Therapy FAQs

Getting started

What happens during the free introductory call?

We talk for 15–20 minutes, by phone or video. You tell me briefly what has brought you; I explain how I work; we see whether it feels like a fit. I will also answer any practical questions — about fees, session times, or which format might suit you. There is no obligation to continue. If I am not the right person for what you need, I will try to point you toward someone who might be.

Therapy FAQ

What can I expect from the first session?

The first session is where we begin properly. You will have space to say more about what is happening for you. There is no need to have it organised in advance. I will listen, ask questions, and start to get a sense of your situation. We will also agree how we want to work together: the format, the frequency, and what you are hoping for. It is a conversation, not an assessment.

Do I need a diagnosis or a referral?

No. You do not need a diagnosis, a referral, or a precise explanation of what is wrong. Many people come because something feels difficult, stuck, or unclear — and that is enough to begin.

How do I book?

You can reach me by email, phone, or through the contact form on this website. I will respond within 24 hours. We will arrange a free introductory call, and if we decide to go ahead, we will book your first session from there.

About therapy with me

My Approach

My work is rooted in existential psychotherapy. That means taking your difficulties seriously as experiences, not only as symptoms to manage. Anxiety, low mood, the sense of being stuck usually have something to tell us, whether a loss, a difficult relationship, a way of coping that has stopped working, or a widening gap between how you’re living and what actually matters to you.

Although the existential-phenomenological approach is my foundation, I’m flexible about method. If difficult thoughts and feelings are pressing on you now, I use practical, present-focused tools. When old patterns need deeper work, I draw on psychodynamic ideas. And sometimes words alone aren’t enough; then psychodrama lets us work with a situation more directly. Working with couples, I also draw on systemic and relational thinking.

Read more about how I work →

What is existential therapy?

Existential therapy is a form of psychotherapy rooted in philosophy. It looks at how you experience your life and make sense of it as a whole.

It doesn’t start from a theory of who you ought to be. It starts from your own experience: how you relate to yourself and other people, to your body and your circumstances, and to what gives your life meaning. It also looks at the things no one can avoid. We are free, yet limited. We choose, and have to live with our choices. We are close to others and still, in some ways, alone. And one day we will die. Most of us find ways to shrink our lives so we don’t have to face these things.

I won’t give you a formula for living. I’ll help you see how you are living now, including the assumptions and habits that shape your world and the possibilities you might be missing. Then you can decide how you want to meet the life you actually have.

Read more about existential therapy →

How is existential therapy different from other therapies?

Most people asking this question have encountered CBT often through the NHS, and want to know what else is available. CBT focuses on identifying and changing specific thought patterns and behaviours. Existential therapy is interested in those patterns too, but it also asks a wider question: what do they mean in the context of your life, and what are they telling you about how you are living?

Psychodynamic and psychoanalytic approaches share existential therapy’s interest in depth, in what is not immediately visible, in unconscious patterns, in how the past shapes the present. I draw on psychodynamic thinking in my work, particularly when longstanding relational patterns need attention.

Humanistic approaches, person-centred therapy especially are closely related to existential therapy and share its emphasis on the therapeutic relationship, personal agency, and the client’s own experience as central. The traditions are intertwined; where they differ is that existential therapy engages more directly with the harder questions — freedom, relatedness, limitation, mortality, meaning, rather than focusing primarily on growth and self-actualisation.

My training covered all of these approaches. The foundation is existential, but I also draw on psychodynamic perspectives, third-wave CBT, and psychodrama depending on what serves the person and the situation. You do not need to know which approach suits you before making contact, that is something we work out together.

What kinds of therapy do you offer?

