Quick answer: Starting therapy in Italy takes three steps: decide which route, public or private; verify that the professional is registered with the Ordine degli Psicologi; and use the first session as an assessment rather than as a test of whether you deserve to be there. Privately you can usually begin within days. You do not need a diagnosis, a referral, or a tidy explanation of the problem.
Therapsy is a multilingual psychotherapy service in Italy that connects expats, international students and Italians with licensed therapists in their own language, online across the country and in person in 24 Italian cities.
Key takeaways
- No referral is needed for private therapy in Italy, and no diagnosis is needed to ask for an assessment.
- Public care through the SSN is free or nearly free, works in Italian and has long waits. Private care starts within days.
- The first session is an assessment. Its job is to work out what is going on and propose a plan, not to fix anything.
- “I do not know what to say” is a normal starting point and a workable one.
- Agree a checkpoint early: a few sessions in, review what has changed and what has not.
- Therapsy works in 14 languages, with a free first conversation and a reply within 12 hours.
How do you know it is time?
What is the actual threshold?
Interference, not severity. If something is deciding how you sleep, what you avoid, how you speak to your partner or whether you apply for things, it is already costing you. Waiting until it is bad enough is the most expensive way to use therapy, because by then there is more to undo.
Do you need a diagnosis or a referral?
No. For private therapy you contact the professional or the service directly. In the public system you go through your GP or the local service. Nobody will ask you to justify the request with a label.
What if you cannot explain the problem?
Then say that. “I am tired and irritable and I do not know why” is a complete opening. Working out what is underneath is the job, not the entry requirement, and most people arrive with a description that changes by the third session.
Public or private?
What does the public system offer?
Through your GP or the local CSM you can access public mental health services. It is free or nearly free, it is the right route in severe cases and emergencies, and it works in Italian. Waiting times are long and you generally do not choose the professional.
What does private care offer?
Speed, choice of professional, choice of language, and continuity for as long as the work needs. It costs money. For most foreigners in Italy this is where therapy actually starts, and plenty of people use both routes at once.
What does it cost?
At Therapsy individual sessions start from EUR 70, couples from EUR 100 and a psychiatric consultation from EUR 110, with the same fee online and in person; the pricing page has the full list. Psychological care is generally deductible as a health expense in the Italian tax return, and some international insurance policies reimburse sessions against a proper invoice, so keep them and check the wording before you start.
Who should you look for?
Someone registered with the Ordine degli Psicologi, and, for psychotherapy, a psicoterapeuta who has completed the four-year specialisation. The register is public and checking it is routine; the detail is in our guide to finding an English-speaking psychologist in Italy.
What happens at the start?
The first conversation
At Therapsy it is free and it happens with the Clinical Director rather than with a form. You describe what is going on, the language you want to work in, your schedule and your budget, and it ends with a proposed therapist and the reason for the choice. The reply arrives within 12 hours.
The first session
Fifty minutes, mostly questions: what is happening now, when it started, what you have already tried, sleep, work, relationships, and what you want to be different. It ends with a proposal: an approach, a frequency, and a point at which you both review progress. You are allowed to ask why that approach and not another.
What should you bring?
Nothing formal. If you have taken medication for this before, bring the name of the molecule and the dose. If something specific triggered the decision to come, say it early rather than saving it. That is all.
How often, and for how long?
Weekly is the usual starting frequency. Duration depends on what you are working on: a focused problem can take a course of weeks, long-standing patterns take longer. A comprehensive meta-analysis including 409 trials compared cognitive behaviour therapy with control conditions, other psychotherapies, medication and combined treatment, which is the kind of evidence a therapist should be able to refer to when explaining their proposal.
The things people worry about
What if I cry, or have nothing to say?
Both are ordinary and neither is a problem. Silence in a session is working time, not wasted time, and a therapist will not sit through it for fifty minutes without helping you into it.
What if I do not like the therapist?
Say so, ideally to them. Fit is a real clinical variable, not a matter of manners. Inside a service you can change therapist without starting your history again, and a rematch does not cost you the work already done.
Is it confidential?
Yes. A licensed psychologist in Italy is bound by professional confidentiality. Nothing goes to your employer, your university or your immigration file. Ask for the limits to be stated explicitly in the first session if you want them on the record.
How will I know if it is working?
Not by feeling better every week. Earlier signs are usually behavioural: sleeping differently, saying something you would have swallowed, shorter self-criticism after a bad day. Agree a checkpoint at the start so this is a conversation rather than a private worry.
Which language, and which format?
Does the language matter?
Yes, and more than most people expect: emotional vocabulary is deepest in a first language, and a session conducted in a second one tends to produce tidier and less accurate answers. Therapsy works in 14 languages and matches on language as well as clinical focus; you can see the network on our therapists page.
Online or in person?
Both work. Online removes travel and keeps the same therapist if you move city, which for foreigners is the part of care that most often breaks; in-person sessions are available in 24 Italian cities. See online therapy for expats in Italy for how sessions run.
Frequently asked questions
Do I need a referral to start therapy in Italy?
Not for private therapy: you contact the professional or the service directly. In the public system you go through your GP or the local service.
How quickly can I start?
Privately, usually within days. At Therapsy the first conversation is free and the reply arrives within 12 hours. Public services are free or nearly free but have long waiting lists.
How much does starting therapy in Italy cost?
At Therapsy individual sessions start from EUR 70 and couples from EUR 100, with no difference between online and in person. Public care is free or nearly free.
What happens in the first session?
It is an assessment: what is happening, when it started, what you have tried, and what you want to change, ending with a proposed approach and a point at which to review it.
Can I have therapy in my own language in Italy?
Yes. Therapsy works in 14 languages, online across Italy and in person in 24 cities, and language is part of the match rather than an extra request.
What if the therapist is not the right fit?
Say so. Inside a service you can change therapist without repeating your history, and fit is treated as a clinical factor rather than a complaint.
