How Therapy Works With US & FAQs

Oftentimes we wait until something “big” happens to start therapy. But it doesn't have to be the case. Starting therapy can be because life is feeling too heavy to carry alone, because you want to finally process something, or because you're ready for change. That might be anxiety, grief, trouble sleeping, communication issues, burnout, a general sense of being overwhelmed, or a relationship that keeps hitting the same wall. Sometimes, it might be harder to name: feeling out of place in a country, a family or a body that doesn't quite fit. If you're wondering whether your reason for beginning therapy is big enough, it is. Remember: you don't need to be in crisis, and you don't need to have it all figured out, because that's what we do together.

Plenty of psychologists here speak English. Fewer have sat with what it means to be queer, polyamorous, neurodivergent, a person of colour, or simply far from anyone who's known you for years, sometimes several of those at once. So look past “do you speak English?” and ask what they've actually worked with: their approach, their experience with people like you, whether you'll have to explain yourself before the real work can start. Every psychologist at The Circle Clinic works in English, in Leiden or online, inside a practice that's, throughout:

• BIPOC-led
• LGBTQIA+ affirmative
• Poly-affirmative
• Sex-positive
• Neurodivergent-affirmative

Start with a free 30-minute consultation and see how it feels.

No referral needed here. As a private practice, we don't ask for one from your GP, and a diagnosis isn't a requirement either. Public mental health care (GGZ) can mean a wait of several months to a year; we're usually able to offer a first conversation much sooner, and we'll tell you exactly how soon when you reach out. That first conversation works both ways: it's there for you to feel out whether one of us is the right fit, as much as it is for us.

Nerves are completely normal. Naming what hurts, or what we feel ashamed of, is frightening before it's freeing. Some people also carry something more specific into that first session: a past therapist who dismissed them, misread their culture, questioned their identity, or treated their neurodivergence as the thing to fix. If that's part of your story, we're sorry it happened, and you won't need to defend yourself here. You set the pace, there's nothing to prepare, and the free consultation is a low-pressure way to feel out whether we're right for you before you commit to anything.

Consistency matters most early on, more than the exact rhythm. It's what turns a session from a weekly check-in into real space to untangle something. Most people start weekly. Twice a week can help through a harder patch, and every two weeks is fine once things feel steadier, though much longer than that and momentum tends to slip. We'll settle on a rhythm together at your intake.

There's no fixed number of sessions. Therapy ends when you've reached what you came for, or whenever you decide you're ready, and we check in on that together at regular points, asking for your honest read as much as giving ours. Common signs that therapy is working include feeling safer telling the truth, more able to sit with a hard emotion, and closer to the shift you named when you started. We're not chasing “finished”. We're aiming for you to leave feeling steadier, more confident, and more whole than when you arrived.

No. We're psychologists, not psychiatrists. A psychiatrist is a medical doctor who can prescribe medication, while a psychologist works through talking therapy, and if medication might help you, we're glad to liaise with your GP and/or psychiatrist. Teamwork!

Our approach is integrative, relational and trauma-informed. Integrative means we're not fitting you into one method; we draw on several evidence-based approaches and choose together which serves you. Trauma-informed means we start from “What happened to you?” instead of “What's wrong with you?”. And it's holistic too (your body, your family history, your relationships and your culture all have a place in the room): we've written more on what holistic actually means to us. The word “healing” comes from the Old English hælan, “the journey back to wholeness”, which is where our name and our mission both began (more on our mission and philosophy). Within that, our psychologists draw on several approaches, and we choose together what fits you best in individual therapy:

• EMDR (Eye Movement Desensitisation and Reprocessing)Helps your brain finish processing distressing memories, so they lose their grip on the present (recognised by the World Health Organization).
• Emotionally Focused Couples Therapy (EFCT)Looks underneath conflict for the vulnerable feelings driving it, and helps you rebuild a bond you can both trust.
• IFS (Internal Family Systems)Gets you curious about the different “parts” of you, rather than critical of them.
• Schema TherapyTraces long-standing patterns back to where they were formed, usually in childhood, and the need still sitting underneath them.
• Relational therapyUses what happens between you and your therapist as a living example of how you relate more broadly.
• Experiential therapyWorks through what you're feeling in the room right now (an image, a memory, a role-play), rather than only through talking about it.
• ACT (Acceptance and Commitment Therapy)Makes room for difficult feelings alongside you, while you keep moving towards what actually matters to you.
• Systemic therapyLooks at you inside your wider systems (family, culture, relationships), not as a single person in isolation.
• DBT (Dialectical Behaviour Therapy)Builds concrete skills for the moments when emotion or conflict runs highest.
• Narrative therapyHelps you loosen your grip on the story you were handed about who you are, and start authoring a truer one.
• Somatic therapyWorks with what the body is already telling you (tension, breath, posture), where talking alone can't quite reach.