I offer three main formats of work:

Single session therapy — a focused, standalone session (75 minutes for individuals, 2 hours for couples) designed to be complete in itself. For a specific question, decision, or situation you want to think through. [→ More about single session therapy]

Short-term therapy — 10 to 12 sessions with a clear beginning, middle, and ending. Focused work on a specific difficulty or transition, with the awareness of time built into the process. [→ More about short-term therapy]

Open-ended therapy — for deeper or longer-standing patterns, questions of identity and meaning, or difficulties that do not resolve in a fixed number of sessions. The work unfolds at its own pace.

If you are not sure which suits you, the introductory call is the place to decide together.

Do you work with couples?

Yes. I work with couples at every stage — acute crisis, slow-building distance, and everything between. I pay particular attention to cross-cultural, multilingual, and expat couples, where differences in background and language quietly shape everything and often go unnamed.

Couples sessions are 75 minutes (or 2 hours for single session therapy).  More about couples therapy →

Do you work with business leaders and professionals?

Yes. I work privately with business owners, founders, and senior professionals who carry real responsibility and have few places where they can speak completely freely.

Having spent many years in business myself, I understand that world from the inside. More about therapy for leaders →

Practical matters

How much does therapy cost?

Fees depend on the type of work — individual, couples, or single session therapy and are discussed during the introductory call. I try to make my practice accessible while keeping it sustainable.

How long is a session?

Individual sessions last 50 minutes. Couples sessions last 75 minutes.

Single sessions are longer: 75 minutes for individuals, 2 hours for couples.

How often do we meet?

Sessions are usually weekly. I recommend this for the first few months while we settle into the work. After that, I am open to discussing what rhythm suits you — fortnightly sessions work well for some people, and the short-term therapy format includes a deliberately spaced final session.

Where are you based?

I see clients online across the UK and internationally, and in person in Riga. Online and in-person sessions are structured in the same way. I am also open to hybrid arrangements — combining online and in-person sessions where that works for you.

What platform do you use for online sessions?

Online sessions take place over Zoom. I am happy to consider alternative platforms if you have a preference. You will need a private space and a device with a camera — a laptop, tablet, or phone all work. If accessing either is difficult, we can think through solutions together.

What languages do you work in?

English, Latvian, Russian. We can talk about your preferences during the introductory call to make sure it’s the fit. I also understand Polish and Italian well enough to work with clients who speak those languages though I don’t offer full sessions in either of them.

Is therapy confidential?

Yes. What you discuss in therapy with me is held in confidence. There are rare exceptions, where there is a serious risk of harm to you or someone else, which I explain in the therapy agreement before we begin. I work in accordance with the UKCP Code of Ethics and under the supervision of experienced colleagues, who may hear about our work in general terms but never your identity.

What is your cancellation policy?

I ask for at least 48 hours’ notice if you need to cancel or reschedule a session. If I can, I will offer an alternative time within the same week. Sessions cancelled with less than 48 hours’ notice, or missed without notice, are charged in full — time and resources will have already been set aside. I do not charge for holidays, and I ask for a month’s notice of planned breaks, as I will give the same.

What if I want to end therapy?

You can end therapy at any time. When the ending is planned, we will use our remaining sessions to work with it — how it feels, what you are taking with you, what it brings up. Endings are an important part of the work, not just the end of it. If you want to return later, the door is open.

What if I want to end therapy?

You can end therapy at any time. When the ending is planned, we will use our remaining sessions to work with it — how it feels, what you are taking with you, what it brings up. Endings are an important part of the work, not just the end of it. If you want to return later, the door is open.

Max Karlin therapy

Get in touch

A free first conversation

I offer a free 15–20 minute call, by phone or video. A chance for you to say briefly what’s brought you, hear how I work, and see whether working together feels right — a conversation, not a commitment.

You’re welcome to get in touch.

Let's Connect

Reach Out

To book a session or ask a question, feel free to call, send a WhatsApp or text message to +44(0)7903848913, or complete the contact form. I’ll respond as promptly as possible.

I’m happy to take your call unless I’m in a session. If I’m unavailable, please leave a message, and I’ll get back to you as soon as I can to answer any questions.