Practice no. 8618321 HPCSA no. PS 0030341

Tel: 012 460 4465 | Emergency: 082 824 2436

Tel: 012 460 4465
Emergency: 082 824 2436

Therapeutic Approaches


“Between a stimulus and response there is a space.  In that space is our power to choose our response.  In our response lies our growth and our freedom.” – Victor E Frankl

Cognitive Behavioural Therapy (CBT) is a psychotherapy model that focuses on the relationship between thoughts, emotions, and behaviours. Emotional and behavioural disturbance is largely determined by the way in which individuals think about their challenges, themselves as well as others.

Treatment is often based on a specific protocol, with brief, direct, and time-limited sessions aimed at addressing specific problems and to help clients develop new ways of thinking and behaving that can improve their mental health and overall quality of life.

Cognitive-behavioural therapy (CBT) is a type of psychotherapy that has been shown to be effective in treating a wide range of mental health conditions including mood disorders, anxiety disorders, attention deficit disorder, interpersonal problems, eating disorders, addiction problems, insomnia, impulse control disorders and behavioural problems.

There are several principles that guide the practice of CBT:

  1. Collaborative and active: CBT is a collaborative and active therapy that involves the therapist and the client working together to identify and challenge negative and/or unrealistic thoughts and beliefs.
  2. Time-limited and goal-oriented: CBT is typically a short-term therapy that focuses on specific goals and objectives that are established at the beginning of treatment.
  3. Evidence-based: CBT is an evidence-based therapy that is grounded in scientific research and has been shown to be effective in numerous studies.
  4. Psychoeducation: CBT includes psychoeducation, which involves educating the client about their condition and teaching coping skills and strategies to manage their symptoms.
  5. Cognitive restructuring: CBT involves identifying and challenging negative or unrealistic thoughts and beliefs and replacing them with more realistic, achievable and helpful ones.
  6. Exposure and behavioral activation: CBT often involves exposure therapy, which involves gradually exposing the client to situations that they fear or avoid, as well as behavioral activation, which involves encouraging the client to engage in activities that they have been avoiding.


“…grant me the courage to change the things that I can change and the serenity to accept the things I cannot change and the wisdom to know the difference” – Friederich Nietzsche

Dialectical Behaviour Therapy (DBT) is a broad based cognitive behavioural treatment with the focus on skills training to help regulating emotions and behaviour.  DBT is based on the principle of dialectics, which emphasizes the importance of balancing opposing viewpoints and finding the truth in both. This involves accepting the client’s thoughts and feelings, while also working to change problematic behaviours.

Emotion dysregulation has been linked to a variety of mental health problems stemming from patterns of instability in emotion regulation, impulse control, interpersonal relationships and self-image. DBT is found to be helpful in treating a range of mental health problems, including mood disorders, anxiety disorders, eating disorders, impulse disorders, personality disorders and substance use disorders.

Principles of acceptance and change skills training practice in DBT:

  1. Acceptance Skills
    • Mindfulness skills: Help focus attention on the present moment, noticing both what is going on within and what is going on outside and experience reality as it is, to be less judgmental, and to live in the moment with effectiveness.
    • Distress Tolerance skills: Help developing strategies to cope with distressing situations, without resorting to harmful behaviours. This involves learning to tolerate distress and developing strategies to manage intense emotions without becoming overwhelmed.
      1. Change Skills
        • Emotional regulation Skills: focuses on helping clients regulate their emotions, which is often a core issue in many mental health disorders. This involves developing skills to identify and manage intense emotions, such as anger or anxiety.
        • Interpersonal Effectiveness Skills: teaches clients skills to improve their communication and relationships with others. This includes learning how to assert their needs, set boundaries, and effectively manage conflicts.


“You cannot stop the waves, but you can learn to surf it” – Jon Kabat-Zim

 “Without continual growth and progress, such words as improvement, achievement and success have no meaning” – Benjamin Franklin

Solution-Focused Therapy (SFT) is a brief and goal-oriented therapy that helps clients identify and achieve their own goals. This approach focuses on solutions rather than problems and encourages clients to imagine a future where they have achieved their desired outcome. SFT is based on the belief that clients have the skills and resources to create positive change in their lives, and the therapist’s role is to help clients identify and refine those skills.

