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 North Macedonia
Public health system · Public health system (Ministry of Health and Health Insurance Fund): community mental health centres and hospital psychiatry
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines. More information
How to check that a professional is licensed
- Chamber of Psychologists of North Macedonia (Комора на психолози). Only psychologists who hold a general and/or special licence issued by the Chamber may provide psychological services. A general licence requires a year of practice, a professional exam and entry in the Register of Psychologists, and a special licence requires additional specialised training. The Chamber publishes a list of licensed psychologists. Search the official register
- Doctors' Chamber of Macedonia (Лекарска комора на Македонија). The Chamber issues doctors' working licences and publishes a register of doctors and a list of doctors with valid licences. Search the official register
Insurance and coverage
According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines in the public system.
Urgent help in North Macedonia
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 112 · Emergencias
Information reviewed in November 2026 · Sources: who.int, borgenproject.org, komoranapsiholozi.mk, lkm.org.mk
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 North Macedonia cover psychological care?
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines.
How do I check that a couples therapist is licensed in North Macedonia?
Chamber of Psychologists of North Macedonia (Комора на психолози): Only psychologists who hold a general and/or special licence issued by the Chamber may provide psychological services. A general licence requires a year of practice, a professional exam and entry in the Register of Psychologists, and a special licence requires additional specialised training. The Chamber publishes a list of licensed psychologists.