Thomas Geffen


I am a registered Counselling Psychologist with a special interest in online therapy. I have a Master's of Arts degree (cum laude) in Counselling Psychology from Wits University and have experience providing online therapy across platforms like Zoom. During the current lockdown, and with concerns around the coronavirus and COVID-19, talking to a psychologist online can provide a safe, effective way to connect. In general, online psychotherapy is useful if a person is unable to travel, stays far away, is home-bound or travels for business. It can be used in conjunction with face-to-face therapy, or as an exclusive alternative. Online counselling is easily conducted after hours or on weekends.

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Online Therapy 

Online therapy is a flexible, convenient and safe method of connecting across distance. It functions similarly to face-to-face therapy, but from the comfort of your home - or wherever the wifi is best. Security is key, so I use ensure using platform where there is a high level of privacy (e.g. encryption and passwords). However, online counselling comes with its own concerns, so I have created a list of frequently asked questions to guide your decision or read my blog  post - Online Therapy 101.


Frequently Asked Questions (FAQs)


How much does therapy cost?

Sessions are between 50-60 minutes, and cost R920 per session. This rate is within most medical aid rates.

How long does therapy take?

That depends - therapy is not a fixed process. Therapy may last anywhere from a few weeks to a few years. Given my experience and way of working, I find that long-lasting change is created over the long-term. Therapy requires the formation of a working relationship, and it will take some time to be able to create a space where we can explore the challenges you are facing. Ideally, therapy would end when both you and I feel that we have adequately worked towards growth, and have reached a sense of completion. However, therapy may end prematurely due to external factors, where one party decides to end therapy. In this case, it is important to have as much time as possible to prepare for the ending, and to give a notice peiod to work through the impact, and for me to make an appropriate referral and consider the best plan going forward.

How does therapy begin?

Therapy begins with a general exploratory period, to consider what has brought you to therapy and to consider how I may best assist you. This is a flexible process, and may take a few sessions. There are also different processes for children and couples in the FAQs below. Contact me now and we can begin this process.

Will my medical aid cover therapy?

I work on a cash practice basis. This means that you will pay upfront and claim back from your medical aid. This may either come from a specific benefit or from your savings. My rates are covered by most medical aids, but this will depend on your cover and plan. If you are concerned it is best to enquire with them first.

What is therapy?

Therapy is a space to form a relationship and explore your world, memories, experiences, emotions and thoughts. It is a conversation that seeks to provide growth, healing, change and new insight. It is a process, something understood when experience, but complex to describe.

What are Prescribed Minimum Benefits (PMBs)?

Prescribed Minimum Benefits (PMB) are the benefits that every medical aid (regardless of your plan) is liable to cover, and extends to specific conditions. For therapy, these include some depressive, bipolar and psychotic disorders. Generally, medical aids will cover 15 therapy sessions for such a condition. After having a few initial sessions, we may discuss a PMB application. If this is authorized it may then be backdated to cover these initial sessions.

Online Therapy

What happens if we get disconnected?

A good wifi connection is ideal, but if the connection is lost, we will attempt to reconnect. If we are not able to after 5 minutes, then you will have the option to continue on the phone or we can attempt to reschedule if possible. I will only charge for the time that we use.

Which online platform do you use?

Zoom is the platform of choice for several reasons: - Secure, password-protected, excrypted meetings - Stable and high quality audio and video transmission - Easy of access on mobile and desktop devices I also address this in my blog and you can visit for more info.

If we have online therapy, can we meet in person?

It is important to discuss expectations of this at the outset. Online therapy can occur in conjunction with face-to-face therapy. For example, if you are travelling or unable to attend sessions, we may meet online temporarily and then continue face-to-face. What is important is that we agreed on the best way to meet in order to maintain a consistent space for therapy.

What if people in my house hear us?

Having a quiet and private space is essential. Try the following tips, or we can also discuss your concerns: - Find a quiet space. It may be neccessary to even sit in the garden/outside or inside a car in a garage - as long as the wifi reaches. - Choose a time when people are unlikely to be around - Use headphones, which will prevent anything. say being heard. The headphones should ideally have a mic which will mean you will not need to speak loudly - Background noise (e.g. white noise) can also create a sense of privacy

What do I need for online therapy?

