How to choose an English-speaking couples therapist in Madrid

By Alejandro Cabeza · Health Psychologist (Reg. no. M-37719) Published on October 25, 2026

If you are an international or bilingual couple living in Madrid, finding the right therapist is not only about finding someone qualified. It is also about finding someone you can both talk to in the language you feel most at home in, so nothing important gets lost in translation. This guide covers what to look for, the questions worth asking before you book, and what to expect from a first session.

Why therapy in your own language matters

Couples therapy works through nuance: how something was said, what was meant, what each of you felt in the moment. When one or both partners have to translate their feelings into a second language, conversations become more careful and less honest. Having an English-speaking couples therapist in Madrid lets you both speak freely, and lets the therapist pick up the details that usually reveal where the conflict really comes from.

What to look for in a couples therapist

• ✓ A licensed health psychologist. In Spain, check that they are registered with the Official College of Psychology (in Madrid, the COP Madrid register is public).
• ✓ Specific training in couples and family therapy, not only general psychology.
• ✓ Experience with attachment and trauma. Many repeated fights have their roots in older experiences; a therapist who can work with that goes deeper than communication tips.
• ✓ Real fluency in English, and ideally Spanish too if you are a mixed couple.
• ✓ Flexibility: sessions in person in Madrid and online, so therapy fits your life.
• ✓ A clear method: you should leave the first session knowing how the therapist will work with you.

Questions to ask before you book

• ✓ What is your training in couples therapy, and how long have you been working with couples?
• ✓ Do you see the two of us together, separately, or both?
• ✓ How do you handle it if one of us is less convinced about coming?
• ✓ How will we know whether therapy is helping?

How I work with couples

I am Alejandro Cabeza, a licensed Health Psychologist in Madrid (registration no. M-37719), with a Master's in Family and Couples Therapy, Crisis and Trauma from the University of Salamanca and clinical experience in Spain and in Massachusetts (USA). I work with couples fully in English, in person in Madrid or online.

My approach combines brief integrative therapy with an attachment-based view of the relationship: we look at the pattern that keeps repeating between you, not just at who is right. When old wounds fuel the conflict (a betrayal, a fear of abandonment, a family history that weighs on you), EMDR therapy helps release them so they stop driving your reactions. You can read more about couples therapy in English in Madrid.

What happens in the first session

The first session is for getting to know each other. Each of you tells me what brings you here, we identify what you would like to change, and I explain how I would work with you. You leave with a clear idea of the process, and with no obligation to continue if it does not feel right.

Frequently asked questions

Do both partners need to speak fluent English?

No. Sessions are held in English, but we can switch to Spanish at any moment if that helps one of you express something more precisely. Many bilingual couples find that useful.

Can we do couples therapy online?

Yes. Sessions can be in person in Madrid or online, which also works if one of you travels a lot or you live outside Madrid.

How long does couples therapy take?

It depends on what you bring and how long it has been going on. I work with a brief, integrative approach: we set clear goals and review progress together, so therapy lasts as long as it is useful and no longer.