If you live in Tenerife and need physiotherapy or psychological support, language is one of the first questions. But it doesn't weigh the same in both cases. In physio, much of the work is examination, hands-on treatment and exercise; language helps mostly with telling your history and understanding the instructions. In therapy, talking is the core of the treatment: you might order a coffee in Spanish without thinking and still find it hard to talk in Spanish about something that hurts.
This is a practical guide: what public healthcare covers, how to check a professional is qualified, what to ask before booking, and what research says about having therapy in your own language. I link to the official sources so you can check them yourself. It isn't medical or psychological advice: for your own situation, talk to a professional.
What public healthcare covers
If you're entitled to Spanish public healthcare, the National Health System's common services package, set out in Royal Decree 1030/2006 (in Spanish), includes:
- Physiotherapy in primary care (what the rules call "basic rehabilitation"), following a doctor's referral: for example, for chronic musculoskeletal problems, minor acute injuries, neurological conditions or respiratory physiotherapy. In specialist care there's also rehabilitation with physiotherapy for patients with a loss of function.
- Mental health. In primary care, detection, diagnosis and treatment of adjustment, anxiety and depressive disorders, with referral to mental health services when needed. In specialist care, diagnosis and treatment of mental disorders, including individual, group and family psychotherapy.
Your way in is your GP (médico de familia). What the package doesn't guarantee is the language you'll be seen in. If it's essential for you to be treated in English or German, in the private sector you can choose the professional, and that's what the rest of this guide is for.
Physio: when language matters most
A good first session starts by listening to you: where it hurts, since when, which movement triggers it, what you've already tried. Then comes the examination and the treatment, and finally the instructions for home. If you can point and move, part of the session works even if the language is shaky. But there are situations where understanding each other properly matters a lot more:
- Chronic pain. The full history (the original injury, previous treatment, what worked and what didn't) is an important part of the assessment.
- Rehab after surgery. You need to pass on exactly what the surgeon told you and which movements they restricted. Bring the report in writing.
- Sports injuries. Nuances like "this pulls but doesn't hurt" versus "this hurts and lingers" change the plan.
- Home exercises. If you don't understand them properly, you won't do them properly. Ask for them in writing, or ask whether you can film them on your phone.
Besides the practical argument, there's a legal one: Spain's patient autonomy law, Ley 41/2002 (in Spanish), which also applies to private healthcare, says clinical information must be given to the patient in a way that is understandable and suited to their needs (article 4). The article doesn't mention languages, but it backs you up when you ask for something to be explained until you understand it, or when you bring someone to translate.
Therapy: language is part of the treatment
Therapy works by putting words to what you feel. If you do it in a language you haven't mastered, you may end up saying what you know how to say rather than what you feel, spending energy translating instead of thinking, or steering around topics you don't have the vocabulary for.
There's research on this. In a 2013 study by Jean-Marc Dewaele and Beverley Costa, with 182 multilingual people who had been in therapy in various countries, clients switched languages during sessions significantly more than their therapists, especially when the emotional tone rose, and used that switching when talking about trauma or shame. The authors conclude that these clients benefit from a therapeutic setting where their multilingualism is valued and where they can switch between languages.
It's worth reading within its limits: it's an online questionnaire study, not a clinical trial, and it doesn't say therapy in a second language doesn't work. What it does suggest is something practical: look for a professional with whom you can use your mother tongue when you need it. If you live here, that usually leaves you two routes: a psychologist on the island who genuinely works in your language, or video sessions with a professional from your home country.
How to check a professional is qualified
Psychology. In Spain, the General Public Health Law, Ley 33/2011 (in Spanish), regulates psychology in healthcare in its seventh additional provision. The health profession of Psicólogo General Sanitario (general health psychologist) requires a degree in Psychology plus the official Master's in General Health Psychology. And to register a psychology practice in each region's register of healthcare centres, the authorities require that master's or the title of Psicólogo Especialista en Psicología Clínica (clinical psychology specialist), with an exception for practices already registered under the transitional route the law provides. Ask the psychologist which of the two they hold.