Although online therapy is similar to meeting face-to-face, there are some requirements: - A good internet connection. - A capable device with Zoom loaded. A laptop or tablet is best as a phone screen means the video will be very small. It is important to rest your device somewhere (e.g. a desk/table) so the picture is stable. - A private space where you can sit, free of distractions. You should be comfortable, so may like water or tissues with you.

Is online therapy safe?

Zoom provides a high level of security, but no online connection is perfectly secure. Videocall psychotherapy does pose particular risks to confidentiality, and it is the role of both myself and you to ensure that relevant measures are put in place, such as password protection, encryption, anti-virus, headphone usage and restricted access to devices as necessary. Videocalls are not to be recorded for any reason by either party. I address this question further in my blog, or you can also find out more about Zoom's security at

How do I begin online therapy?

Thank you for your interest - the first step is to contact me here, and then we set up a meeting, and see how I may best be able to assist you. A good 'fit' is important in therapy, so we may take a few sessions to consider if online therapy is a good option and if we are able to work well together to help you.

Is online therapy for me?

That depends. Generally, it is a suitable alternative for many people. However, it is not an appropriate medium if you are severely depressed, have a severe substance dependence, or you are experiencing intense suicidal or homicidal thoughts. Seeing a mental health professional face-to-face is recommended in these situations. If you are unsure, it is best to contact me, and we can see if it will be suitable for you.

What happens if there is an emergency?

It can be difficult to deal with crisis situations when using online therapy as we are often in separate locations. I will therefore ask you to provide the contact details of a local family member or friend who I can contact in the case of an emergency. If you are in crisis and there is a disruption while we are engaging in online therapy, then you should immediately phone me, or if I cannot be contacted call emergency services if required.

Play Therapy

Who do you meet with?

It is vital to meet with the primary caregivers and child separately during the initial intake process. Sometimes, it can be helpful to engage with the school, which may include observing the child at school or being in contact with teachers.

How do I explain play therapy to my child?

The first step is for me to meet with you, and we will be able to discuss your concerns then. The following guideliness may also be useful: - Say as little as possible. The introduction will happen primarily in the room with me. Try not to give them too much information or cause for concern before hand. - Explain to them that they will be meeting with someone who will be helping them and will spend some time playing them. - If they are anxious that they are in trouble, emphasise that this is to help them - If they have questions about what the place looks like, it may help to give them some information about where it is

How do I know if my child needs play therapy?

The best ways is for us to meet, and then we will discuss what is concerning you. I will also be able to provide you with some information about play therapy (or you can read more here). Then, we will decide whether play therapy will help.

What is play therapy?

Play is the natural language of children, and play therapy uses it as a tool for children to express their emotions. The aim of this therapy is to help children make sense of difficult situations and feelings by exploring hidden thoughts and desires. Find out more here.

Is my child too old or too young for play therapy?

I see children of all ages. However, play therapy is especially suited for 5 to 10 year-olds. For children that are younger, I provide a different approach, often this may be parent-infant psychotherapy. Once children begin to enter adolescents, or are teenagers, therapy also take on a diffrent form.


How does couple therapy begin?

I usually begin with a few sessions to get to understand the couple and what problems are occuring. Usually, I will meet with both partners in the first session, and may suggest individual meetings as well. Following this, we will look at how therapy may work and what the best way forward will be.Contact me now and we can begin this process.

Who is couple therapy for?

There are many reasons couples seek counselling. This includes, but is not limited to: pre-marital counselling, separation counselling, and general relationship problems such as communication, infidelity, arguments or conflict.

What if my partner does not want to come?

This is a common challenge that can be faced. Most importantly, begin by discussing couples counselling with your partner, listening to their concerns and sharing your own feelings. It may also help to suggest that they talk to me about their concerns, and that they may give it a try before deciding whether it will help. Ultimately, it will remain their decision and forcing them into coming often does more harm than good. If they are not willing, perhaps individual therapy may be an option for you.

What is couples therapy?

Couples therapy is called by many different names, such as marriage counseling or relationship therapy. My aim is to facilate discussions between the couple, which allows them to work on their communication. In particular, much can be communicated unknowingly or the partner may recieve a different message than intended. Working on these patterns of relating is a key area that may help grow your relationship.


Read my latest article How to Be More Playful, published in Bona Magazine.

Find out more about psychology, the mind, therapy and you. Visit my blog - more posts coming soon...


In my career, I have had the privilege of working with several organisations, including:

Conselling Symbol

You can also find me on the following websites: