How to find an English-speaking therapist in Madrid
Last updated 2026-08-21.
If you are living in Madrid and you would rather do therapy in English, the hard part is not that there is nobody. It is that the lists you find are a mixture of qualified psychologists, life coaches, unregulated counsellors and people who advertise in English but do not actually work in it. Nothing on those pages tells you which is which.
This guide explains how the Spanish system works, how to check in two minutes whether someone is legally allowed to practise, and what to ask before you book. It is written by a psychologist who is registered in both Spain and the UK, and it names the public registers so you can verify anything here yourself.
First, the one check that filters almost everything
In Spain, calling yourself a psychologist is regulated. To work clinically with the general public you need to be a Psicólogo General Sanitario, or hold the older clinical specialist qualification. That is the health authorisation, and it is not the same as having a psychology degree.
The professional bodies publish their registers openly. In Madrid it is the Colegio Oficial de la Psicología de Madrid. You can search a person by name or by their registration number and see whether their health authorisation is recorded. If someone is not there, they may still be a perfectly good coach or counsellor, but they are not a registered clinical psychologist and you should know that before you start.
This one check removes most of the ambiguity in any list you find, and it takes about two minutes.
"English-speaking" is doing a lot of work in those listings
There is a real difference between a therapist who can hold a conversation in English and one who works in English. Therapy runs on nuance: hesitation, the word someone reaches for and rejects, humour, the phrase from childhood that still stings. A therapist working in their second language can miss those, and more importantly, you may find yourself simplifying what you say so the session keeps moving.
The reverse is also worth knowing. Some people find it easier to talk about painful things in a second language, because the words carry less weight. That is a legitimate reason to choose English even if it is not your first language. Either way, it is a decision worth making on purpose rather than by accident.
Ask directly: in which language did you train, and in which language do you usually work? The answer is more useful than a flag icon on a profile.
Where people actually look, and what each place is good for
There is no single directory that covers Madrid well in English. Each source has a bias worth knowing before you trust it.
Online or in person
Since 2020 most Spanish practices offer both. Online widens your choice enormously, because you are no longer limited to whoever happens to work near you, and for English-language therapy in Madrid that matters more than in most cities: the pool is small.
In person is worth the constraint if you find video draining, if you want a clear boundary between the session and your home, or if the work involves trauma and you would rather be in the room. Neither is better in general. What matters more is that you can get to it reliably, because the thing that most often ends therapy early is not the method, it is the commute.
What it costs, and what to check about insurance
Private therapy in Madrid is normally paid per session, and practices publish their fees. Be wary of anyone who will not tell you the price before the first appointment.
On insurance, Spanish health policies vary a lot. Some cover a limited number of sessions with an in-network psychologist, some reimburse part of an invoice from any registered professional, and some cover nothing psychological at all. The question to ask your insurer is specific: do you reimburse sessions with a Psicólogo General Sanitario, how many, and what do you need on the invoice? Then ask the practice whether they issue that kind of invoice.
How many sessions, and how to tell if it is working
There is no fixed number, and anyone who promises one before meeting you is guessing. What you can reasonably expect is a shared plan: what you want to be different, roughly how you will both know if it is happening, and when you will review it.
Brief approaches exist precisely because not everyone needs long-term work. Some people come with one decision to make and leave after a single focused session. Others need longer. The useful question at the start is not how long will this take, it is what will we look at in four sessions' time to decide whether to continue.
The five places most people end up looking, and what each one is actually good for.
| Where | Good for | Watch out for |
|---|---|---|
| The COP Madrid public register | Confirming someone is a registered psychologist with health authorisation | It verifies credentials, it does not tell you who works in English or who is taking new clients |
| International directories such as Psychology Today | Filtering by language and seeing fees and approach in one place | Listings are paid and self-written. Ranking reflects the subscription, not quality |
| Expat groups and forums | Honest word of mouth, and names that never appear in directories | One person's good fit is not evidence. Recommendations rarely mention registration |
| Your embassy or consulate list | Names that have been used before by people in your situation | Lists are often years out of date and are not vetted for current registration |
| Your insurer's own directory | Knowing in advance that the sessions will be covered | The English-speaking filter is usually crude or missing entirely |
Five questions worth asking on the first call
- Are you registered with a Colegio Oficial de Psicología, and what is your registration number?
- In which language did you train, and in which language do you normally work?
- What approach do you use, and why that one for what I have described?
- What do you charge, and do you issue an invoice my insurer can process?
- How will we decide together whether this is working?
Disclosure
This guide is written by Dr Santiago de Ossorno García, a psychologist registered with the Colegio Oficial de la Psicología de Madrid (M-25309) and with the Health and Care Professions Council in the UK (PYL040507). Spanish is his first language and he works in both English and Spanish, online across Spain and the UK and in person in Madrid and London.
So yes, he is one of the people this guide is about, and you should read it with that in mind. It is written to be useful whether or not you contact him, and every check it recommends can be done on public registers without asking anyone's permission.