Yes. Online, in person, or a mix of the two: we'll talk through what suits you at your consultation. The research backs it up too. A meta-analysis of 57 studies found online sessions produce results largely on par with in-person ones, though the authors would still like to see more high-quality trials. All we'd ask of you is a private space and a stable internet connection.

Yes, and not only every June. The Circle Clinic is queer-affirming, LGBTQIA+ affirmative and sex-positive, led by Ishana, herself a queer psychologist of Indian and Italian heritage, and built for people whose stories haven't always been met with care. You won't be asked to justify your pronouns, your gender, your sexuality or your relationship structure before the actual work can start. We see queer, trans, non-binary and questioning clients in individual therapy, and queer couples and polycules in couples therapy, in English, in Leiden or online.

Yes. We're a neurodivergent-affirmative, anti-ableist practice, so ADHD and autism aren't things we're trying to fix. We look instead at what it costs to live in a world built for other brains: the masking, the burnout, the sensory overload, the rejection sensitivity, years of being told to just try harder. Sessions can flex around what actually helps you (a written summary afterwards, fidgeting welcome, camera off online if that's easier). We don't run formal ADHD or autism assessments ourselves, but a diagnosis, or the absence of one, was never a condition for working with us.

Yes. The Circle Clinic is BIPOC-led (Ishana grew up between Dubai, Italy and India) and our wider team is multicultural and multilingual. We work with racial trauma, microaggressions, the particular exhaustion of migration, intergenerational trauma, and the quieter confusion of belonging to more than one culture at once. You won't need to prove that something counted as racism before we can talk about how it landed. Your culture is part of how we understand you, not a detail we set aside.

Yes. We work with couples, polycules and dyads of every configuration in Leiden and online: queer and trans partnerships, multicultural relationships, and ethically non-monogamous or polyamorous ones. Your structure isn't the thing we're trying to fix. We work with what any relationship brings into the room (communication, conflict, trust, intimacy), alongside whatever is specific to yours (agreements, jealousy, family who don't quite get it). Sessions last 1.5 hours; fees are further down this page.

Yes, and actually most of our own clients are internationals, several of us included. Every psychologist here works in English, and between the team we also speak Italian and Estonian. We know the particular weight of building a life somewhere new: the loneliness, the friendships you have to start again from scratch, the identity questions that come with starting over. Sessions run from Leiden or online.

Individual sessions typically last 60 minutes, and our fees follow a sliding scale based on your gross monthly income, so cost is less of a barrier to care. We believe mental health care is a right and not a privilege, and our scale is informed by John Rawls' ideas about fairness (distributive justice). You can choose between Ishana's scale and the clinical internship scale (sessions with our interns), and if a parent or guardian pays, their income sets the band.

Sessions longer than an hour are charged proportionally (a 1.5-hour session costs 1.5 times the session fee). If you're unsure which band fits you, we'll work it out together in your free consultation.

Dutch basic health insurance doesn't cover sessions with a private practice like ours, and most Dutch supplementary policies don't either. International and expat health insurance is more often where cover appears, so if you have one of those, it's worth checking your own policy or asking your insurer directly before you book. Either way, one upside of paying privately is a much shorter wait and far fewer restrictions on your treatment.

Sessions for couples and polycules last 1.5 hours, in person in Leiden or online. Fees depend on your gross monthly income:

We suggest that partners divide the fee equitably between them.

Please give us at least 48 hours' notice to cancel or move a session. Anything later than that, including a missed session, is charged in full, since that hour was held for you alone. Life happens; just tell us as soon as you know.

Yes, fully, with one exception: a serious risk that you might harm yourself or someone else, and even then we'd talk it through with you first wherever we possibly can. We know Leiden, and plenty of the queer and international communities within it, can feel small, and that privacy worries can sit alongside the therapy itself. If that's on your mind, say so. We take it seriously, and we can talk through exactly what confidentiality looks like for you before you start.

No, we're not an emergency service, and we can't respond to urgent situations in real time.

Please tell us first. If something about your therapy doesn't sit right, that's worth naming, not carrying alone, and moments like that can end up being some of the most important parts of the work itself. We'd always rather hear it directly and talk it through with you than have you leave without saying anything. If that conversation doesn't resolve it, Ishana is registered with the NIP (Nederlands Instituut van Psychologen), who run an independent complaints procedure you're welcome to use.