Psychotherapy in Latviawho is who, what it costs, what the state covers

State-funded psychological and psychotherapeutic help has been available in Latvia since 2020.

The programme covers specified diagnoses: depression, stress-related disorders, neurotic spectrum disorders, eating disorders, and behavioural and emotional disorders beginning in childhood and adolescence.

Important: the Latvian Association of Medical Psychotherapists states that medical psychotherapists are not currently contracted with the National Health Service, though psychotherapy specialists without a medical degree are available within the state system. Approaching a medical psychotherapist expecting state-funded psychotherapy can therefore end in refusal.

A Latvian Association of Local Governments document on state-funded psychologist consultations states that 63 specialists deliver the service: 45 clinical and health psychologists, 17 with further training in psychotherapy, and one medical psychotherapist.

The Latvian Association of Medical Psychotherapists sets out these requirements:

• A medical degree and entry in the practitioners register.
• A completed residency programme lasting 4 years.
• Passing the examination in the psychotherapy specialty.
• Certification is carried out by the Latvian Medical Association's Certification Council on the proposal of the association's certification commission, under Cabinet Regulation No. 391 adopted on 18 June 2024.
• The certificate is issued as an electronic document valid for five years.
• Recertification requires regular professional activity: at least 3 years of practice in the past 5 years involving clinical work with patients.
• Documents must reach the certification commission no later than 4 months before the examination date.

• State-funded appointments: book through rindapiearsta.lv, searching under "Service" for a psychologist or psychotherapist.
• Medical psychotherapists: through the Latvian Association of Medical Psychotherapists.
• Psychologists: in the Latvian register of psychologists.
• Overview resources: the apzinaties.lv portal, which collects information on specialists, therapeutic approaches and support organisations.

Psychotherapy is often delivered remotely, so where you live does not always limit the choice.

• What you need. If medication or a medical diagnosis is required, you need a doctor: a psychiatrist or a medical psychotherapist.
• State-funded or private. The state programme is staffed by clinical and health psychologists, so the route to free help starts with a referral.
• Approach. Specialists practise particular therapeutic approaches, which are worth comparing.
• Duration. A few sessions can be enough to stabilise in a crisis, but serious emotional difficulties need longer therapy.
• Language and format. Check whether the specialist works in a language you are comfortable in and offers remote sessions.

• The first session establishes the situation, how long the difficulties have lasted, and what you want to achieve.
• The frequency and approximate duration of therapy are agreed together.
• Psychotherapy is systematic treatment, so regularity affects the outcome.
• If it emerges during therapy that medication may be needed, the specialist will advise seeing a doctor.
• In the state programme the number of sessions is capped at ten, so the plan is built around that.

The Latvian Association of Medical Psychotherapists publishes indicative private prices, noting they vary with the specialist's training, experience and practice terms.

• Session with a resident doctorPrice EUR: from 35.00 to 40.00Source: Latvian Association of Medical Psychotherapists
• Session with a certified medical psychotherapistPrice EUR: 70.00 to 90.00 on averageSource: Latvian Association of Medical Psychotherapists
• In some cases, a single therapy sessionPrice EUR: 110.00 to 130.00Source: Latvian Association of Medical Psychotherapists
• State-funded session for the patientPrice EUR: 0.00, up to 10 sessionsSource: Cabinet of Ministers

The National Health Service has published that within the programme certified clinical and health psychologists receive 25.33 EUR of state funding per session, while those with further training in psychotherapy and medical psychotherapists receive 28.52 EUR. These amounts are paid by the state, not the patient.

Several organisations represent the field:

• Latvijas Ārstu psihoterapeitu asociācija, registration number 40008193067, president Gunta Andžāne, executive secretary Agita Lazdiņa, arstipsihoterapeiti.lv.
• Latvijas Ārstu psihoterapeitu biedrība, registration number 40008101221.
• Latvijas Psihosomatiskās medicīnas un psihoterapijas asociācija, registration number 40008196773.

Medical psychotherapists are certified by the Certification Council of the Latvian Medical Association. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of a service received at a healthcare provider, raise them first with the provider's management. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.