Five-card spread for a decision with two paths
intermediate5

A V-shaped layout for comparing two options: which card describes each branch, which one holds the base and why there's no card that tells you which to choose.
You place one card at the bottom centre, two rising to the left and two rising to the right, forming a V. The bottom one describes the point you are at, the common ground of both options. Each branch gets two cards: the first, what taking that path involves in the short term, and the second, what sustaining it afterwards will ask of you.
The usefulness of this layout lies in that second card of each branch. Almost all difficult decisions get stuck because only the first step is considered, which tends to be the showiest one. What really decides matters is what staying there six months later demands, and that is precisely the slot people skip.
Before shuffling you have to name the two options with one sentence each and write them on the left and right of your journal. The sentences have to be comparable: "accept the post in Valencia" and "stay where I am for another year" work. "Change my life" and "no" don't work, because the second branch has no content and the cards that fall there will have nothing to refer to.
There is a limit worth respecting: this spread does not choose. If one branch comes up with the Ten of Pentacles and the other with the Tower, the honest reading isn't that one is good and the other bad. The Tower speaks of something falling that was held up with pins, and that may be exactly what you need. Describe each branch with its two cards, write down both descriptions, and the decision is still yours with more information on the table.
It also doesn't work for decisions that aren't yours, or for asking what the other party will do. If your dilemma depends on someone else's answer that hasn't arrived yet, this spread will hand you back your own expectation spread across five cards.
Forty minutes is a reasonable amount of time, including writing the two descriptions. A sign that it has worked: when you finish you can explain to someone what each option involves using words you didn't have before, even if you still haven't chosen.