The principles of SFT include:

  • If it’s not broken, don’t fix it: the therapist will not try to solve a problem that the client does not see as a problem or that has already been solved.
  • If it works, do more of it: the therapist will identify the client’s existing strengths and resources and build on them to achieve their goals.
  • If it’s not working, do something different: the therapist will explore new options and strategies with the client if their current approach is not effective.
  • Small steps can lead to big differences: even small interventions can have a significant impact on achieving a desired outcome.
  • Solution language is different from problem language: focusing on solutions rather than problems can create hope and energy for change.
  • Change is inevitable, problems do not happen all the time: by studying times when problems are less severe or absent, clients can uncover their unconscious wisdom and skills and build true confidence.
  • A solution is not necessarily related to the problem: the therapist and client may explore solutions that are unrelated to the presenting problem but still help the client achieve their desired outcome.

Overall, SFT empowers clients to take control of their lives and work towards their own goals in a positive and collaborative way.


Brain Working Recursive Therapy (BWRT) is a relatively new form of therapy that operates from the priciple that our physical brains respond to events and make decisions even before we are physically aware of them.  The brain however, is adaptable and capable of learning in a fast and efficient way to rapidly resolve psychological and emoional difficulties by changing the thought patterns and responses to triggers.  The technique is based on the idea that the brain is constantly creating new neural pathways.  The priciple is that we learn something new by practicing it over and over again until it becomes second nature to us.  BWRT uses the same idea of learning a new way of reacting and behaving via repetition, rehearsal and reflection of successed.  In doing so the brain provides a new neural pathway network.  It is about changing an undesired behavious in favour of a better behaviour.  BWRT also uses a specific protocol to access the client’s own powerful imagination and thought processes to treat a wide range of psychological and emotional difficulties including anxiety disorders, trauma, mood disorders and phobias.

There are several principles that guide the parctice of BWRT:

  1.  Brain-based: BWRT is based on the latest findings from neuroscience and psychology, and is designed to work with the way the brain processes information.
  2. Visualization: BWRT uses the client’s own powerful imagination and thought processes for self-reflection and awareness.
  3. Solution-focused: BWRT is a solution-focused therapy that is aimed at helping the client to achieve their goals as quickly and efficiently as possible.
  4. Non-invasive: BWRT does not require the client to reveal deeply personal or traumatic information, and is therefore less invasive than some other forms of therapy.
  5. Multi-level: BWRT works at multiple levels of the brain and mind simultaneously, which can lead to rapid and long-lasting change.
  6. Outcom-based: BWRT is focused on achieving specific outcomes, and the therapist will work with the client to ensure that these outcomes are achieved.


“You use hypnosis not as a cure but as a means of establishing a favorable climate in which to learn” –  Milton H. Erickson

Humans are intrinsically creatures of habit, and we tend to respond emotionally in somewhat the same manner to similar sets of circumstances. It is useful to remember that almost everything we do is habit, and this is required for everyday functioning. When we are confronted with a new situation, we are able to form a new habit. Similarly, it is very difficult to change habits because, because our brains have already made decisions to handle the challenges in a certain manner.

The human mind is fearful of exploring past memories when an uncomfortable feeling exists. Hypnosis allows us to rapidly uncover these uncomfortable feelings to discard them, thereby allowing positive feelings to erupt. Unpleasant responses may continually occur if an emotional trigger is accidentally pulled, so it’s important to use a natural, heightened state of concentration to understand the information stored in our minds.

Dr Karen van Niekerk uses hypnotherapy to make post-hypnotic suggestions that are used to help patients change old, unwanted habits and establish new, positive ones.

In Dr Karen van Niekerk’s practice, students are in a safe environment where they can learn how to distinguish between self-defeating fixed mindsets and how they can acquire skills to develop growth mindsets to enable a richer learning experience.