penis size, breast sizes, muscle obsessions and things to be mindful of when having sex. I provide a reflexive and educational space to talk about this and promote critical thinking around sex.
I also explore pornography with individuals and couples and how couples can talk about this with each other. In the couple relationship I will aim to focus on addictions around pornography and how Infidelity through pornography could be explored and spoken about. Pornography and the risks around body issues and unrealistic expectations of self and other are usually hot topics in couple therapy.
Exploring different parts of ones sexuality and sexual orientation has also been topics of discussion and curiosity in my work, especially with men, who sometimes live within a very fixed idea about themselves.
I am also very much into fitness and I believe when one feels good about oneself; one expresses oneself as a whole person, body, mind and soul. Having a healthy lifestyle and diet improves ones confidence and I provide support with this as well.
Andre's therapy hub offers Gestalt
Therapy to children, young people and adults.
Gestalt Therapy is an existential and experiential
psychotherapy that focuses on the individual’s
experience in the present moment,
the therapist-client relationship, the environmental
and social contexts in which these dynamics take
place, and the self-regulating adjustments people
make as a result of the overall situation.
It emphasises personal responsibility.
In Gestalt therapy, the whole of a person’s
experience is considered important; thoughts,
feelings, body sensations. The approach focuses
on the ‘here and now’ – what is happening
moment by moment.
Staying with present experience allows you to become more aware of who you are. ‘Unfinished business’ from the past that causes fixed ways of being can emerge and be completed. Different aspects of the self come into awareness, allowing more fulfilling relationships and a freer way of functioning in the world.
A Gestalt therapist will often suggest creative ‘experiments’ to enhance awareness. You may choose to move, to draw, to say a phrase with more energy, mindfulness and meditation, yoga or whatever is appropriate in the moment. You may be helped to attend to all aspects of your dreams and discover what they mean to you.
The Gestalt therapist works in dialogue with you, sharing perceptions and feelings if it helps to further your awareness.
SYSTEMIC PSYCHOTHERAPY WITH CHILDREN & ADOLESCENTS
Studies show evidence based outcomes for the following issues:
problems in infancy;
sleep, feeding and attachment issues
child abuse and neglect;
conduct problems, including:
childhood behavioural difficulties,
attention and overactivity (ADHD),
delinquency and drug abuse;
emotional problems (including anxiety,
depression, grief, bipolar disorder and suicidal thoughts);
eating disorders (including anorexia,
bulimia and obesity);
somatic problems (including enuresis,
encopresis, recurrent abdominal pain, and
poorly controlled asthma and diabetes).
SYSTEMIC PSYCHOTHERAPY WITH ADULTS
Studies show that Systemic Psychotherapy is
efficacious for the treatment of:
substance use disorders,
mental and social factors related to medical
conditions and physical disorders and schizophrenia.
Systemic therapy may also be efficacious for
Carr (2009) also found good support for
Systemic Psychotherapy in the following range:
adjustment to chronic physical illness.
COUNSELLING & PSYCHOTHERAPY FOR CHILDREN & ADOLESCENTS THROUGH PLAY THERAPY
Gestalt Play Therapy
What is Play Therapy?
Play Therapy helps children understand
muddled feelings and upsetting events that they
haven’t had the chance to sort out properly.
Rather that having to explain what is troubling
them, as adult therapy usually expects, children
use play to communicate at their own level and at
their own pace, without feeling interrogated
Play Therapy is an effective therapy that helps
children modify their behaviours, clarify their
self-concept and build healthy relationships.
In Play Therapy, children enter into a dynamic
relationship with the therapist that enables them to express, explore, and make sense of their difficult and painful experiences. Play therapy helps children find healthier ways of communicating, to develop fulfilling relationships, to increase resiliency and facilitate emotional literacy.
Children use play as a form of communication. So often children referred to Play Therapy, lacks the vocabulary to describe their thoughts, feelings and perceptions of their internal and external world.
Since the 1920’s, play has been used in psychotherapy to help children express themselves.
When to refer a child for Play Therapy?
Difficult family lives, domestic violence, matrimonial discord, sexual, physical and emotional abuse can have a detrimental impact on a child’s development. Children also hold important information that can assist the court in making an informed decision about if a child should be placed back with his parent or if one of the parents does not have the capacity to meet the child’s needs. Andre helps the child to tell his/her story in a safe environment and become the voice of the child when the child feels overwhelmed by his/her family conflicts and supports the court in making a decision in the best interest of the child.
