What This Service Is — And What It Is Not
This clinical psychology service includes:
- Individual psychotherapy — structured, evidence-based psychological intervention
- Psychological assessment — formal assessment of psychological difficulties and report where indicated
- Collaborative work with the Global Health psychiatrist where a combined psychotherapy and pharmacology approach is appropriate
- Psychological guidance for family members of people experiencing psychological difficulties — where indicated
- Psychotherapy in English or Portuguese for international residents and expats
This service does not include:
- Medication prescribing — clinical psychologists do not prescribe in Spain. If you need pharmacological assessment, our specialist psychiatry service is appropriate
- Crisis intervention — if you are in crisis, use the resources at the top of this page
- Couple or family therapy — this service is individual psychology
- Forensic or medico-legal psychological assessments — please enquire directly about availability
Not sure whether you need psychology or psychiatry? The practical distinction is straightforward: if you want to talk in depth about what is happening and learn psychological tools to manage it, psychology is the right starting point. If you think medication may be part of the solution, or if you are already taking psychiatric medication and want someone to manage it, psychiatry is more appropriate. For many people, both working together is the most effective approach.
Who This Service Is For
This clinical psychology consultation is appropriate for adults with:
- Anxiety — generalised anxiety disorder, social anxiety, panic attacks, health anxiety
- Depression — low mood, loss of interest, mild to moderate depression
- Stress and burnout — work-related stress, emotional exhaustion, work-life difficulties
- Trauma and PTSD — past or recent traumatic experiences that continue to affect daily functioning
- Grief — loss of a loved one, loss of a relationship or significant life role
- Relationship difficulties — relational patterns that cause distress or conflict
- Low self-esteem and self-criticism — negative thought patterns about oneself
- OCD — obsessive-compulsive disorder, intrusive thoughts, compulsions
- Phobias — specific fears with impact on daily functioning
- Adjustment difficulties — moving country, job change, relationship breakdown, significant life changes
- Expat stress — cultural adjustment, isolation, identity, family separation
- Adult ADHD — psychological support and management strategies for adults with established diagnosis
- Sleep disorders with significant psychological basis
- Eating and body image concerns — non-severe presentations
- Anyone seeking structured psychological support to improve wellbeing and functioning
Therapeutic Approaches
Psychotherapy is not a generic conversation — it is structured, evidence-based psychological intervention. The therapeutic approaches our clinical psychologists use include:
Cognitive Behavioural Therapy (CBT)
The approach with the strongest scientific evidence for most anxiety disorders and depression. Works on the relationship between thoughts, emotions, and behaviours — identifying thought patterns that generate distress and developing more adaptive strategies.
Acceptance and Commitment Therapy (ACT)
A third-generation approach working on psychological flexibility — learning to relate differently to difficult thoughts and emotions, and acting in line with personal values even in the presence of distress.
EMDR — Eye Movement Desensitisation and Reprocessing
The treatment with the strongest evidence for trauma and PTSD. Helps the brain process traumatic memories that have become blocked, reducing their emotional impact.
Dialectical Behaviour Therapy (DBT)
Particularly useful for difficulties in emotional regulation, borderline personality disorder, and self-destructive behaviours. Works on mindfulness skills, distress tolerance, emotional regulation, and interpersonal effectiveness.
Brief Psychodynamic Psychotherapy
Useful when current difficulties have roots in past experiences and relational patterns. Works on the meaning of symptoms and deeper understanding of recurring patterns.
Mindfulness-based approaches
Integrated into several therapeutic frameworks, particularly useful for stress, anxiety, and burnout.
The most appropriate therapeutic approach for you depends on your presentation, your goals, and your preferences. Your psychologist discusses this with you in the first consultation and adapts the approach to your specific situation.
What Your First Consultation Includes
Initial psychological assessment
The first consultation is an assessment — your psychologist listens in depth to your situation, understands the impact on your daily functioning, explores relevant personal history, and establishes with you the goals of the therapeutic work.
Clinical formulation
At the end of the first consultation, your psychologist provides an initial formulation — a clinical understanding of what is happening, what factors are contributing, and how the therapeutic work can help.
Therapeutic plan
Your psychologist proposes a therapeutic plan — including the most appropriate approach for your presentation, the recommended session frequency, and the therapeutic objectives to work towards.
Coordination with psychiatry where indicated
Where a combined psychotherapy and pharmacology approach is appropriate, your psychologist coordinates with our specialist psychiatry service within the same platform — so you do not need to start from scratch with each professional.
How Online Therapy Works
Video call psychotherapy has solid and comparable scientific evidence to in-person therapy for most presentations. The therapeutic alliance — the relationship between patient and psychologist, one of the most important factors in therapy outcome — develops equally effectively in the online format.
Practical advantages of online psychotherapy:
- No travel — consult from the space where you feel most comfortable
- No waiting room — greater privacy
- Easier to maintain regularity — sessions are not lost due to scheduling conflicts or travel
- Access from anywhere in Spain — no geographical limitation
- Especially useful for expats and international residents — no limitation by language or location
For an effective video session
- Find a private space where no one can hear you
- Ensure a stable internet connection
- Use headphones if possible — improves privacy and sound quality
- Reserve the full session time — without interruptions
Psychology in Spain — The Access Gap
Clinical psychology in the Spanish public system is significantly under-resourced. In most autonomous communities, the number of psychologists in the SNS is well below the European average — approximately 6 psychologists per 100,000 inhabitants compared to a European average of 18. Waiting times to access SNS clinical psychology are months — where access exists at all.
Private in-person psychology in Spain is expensive in major cities and limited outside them. For international residents who need psychotherapy in English, options narrow dramatically.
This service provides access to clinical psychology by video call — same day for the first consultation — from anywhere in Spain, in English, Spanish, or Portuguese.
Confidentiality
Everything discussed during your psychology sessions is strictly confidential and protected under Spanish and European data protection law — including Regulation (EU) 2016/679 (GDPR) implemented through Organic Law 3/2018 (LOPDGDD), Law 41/2002 on patient autonomy, and the Psychologist's Code of Ethics.
Mental health data has reinforced protection as a special category under the GDPR.
There are two circumstances in which confidentiality may need to be carefully considered — when there is serious and immediate risk to your life or safety, or when there is serious risk to the safety of another person. Your psychologist discusses confidentiality with you at the outset of the first session.
