About couples therapists
Couples therapists help partners with communication problems, frequent arguments, infidelity, crises or decisions about the future of the relationship. Sessions are usually joint, sometimes combined with individual ones.
Getting mental health care in Madagascar
Public health system · Ministère de la Santé publique
Public psychiatric services exist at the university hospitals (CHU) of the six former provinces, including the psychiatry department of CHU Joseph Raseta Befelatanana in Antananarivo; mental health prevention and diagnosis centres exist only in Antsirabe, Ambositra and Manakara. The country has very few psychiatrists (a few dozen) and only one psychologist employed by the state. Many patients first see traditional healers, which delays care. More information
How to check that a professional is licensed
- Ordre national des psychologues de Madagascar (ONPM). Psychologists have a national professional order, the ONPM. Ask the psychologist whether they are a member.
- Ordre national des médecins de Madagascar. Doctors, including psychiatrists, belong to the Ordre national des médecins, which oversees medical ethics. Ask for the doctor's order registration.
Urgent help in Madagascar
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 117 · Police secours (depuis un mobile)
Information reviewed in November 2026 · Sources: ncbi.nlm.nih.gov, newsmada.com, lexpress.mg, newsmada.com
What does a couples therapist do?
A couples therapist helps two people understand and improve their relationship. Day to day they work with couples on communication, recurring arguments, trust after infidelity, intimacy, life transitions such as parenthood or retirement, and decisions about continuing or separating. They stay neutral, make room for both perspectives, and teach practical skills to talk, listen and repair after conflict.
When to see a couples therapist
Couples therapy makes sense when arguments repeat without resolution, you feel distant or misunderstood, trust has been damaged, sexual or emotional intimacy has changed, or you face a big decision together. It also helps couples who want to separate respectfully. If there is violence, control or fear in the relationship, couples therapy is not appropriate; individual support and safety come first.
How is it different from other professionals?
A couples therapist focuses on the relationship between partners, while a family therapist includes children or other relatives. A sex therapist concentrates on sexual concerns, which may or may not be part of couples work. Individual therapy addresses one person’s difficulties. Well-supported approaches in couples work include emotionally focused therapy, integrative behavioural couple therapy and other structured methods.
What happens in the first session
In the first session the therapist usually listens to how each partner sees the relationship, what brought you now and what you each hope for. Many therapists also hold one individual session with each partner. Ask about their approach, how they handle secrets shared individually, and how they work if one of you is unsure about continuing the relationship.
How long does the process take?
Couples sessions often last around 60 to 90 minutes and are usually weekly or fortnightly. Some couples see changes in a relatively short process, while others need more time, especially after a breach of trust or long-standing conflict. Duration depends on the goals, the approach, whether both partners are committed, and how much they practise new skills at home.
Online or in person?
Online couples therapy is a practical option when schedules are hard to match, you live in different places, or there are few specialists nearby. Partners can connect from the same room or separately. In-person sessions may be better when emotions escalate quickly, when one partner feels less comfortable with screens, or when home offers no privacy from children or others.
How to check their qualifications
Couples therapist is often not a protected title. Check the professional’s base qualification, such as psychology, medicine or social work, and registration in that profession. Ask about specific training in couples therapy, the models they use, supervised experience and membership of recognised associations. A good couples therapist explains their approach clearly and will tell you if another type of support fits better.
What affects the price?
Couples sessions are often longer and priced differently from individual therapy. Fees vary with the therapist’s training and experience, session length, the city and modality. Some professionals offer packages, intensive formats over one or two days, or a free introductory call. Ask about cancellation policy and how individual sessions within the process are charged.
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 Madagascar cover psychological care?
Public psychiatric services exist at the university hospitals (CHU) of the six former provinces, including the psychiatry department of CHU Joseph Raseta Befelatanana in Antananarivo; mental health prevention and diagnosis centres exist only in Antsirabe, Ambositra and Manakara. The country has very few psychiatrists (a few dozen) and only one psychologist employed by the state. Many patients first see traditional healers, which delays care.
How do I check that a couples therapist is licensed in Madagascar?
Ordre national des psychologues de Madagascar (ONPM): Psychologists have a national professional order, the ONPM. Ask the psychologist whether they are a member.