Thoughtful Psychiatric Consultation and Psychotherapy in New Hampshire
A psychiatrist offering two things that are increasingly hard to find: careful, unhurried consultation for people who want a second look at their diagnosis or medications, and psychotherapy for those ready to do deeper clinical work. Serving New Hampshire by secure telehealth.
Board-Certified Psychiatrist (ABPN) | Clinical Assistant Professor, Geisel School of Medicine at Dartmouth | Licensed in New Hampshire
Who This Practice Is For
There is a particular kind of person who finds their way to Brian T. Paul, MD Psychiatric Consultation & Psychotherapy in New Hampshire. They have often been through several providers. They carry a diagnosis or two, maybe a medication list, but they have never quite had the conversation that made sense of it all. This practice is not designed for emergencies or crisis care. It is for adults seeking time, clarity, and careful psychiatric thinking around complex clinical questions.
This practice exists for exactly that situation. Whether the need is clarity about a diagnosis, a careful review of a long medication history, or ongoing psychotherapy with a physician who engages deeply, the approach is the same: consider the whole person and their lived experience, think critically, and give honest guidance grounded in the clinical evidence.
This practice exists for exactly that situation. Whether the need is clarity about a diagnosis, a careful review of a long medication history, or ongoing psychotherapy with a physician who engages deeply, the approach is the same: consider the whole person and their lived experience, think critically, and give honest guidance grounded in the clinical evidence.
Core Services
Brian T. Paul, MD Psychiatric Consultation & Psychotherapy in New Hampshire is built around two related but distinct branches of clinical work. The first is psychiatric consultation: time-limited, evaluation-focused, and designed to produce a clear clinical picture and written recommendations. The second is psychotherapy: an ongoing therapeutic relationship, structured differently, with different expectations and a longer arc.
Both are available here. They overlap in philosophy but they are different services. The sections below describe each one. If you are unsure which fits your situation, that question can be answered during the initial inquiry.
Both are available here. They overlap in philosophy but they are different services. The sections below describe each one. If you are unsure which fits your situation, that question can be answered during the initial inquiry.
Psychiatric Consultation / Second Opinion
A careful, independent evaluation for people who want a second look at their diagnosis, treatment history, or overall clinical direction. Dr. Paul may review relevant records when appropriate and with consent, considers the full clinical picture, and provides a written report you can share with your existing care team.
Medication-History Review / Deprescribing-Oriented Consultation
A focused review for patients whose medication history has grown complicated across multiple providers or years of treatment. The evaluation considers what helped, what did not, and what the evidence and clinical picture support. A written report is provided.
Psychotherapy
Individual psychotherapy with a board-certified psychiatrist, informed by Acceptance and Commitment Therapy (ACT). The work emphasizes awareness, acceptance, values, and psychological flexibility. This is ongoing clinical work, distinct from the consultation services.
For Clinicians Across New Hampshire
Brian T. Paul, MD Psychiatric Consultation & Psychotherapy is built with clinician referrals in mind. Therapists, primary care physicians, and other treating clinicians in New Hampshire can refer patients who need an independent psychiatric evaluation, a careful medication-history review, or who may benefit from psychiatrist-led psychotherapy as a distinct service.
The consultation report can be shared with the patient and, with appropriate consent, relevant members of the existing care team. The consultation is designed to support the existing care team, not replace it. For cases involving diagnostic complexity, polypharmacy, trauma, or a long history of partial treatment response, this kind of physician-level consultation can be a useful resource for New Hampshire clinicians.
Clinician-to-clinician calls are welcomed before a formal referral if that would be useful. A dedicated For Clinicians page and referral pathway are available on this site.
The consultation report can be shared with the patient and, with appropriate consent, relevant members of the existing care team. The consultation is designed to support the existing care team, not replace it. For cases involving diagnostic complexity, polypharmacy, trauma, or a long history of partial treatment response, this kind of physician-level consultation can be a useful resource for New Hampshire clinicians.
Clinician-to-clinician calls are welcomed before a formal referral if that would be useful. A dedicated For Clinicians page and referral pathway are available on this site.
Board-Certified Psychiatrist
(ABPN)
Clinical Assistant Professor
Geisel School of Medicine at Dartmouth
Nearly a Decade in NH Community Mental Health
Medical Director Experience
NH Medical
License
Telehealth Available Statewide
All services are currently offered by secure telehealth across New Hampshire.
Common Questions
Common questions patients and clinicians often have about psychiatric consultation and psychotherapy. The full FAQ page covers all 20 questions in detail.
What is a psychiatric second opinion?
A psychiatric second opinion is a careful consultation with a psychiatrist for people who want another look at their diagnosis, medication history, treatment plan, or overall clinical direction. It does not necessarily mean changing clinicians or starting over. At Brian T. Paul, MD Psychiatric Consultation & Psychotherapy in New Hampshire, the goal is clarity, a thoughtful formulation, and practical written recommendations that you and your existing care team can work from.
Do you accept insurance?
This is a private-pay practice and does not bill insurance directly. This is an intentional decision: it allows for longer, more comprehensive evaluation than is typically possible in brief insurance-based appointments. Details about receipts, superbills, and out-of-network reimbursement can be clarified during the inquiry process.
What is the difference between psychiatric consultation and medication management?
Medication management involves ongoing prescribing and follow-up visits with the same clinician over time. Psychiatric consultation at this practice is more focused and time-limited. It involves evaluation, diagnostic clarification, medication-history review, and written recommendations, without the consulting psychiatrist necessarily becoming the ongoing prescriber. The goal is to give you and your existing clinicians a clearer clinical picture, not to replace the care you already have.
What kind of psychotherapy does Dr. Paul offer?
Dr. Paul's approach is informed by Acceptance and Commitment Therapy (ACT) and other foundational psychotherapy principles. The work emphasizes awareness, acceptance, values, psychological flexibility, and helping people relate differently to thoughts, emotions, body sensations, and patterns of behavior. This is ongoing clinical work, distinct from the consultation service, and typically involves a longer-term therapeutic relationship.
Can I keep seeing my current therapist, PCP, or prescriber after a psychiatric second opinion?
Yes. The consultation model is designed to support your existing care, not replace it. Many patients continue working with their current therapist, PCP, or prescriber and use the written consultation report as a practical roadmap for next steps. The consultation is designed to support the existing care team, not replace it.
Ready to Connect?
If what you have read here resonates, the next step is a simple inquiry. Brian T. Paul, MD Psychiatric Consultation & Psychotherapy in New Hampshire accepts a limited number of consultations to maintain the depth and quality this model requires. Dr. Paul reviews each inquiry personally and will be direct with you about whether this is a good fit.