In the province of Santa Cruz de Tenerife, the Official College of Psychology publishes its list of registered members (in Spanish), in alphabetical order with name and membership number, and a psychologist search that you can filter by approach, patient age and format (online therapy included), and search by surname, membership number, postcode or keyword. Only those who have agreed to be listed appear in the search, and there's no language filter, so you'll have to ask about that directly.
Physiotherapy. Spain's General Council of Physiotherapy Colleges publishes a register of members (in Spanish) that you can filter by college, including the Official College of Physiotherapists of the Canary Islands, showing name and membership number.
If you have online therapy with someone from your home country, check they're registered with the relevant official body there and ask whether they work with people living in another country. Ask too what to do in an emergency between sessions: from a distance they can't see you in person, so keep the local resources to hand (you'll find them below).
What to ask before booking
- Does the person who'll treat me speak my language fluently, or only the front desk?
- Are they registered with their professional college? And for psychology: are they a Psicólogo General Sanitario or a clinical psychology specialist?
- How long is each session, how much does it cost and how do I pay? What happens if I cancel?
- What kind of problems do they work with, and with what approach?
- For physio: do I need a doctor's report? Will I get the exercises in writing?
- For therapy: do they offer online sessions in case I travel or move?
The professional doesn't have to be from your country. What counts is that you understand each other well, with that particular person. If after the first sessions that isn't the case, you can switch.
Private insurance: ask before you start
If you have private health insurance, don't assume what it covers for physio or therapy: every policy has its own conditions. Before you start, ask your insurer:
- Do I need a doctor's prescription or prior authorisation?
- How many sessions are covered per year or per condition?
- Only with professionals on your list, or do you reimburse me if I go elsewhere?
- Is there a co-payment per session?
- Are online sessions covered?
- Are there professionals on your list who work in English or German?
If you're paying yourself, do the maths before you start: price per session times the number of sessions you expect. Ask the professional how many sessions a case like yours usually takes. They won't be able to give you an exact number, but they can give you an idea.
If you're in crisis
If you're having thoughts of suicide or you're worried about someone close to you, Spain has the Ministry of Health's 024 line (in Spanish) for suicidal behaviour: free, confidential and available 24 hours a day, every day of the year, also for family and friends. If there's an immediate danger to life, call 112.
Frequently asked questions
Do I need a referral to see a physio?
In public healthcare, yes: the primary care package provides physiotherapy following a doctor's referral. With private insurance it depends on your policy, so ask first. If you're paying yourself, ask the clinic when you book whether they need any report.
Can I have online therapy with a psychologist from my home country?
It's worth considering if you can't find anyone on the island who works in your language. Check they're registered with the official body in their country, ask whether they work with people living abroad, and keep the local emergency resources to hand: 024 and 112.
How do I know if a psychologist can practise as a health professional in Spain?
Ask whether they're a Psicólogo General Sanitario (degree plus official master's) or a clinical psychology specialist, the titles named in Ley 33/2011, and check on the Official College of Psychology's list that they're registered.
Does public healthcare offer psychological therapy?
Yes. The common services package includes mental health care, with individual, group or family psychotherapy in specialist care. You access it through your GP. What it doesn't guarantee is the language.
Why I am writing this
I design websites for businesses in Tenerife, and physiotherapy and psychology practices are one of the sectors I focus on. If you run a practice and work in English or German, say so clearly on your website, in those languages and properly written: who works in which language, whether you offer online sessions, how to book. They're exactly the questions on the list above.
Related guides: for anyone looking for a physio or psychologist in their language, I have patient guides in English and German: English-speaking physiotherapist in Tenerife, Physiotherapie auf Teneriffa, English-speaking psychologist in Tenerife and Deutscher Psychologe auf Teneriffa. If you run a practice, here is how I build sites for physiotherapists and psychologists in Tenerife.
If you run a practice and you treat patients in several languages but your site does not reflect it, see the sectors I design websites for (in Spanish) or the Plan Teide Completo.