Children also need to make sense of their developing and changing worlds and Andre helps children through Play Therapy to integrate and assimilate their experiences and empower children to achieve a sense of self-mastering. Andre also helps children to reflect and develop healthy relationships with their parents and family members when the child has muddled and confused feelings following an acrimonious divorce of his/her parents.
Children can display all sorts of symptoms and Andre has years of experience working in CAMHS (NHS) helping children to overcome difficulties and to develop healthy strategies. Children may be anxious, have difficulties sleeping, refuse to go to school, bed-wetting, aggression, depression, or developing obsessive-compulsive disorders to try to manage their confusing worlds. Andre works in conjunction with parents/foster carers, local authorities and courts to help the child to develop healthy relationships.
Gestalt Play Therapy helps children in a variety of ways. Children receive emotional support and can learn to understand more about their own feelings and thoughts. Sometimes they may re-enact or play out traumatic or difficult life experiences in order to make sense of their past and cope better with their future. Children may also learn to manage relationships and conflicts in more appropriate ways.
The outcome of Gestalt Play Therapy may be general e.g. a reduction in anxiety and raised self-esteem, or more specific such as a change in behaviour and improved relationships with family and friends.
What will happen in the child’s Play Therapy?
The child’s Play Therapy will have a large selection of play materials from which the child may choose. These may include art and craft materials, dressing up props, sand and water, clay, small figures and animals, musical instruments, puppets and books. Andre will enable the child to use these resources to express him or herself and would gently lead the child to become dialogical.
What does a Gestalt Play Therapist do?
André holds a Clinical Masters Degree in Gestalt Play Therapy. Gestalt Play Therapists are mostly trainined within South Africa under the guidance of Dr Hannie Schoeman who had intensive training with Dr Violet Oaklander in Amerika. Gestalt Play Therapists are either Clinical Social Workers (South African Trained) or Clinical Psychologists and have received an extensive and clinical training in subjects such as child development, attachment, psychology and sociology as well as the legal procedures in helping children through the court process. They are also trained to use play, a child’s natural form of expression, as a means for understanding and communicating with children about feelings, thoughts and behaviour.
A Gestalt Play Therapist will begin by carefully listening to everyone’s concerns about the child and family. They will review their history and find out about the stresses the family have been through so that they can help the child make sense of it. The Gestalt Play Therapists may ask to seek information from school and other significant adults in their lives. An assessment is made of the child’s strengths as well as their difficulties. André follows an evidence based process of working with children and adolescnets by making use of the Schoeman model. This process take into account the following: (1) Building a relationship with a child/adolescent. This process is a delicate and sensitively crafted process that allows the child/adolescent to feel safe to start telling their story or playing out their unfinished issue. (2) Sensonry awareness. Gestalt Therapy heightens senses in order for emotional unfinished issues to become aware. André does this through many different approaches, such as creating focus on breathing, muscle tension, body movements, heightening of smell, touch, sight, hearing and intuition, mindfulness, fantasy trips and hypnotic states and deepening states through hypnotic deepening strategies. (3) Helping the child/adolescent to make a projection through play or if the child/adolescent or adult for that matter does not want to play, the principles of Gestalt Psychology is used to help heighten awareness of the here and now and to become dialogical with the unfinished issues that present in the room. (4) This leads to negotian and finding an alternative narrative, story or outcome. This process goes hand in hand with the use of Systemic and behavioural techniques within a Gestalt Framework. (5) This leads to a process of self-nurturing, which in the Gestalt Psychology language means the connection with feelings that have just come to the emotional foreground. Self-nurturing paradoxically means that we own up to those parts we have denied for so long, those parts of who we are that we tried to push away or hide from the world. A Gestalt Play Therapy sesison always end with suggestions of how to be kind to oneself untill Andre sees the child again.
What is Play Therapy?
Play therapy is a mode of therapy that helps children
to explore their feelings, express themselves and
make sense of their life experiences.
Play is a child’s natural medium to learn,
communicate and explore their world. Recovery
from difficult life experiences can be facilitated by
a Play Therapist, allowing a child freedom of
expression in a safe and trusting environment.
