Tarot in therapy
Some clients ask to bring tarot into their sessions. I use the cards as a clinical tool: images that help put words to what is hard to say, clarify what matters to you, and look at the stories you live by. They are never used to predict the future.
How I use the cards
Projective and imagery work
A card is a picture, not a message. What you notice in it, and what it stirs, becomes something we can talk about. Images often reach feelings and memories that are hard to get to with words alone.
ACT values work
Drawing on Acceptance and Commitment Therapy, cards can help name your values and notice where life and values have drifted apart, then choose small steps back toward them.
Narrative work
A spread can lay out a story: where you have been, where you are, what you want next. We look at which parts of the story are yours to keep and which you might rewrite.
Trauma-informed pacing
You choose whether to use the cards, which cards to look at, and when to stop. Grounding and safety come first, and we can set the deck aside at any point.
I use the Rider–Waite–Smith deck, illustrated by Pamela Colman Smith (1909, public domain).
Therapy first: tarot is a tool, not the reason
Therapy is health care. Whether you use insurance or pay for sessions yourself, we begin with an assessment and a treatment plan built around what is getting in the way of your life. Tarot is one tool I may use toward those goals.
- If you use insurance, your plan covers therapy when there is a diagnosis and the sessions are medically necessary, which means they treat a mental health condition that affects your daily life. Insurance does not pay for tarot readings, and sessions are never billed as one. My notes show how each part of a session, the cards included, serves your treatment goals.
- If you pay for yourself, the same clinical approach applies: an assessment, a plan, and goals we review together.
- If there is no clinical concern, and you want tarot for reflection, creativity or personal growth, you may be looking for coaching or a reflective practice rather than therapy. That is useful to know, and the checklist below can help you sort it out.
Is this the right fit for me?
Tick anything that sounds like you. This is not an assessment or a diagnosis, and nothing you tick is saved or sent anywhere. It stays on your screen.
Your ticks will show here.
Middle Path Coaching is my separate coaching practice. Coaching is not therapy and is not covered by insurance. If you are a current BridgePath client, please talk with me before starting coaching.
When the cards may not be the right tool
Tarot is optional, and some times call for other approaches: when images feel distressing or confusing, when the cards conflict with your faith or values, or when steadiness and safety need to come first. We will decide together, and therapy works well without them.
My training
I have completed continuing education in the clinical use of tarot that counts toward my licenses in Washington, Idaho and Utah, including:
- Tarot Certificate Program (Cascadia Training; Dreya Blume, LCSW), 18 hours, 2026
- The Hidden Self: Shadow Work as a Clinical Intervention (Cascadia Training; Dreya Blume), 2026
- Tarot & Acceptance and Commitment Therapy: Values Work Through Archetype and Imagery (Dreya Blume), 2025
- Using Tarot Card Imagery with Clients: Clinical and Ethical Applications (Cascadia Training; Dreya Blume, LCSW), 2025
- The Tarot Journey in Action (Lancaster Psychodrama; Karen Carnabucci), 2024–2025
- Ethical & Clinical Applications of Tarot Cards (Dreya Blume), 2024
What the research says
Research on tarot in therapy is still small and mostly qualitative. Studies describe people using the cards for self-reflection, comfort in hard times, new perspectives and naming goals, rather than for prediction (Hofer, 2009), and describe tarot as one possible addition to integrative counselling (Semetsky, 2005). It is not an evidence-based treatment on its own, which is why it sits inside therapy approaches that are.
Hofer, G. (2009). Tarot cards: An investigation of their benefit as a tool for self reflection [Master's thesis, University of Victoria]. UVicSpace.
Semetsky, I. (2005). Integrating tarot readings into counselling and psychotherapy. Spirituality and Health International, 6(2), 81–94.
Tarot sessions are not for emergencies. In a crisis, call or text 988, call 911, or go to the nearest emergency room.