Seeking a Therapist in France? The Rules Are Complicated |
Take our Do I Need Therapy?
Find a therapist near me
In France, titles are protected but practice isn't—anyone can legally offer "therapy" without credentials.
Asking whether an approach is evidence-based is the most important question most people never ask.
The therapeutic relationship predicts outcomes more reliably than any specific therapy type.
Early movement—within four weeks—reliably predicts long-term outcomes.
A friend recently told me she had spent three weeks in a mental-health waiting room of sorts: not a physical one, but 20 open browser tabs, trying to figure out who she should call. Psychologue, psychiatre, psychothérapeute, psychanalyste, psychopraticien, thérapeute holistique, coach de vie—her head was spinning. She didn't know what any of it meant, and she didn't know what she actually needed.
If you have tried to find a therapist in France, this might sound familiar. The landscape is genuinely confusing—and that's more consequential than most people realize. Because France has a quirk that surprises even seasoned professionals: Some titles are legally protected, but the practice of psychotherapy is not. Anyone can legally offer "therapy sessions" as long as they don't claim a protected title. That gap has real implications for people seeking help.
Here's what research—and a closer look at French regulations—tells us about how to choose well.
The title maze, briefly decoded
Three titles in France are legally protected and verifiable. A psychologue holds a Master's degree (five years) in psychology from an accredited university, with at least 500 hours of supervised clinical training. They can be verified on the national health directory, annuaire.sante.fr. A psychiatre is a physician with a specialty in psychiatry—the only professional authorized to prescribe psychiatric medication. A psychothérapeute (as a standalone title) requires documented training in clinical psychopathology, registered with the regional health authority.
Everything else—psychanalyste, psychopraticien, thérapeute holistique, coach de vie—carries no legal definition and no minimum training requirement. Some practitioners using these titles are genuinely competent and work with evidence-based approaches. Others may have just completed a weekend workshop. The public has no reliable way to distinguish them without asking directly.
Start with the "Annuaire Santé". If the person holds a protected title, they'll be listed there with an RPPS number. If they don't appear, ask them explicitly: What is your exact training, and is it equivalent to a five-year psychology Master's with supervised clinical hours?
But checking credentials is only the first filter. It tells you whether someone has the right to use a title. It tells you nothing about whether what they actually do is likely to help you.
The question most people forget to ask
Once you've confirmed credentials, the most important question most people never ask is: "Is your approach evidence-based?"
It sounds academic. It isn't. It's the question that separates practitioners who can explain their method, cite the research behind it, and describe how they know it's working from those who cannot. A competent therapist should be able to tell you, in plain language, what research their approach draws on and how they evaluate whether it's effective.
Some answers signal genuine grounding in the evidence:
"I use cognitive-behavioral therapy, which has strong evidence for anxiety and depression. I'll explain how we'll apply it to what you're describing."
"I work integratively—I start with a careful assessment and select strategies based on your specific situation and what the research supports for your type of difficulty."
Take our Do I Need Therapy?
Find a therapist near me
Other answers are worth pausing on:
"Scientific studies can't capture what I do."
"My approach is unique—I'm one of the few practitioners using it."
"I do a bit of everything, depending on what feels right."
None of these responses are automatic disqualifiers. But they should prompt follow-up: What research does your approach draw on, and how do you evaluate whether it's helping?
What research says actually predicts outcomes
Here's where the science gets counterintuitive.
Most people search for the right technique: CBT or psychodynamic? EMDR or mindfulness-based? That's understandable. But decades of psychotherapy research have produced a humbling finding: Among approaches that are grounded in solid psychological principles—that is, among evidence-based therapies—differences in outcomes are often modest. A meta-analysis of 295 studies and more than 30,000 patients found that the therapeutic alliance—the quality of trust and collaboration between client and therapist—predicts success more consistently than any specific method.
This is sometimes called the "dodo bird verdict," after Lewis Carroll's character who declares that everyone has won and all must have prizes. The point isn't that the technique is irrelevant. Exposure-based therapies show strong evidence for treating phobias and PTSD. Trauma-focused CBT and EMDR both have robust support for trauma. Mindfulness-based cognitive therapy meaningfully reduces relapse in people with recurrent depression. These matches are real and worth knowing.
But the critical phrase is among evidence-based approaches. The dodo bird verdict applies within that set, not across all therapeutic traditions equally.
And even within evidence-based therapy, the person delivering it matters enormously. Research on therapist effects shows that the best therapists are roughly twice as effective as the least effective ones, within the same approach. What distinguishes them is not their technique but their ability to build a genuine alliance, notice when something isn't working, and adapt.
The questions worth asking in a first session
Treat the first session as a mutual evaluation. Beyond credentials and the evidence-based question, a few more will tell you a great deal:
"How will we know whether therapy is helping—and how many sessions should I expect?" Both parts matter. A therapist should be able to give you a rough horizon and name what "working" looks like. A vague answer—"Therapy is a long journey, it's hard to say"—without any benchmarks is itself information. Lambert's research has shown that routinely measuring client progress with brief standardized tools, rather than relying on clinical intuition alone, significantly improves outcomes. A therapist who tracks progress isn't being bureaucratic. They're being rigorous.
"What will you do if I'm not improving?" This reveals whether you're working with someone who sees therapy as a fixed process or as a dynamic calibration. A good answer includes the possibility of changing the approach or referring you elsewhere.
If a therapist is defensive when asked these questions, that matters. You are not being difficult. You are being a well-informed patient.
Your role in building the alliance
The research on therapeutic alliance is sometimes read as a checklist for evaluating your therapist. But that misses something important: Alliance isn't something a good therapist delivers to you. It's something you build together.
This means the first session is also a chance to show up actively. Share your preferences early; if you want concrete exercises rather than open-ended exploration, say so. If something feels off, name it as soon as you can. Studies show that therapists who receive direct feedback from patients adapt more effectively, and that alliances which survive small ruptures—moments of friction, honestly addressed—end up stronger than those that never encounter any.
You don't need to arrive with a perfect sense of what you need. But you do have permission to be a participant rather than a passive recipient. A good therapist will treat your preferences and reactions as clinical information, not as an inconvenience.
Early response matters. Research consistently shows that movement in the first four weeks predicts long-term results. Not cure—movement. A better understanding of what's happening. A sense of being genuinely heard. If after four to six sessions, none of that is present, name it with your therapist. A good one will welcome the conversation, adjust course, or refer you to someone better suited.
If that conversation itself isn't possible—if raising it leads to defensiveness or guilt—that's a clear signal to look elsewhere. Leaving a therapy that isn't working isn't failure or disloyalty. It's a decision the evidence supports.
France's system is improving. The Mon Soutien Psy program now covers up to 12 sessions annually with a networked psychologist—a real step, even if the reimbursement rate leaves much to be desired. The regulatory gaps, however, remain. In that context, knowing which questions to ask matters. So does this: Deciding to look for help in the first place is not a small thing. It takes clarity about yourself and courage to act on it. You deserve care that is worthy of that effort—a professional who can explain what they do and why, adapt when needed, and work with you rather than at you.
These questions exist so that you can find that person more reliably; not to make the search harder, but to make it more honest.
This post is co-authored by Dr. Hans Rocha IJzerman (CEO of Annecy Behavioral Science Lab) and Rebecca Shankland (Professor of Developmental Psychology at Université Lumière Lyon 2). It is an adapted, shorter and translated version of Comment choisir un·e thérapeute en France : ce que la recherche nous apprend, a longer guide on how to choose a therapist in France.