Skye Warrener

Ask for two things: verifiable credentials and a clinical governance plan. Verifiable credentials mean a SAQA‑recognised qualification and current registration with the appropriate South African professional body (for example HPCSA or SACSSP where relevant), plus evidence of ongoing CPD and a criminal background check. Clinical governance means regular documented supervision with a registered clinician, written treatment plans, outcome measures and clearly stated scope of practice. A counsellor who opens with their recovery story but can’t show registration, supervision or measurable goals is offering lived experience without clinical accountability — that’s useful for rapport, dangerous if it replaces evidence‑based care.

Personal recovery can speed trust, make relapse conversations realistic, and give families a translator for behaviours that look inexplicable. But it becomes a liability when the counsellor treats their own method as the only method, overshares, or crosses boundaries by becoming a peer instead of a clinician. Clinically competent counsellors use their experience to inform empathy and practical tips while still applying structured interventions (motivational interviewing, relapse prevention planning, screening for co‑occurring disorders) and referring when needed. If a counsellor keeps prescribing "what worked for me" instead of offering a tailored, evidence‑based plan with measurable goals, ask for another clinician.

An accredited counsellor with lived experience will perform immediate risk and intoxication assessments, put a safety plan in place, mobilise family supports, and coordinate with medical services — calling an ambulance or facilitating admission to a medical detox or psychiatric unit when necessary. What they cannot do is provide medical detox, prescribe medication, or detain someone against their will; those actions require doctors and hospital services. Good counsellors will have established referral pathways to Johannesburg public and private acute services, know which facilities accept medical‑aid or self‑funded admissions, and will actively liaise with doctors to ensure continuity of care rather than leaving families to scramble.

Use the counsellor’s lived experience as a bridge to accountability, not an excuse for avoidance. A competent counsellor will offer family‑focused interventions: psychoeducation about addiction and mental illness, structured family sessions with clear roles and limits, relapse contingency plans and coaching on boundary setting. They will call out enabling patterns, help draft practical steps (who pays for housing, how to handle intoxicated behaviour, when to withdraw contact) and document agreements. If a counsellor sympathises but refuses to help families set and enforce boundaries, or pressures the family to accept a single “program” because it worked for them, that’s a red flag.

Expect wide variation. Private accredited counsellors typically charge session fees comparable to other registered mental‑health professionals; some offer sliding scales or group therapy for lower cost. Medical aid cover depends on your scheme and on the provider’s registration: schemes usually reimburse registered psychologists, psychiatrists or clinical social workers under outpatient benefits or chronic programmes, but may not recognise an addiction counsellor unless they are registered with an accepted body or supervised by a recognised clinician. Always request the counsellor’s registration number and invoice codes up front, ask them whether they submit claims, and whether they can help with preauthorisation for inpatient detox or rehab. If private care isn’t affordable, ask the counsellor for public sector or NGO referrals in Gauteng — a good counsellor will know the local landscape and work to make clinically appropriate care accessible.