Conventional talking therapies may be inappropriate
for children and young people who struggle to put
their feelings into words. Play Therapy provides
children with the opportunity to explore and
understand these feelings.
Who can benefit from Play Therapy?
Play Therapy is an effective intervention for children with a variety of presenting problems, including:
• Children or young people who have been abused, or witnessed abusive relationships
• Those who have experienced loss through bereavement, family breakdown or separation from culture of origin
• Children who are ill, disabled or who support Carers or siblings with disabilities
• Those who have witnessed violence or substance misuse
Play Therapy can offer children a space in which their feelings generated by their experiences can be expressed and contained. It cannot change what has happened but it can promote resilience within each child to enable him or her to discover a more hopeful view of the world.
Gestalt Play Therapy is appropriate for children and adults. However, Play Therapy is most often used for children aged between three and twelve years.
1. Specialised Family, Adult and Child
The analysis of the individual and the family unit
as part of a function or the individual that stands
in isolation. The socio-ecological perspective,
Systemic and Gestalt Approaches are
used to analyse and assess the impact of
domestic violence, violence
against children, sexual crimes, dysfunctional
family dynamics and behaviour patterns. Social
phenomenon’s that are problematic can be
analysed with the indicated models to give a
relational understanding into the matters at hand
to enable the necessary recommendations.
2. Divorce related matters
Specialised assessments in divorce-related matters;
Pre-and-post divorce guidance;
Statutory investigations evaluating the best interest standard of children set out in accordance with the Children Act;
Evaluation of parental rights and responsibilities and children’s contact schedules;
Mediating with divorcing couples;
Certain recurring themes emerge clearly from the literature on divorce. The main point is that reducing the level of conflict between the two parents is most strongly associated with the eventual adjustment of the children of all families, including the families of divorce. Mediation of conflicts and civil interaction between parents must be encouraged. Understanding children’s reactions to the separation of their family and understanding what role the stage of child development plays in the reactions of children can help decrease the turmoil experienced by these families. Some children who are products of divorce are emotionally strained and their lives are seriously damaged by their parents’ separation and pre and post-divorce conflict. Other children of divorce develop into normal, healthy adults who go on to reach the levels of success and mental well being that every parent wishes for their children. Divorce can scar, but it does not have to.
Statutory assessments pertaining to sexual abuse related matters.
Child sexual abuse has been at the centre of unprecedented public attention during the last decade. This crime encompasses different types of sexual activity, including voyeurism, sexual dialogue, fondling, touching of the genitals, vaginal, anal, or oral rape and forcing children to participate in pornography or prostitution. Perpetrators of child sexual abuse come from different age groups, genders, races and socio- economic backgrounds. Women sexually abuse children, although not as frequently as men, and juvenile perpetrators comprise as many as one-third of the offenders (Finkelhor, 1994). One common denominator is that victims frequently know and trust their abusers. Child abusers coerce children by offering attention or gifts, manipulating or threatening their victims, using aggression or employing a combination of these tactics.
Specialised assessments of children
Andre has many years experience working in the Child and Adolescent Mental Health Services (NHS) in the UK. Assessments focused on the functioning of the child on an emotional and psychological level. The exploration and assessment of family functioning, the child’s developmental position and how the child interacts on a socio-emotional level with regard to school/home. Evaluating scaling’s on the child’s interpersonal feelings and position with regards to the self/family members/school individuals.
Securing the wellbeing of children by protecting them from all forms of harm and ensuring their developmental needs are responded to appropriately, are the primary aims within an assessment. Andre has developed a framework with the help of the Schoeman model, which provides a systematic way of analysing, understanding and recording what is happening to children and young people within their families and the wider context of the community in which they live. Andre is a qualified Play Therapist and obtained a Master’s Degree in Play Therapy at the University of South Africa Through Dr Hannie Schoeman and in accordance with Dr Violet Oaklander from the USA. This makes him a specialist in the field of Play Therapy, especially from the understanding of the Gestalt Phenomenological Approach.
Child Protection Issues
Children whom Display Sexually Harmful
or Concerning Behaviours
Sexual Identity and Gender issueas
Direct Work with Children, Young People
Andre can offer consultancy and clinical
supervision to a wide range of professionals
including Residential and Field Work Social
Workers, Foster Carers, Health Professionals