About couples therapy
Couples therapy helps partners improve communication, handle conflict, rebuild trust after a crisis or make decisions together, including separation. Sessions are usually joint, sometimes with individual meetings. It is not about deciding who is right but about understanding the patterns between you.
Sexologists help with sexual difficulties, desire, communication about sexuality, and sexual and gender identity, individually or as a couple, in a respectful and confidential setting.
Getting mental health care in Spain
Public health system · Sistema Nacional de Salud (SNS)
Public mental health care is free at the point of use. Access is usually through your family doctor (médico de familia) at the primary care centre, who refers you to a community mental health centre or unit for psychiatry and clinical psychology. Waiting lists for psychological treatment in the public system can be long and vary by region.
How to check that a professional is licensed
- Consejo General de la Psicología de España and the regional Colegios Oficiales de la Psicología. Membership of a Colegio is required to practise. For health care, check that the psychologist is a Psicólogo General Sanitario (official master's degree) or a specialist in Clinical Psychology (PIR route). Search the official register
- Organización Médica Colegial (Consejo General de Colegios Oficiales de Médicos) and the provincial Colegios de Médicos. Doctors must be registered with a provincial Colegio de Médicos; check that the doctor holds the specialist title in Psychiatry. Search the official register
Typical private fees
- Session with a psychologist
- €40 – €80
Typical private fee per individual psychology session, higher in large cities (2026 press report). Sources
Urgent help in Spain
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
Information reviewed in November 2026 · Sources: infocop.es, sanidad.gob.es, elespanol.com
Signs to look out for
All couples argue. It may be time to seek help when the same arguments repeat without resolution, conversations quickly turn into criticism or silence, you feel lonely within the relationship, affection or sex have faded and that worries you, trust has been broken, or a big change such as a baby, illness or a move has unbalanced things. Considering separation is also a reason to talk.
What helps: treatments and professionals
Couples therapy approaches with good evidence include emotionally focused therapy, integrative behavioural couple therapy, cognitive-behavioural couples therapy and the Gottman method. Couples therapists, psychologists and psychotherapists with couples training usually lead the work, and a sex therapist can help when sexual concerns are central. Therapy can help couples reconnect, or separate with less damage, especially when children are involved.
When to seek urgent help
If there is physical violence, threats, sexual coercion, or you feel afraid of your partner, your safety comes first: contact your local emergency services if you are in immediate danger, and seek specialised support for domestic violence. Couples therapy is not recommended in these situations. Seek urgent help too if anyone has thoughts of suicide or harming others.
What you can do in the meantime
Choose calm moments to talk about difficult topics, rather than in the middle of an argument. Try to describe how you feel and what you need, instead of criticising. Take a break if things escalate and agree to come back to it. Make time for small moments of connection. Reading reliable information on relationships together can also open useful conversations.
What does a sex therapist do?
A sex therapist helps individuals and couples with concerns about sexuality in a respectful, confidential space. Day to day they talk about desire, arousal, pain, orgasm, sexual communication, body image, identity and orientation, and the impact of illness, ageing or past experiences. They use psychoeducation, talking therapy and practical exercises, and coordinate with doctors when a physical cause needs to be checked.
When to see a sex therapist
Seeing a sex therapist makes sense when a sexual difficulty causes distress or tension, when desire differs a lot within a couple, when there is pain or anxiety around sex, after illness, childbirth or menopause, or when you have questions about identity or orientation. A medical check-up is advisable first for pain or sudden changes; trauma may need trauma-focused therapy.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in Spain cover psychological care?
Public mental health care is free at the point of use. Access is usually through your family doctor (médico de familia) at the primary care centre, who refers you to a community mental health centre or unit for psychiatry and clinical psychology. Waiting lists for psychological treatment in the public system can be long and vary by region.
How do I check that a sex therapist is licensed in Spain?
Consejo General de la Psicología de España and the regional Colegios Oficiales de la Psicología: Membership of a Colegio is required to practise. For health care, check that the psychologist is a Psicólogo General Sanitario (official master's degree) or a specialist in Clinical Psychology (PIR route).
How much does a session with a psychologist cost in Spain?
Usually between €40 and €80 per individual session in private practice. Typical private fee per individual psychology session, higher in large cities (2026 press report).