Comprehensive Psychiatric Consultation and Psychotherapy in New Hampshire
A practice offering careful, unhurried consultation for those 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 of Psychiatry
Geisel School of Medicine at Dartmouth
Medical Director
Licensed in New Hampshire
Clinical Assistant Professor of Psychiatry
Geisel School of Medicine at Dartmouth
Medical Director
Licensed in New Hampshire
About
Brian T. Paul, MD
Psychiatric Consultation & Psychotherapy in New Hampshire
Many of the clients I work with have spent considerable time in treatment. They have often seen other providers, been given a diagnosis, and possibly been prescribed medications. My practice is for adults who want careful, unhurried attention: time to revisit a diagnosis, think clearly about medications, or undertake deeper psychotherapy. It is not an emergency or crisis service.
My approach is to listen carefully, understand each person in the context of their life, think critically about the clinical evidence, and offer honest guidance.
My approach is to listen carefully, understand each person in the context of their life, think critically about the clinical evidence, and offer honest guidance.
Services
Psychiatric Consultation
A comprehensive, independent evaluation for those seeking a second look at their diagnosis, medication history, or overall clinical direction. The consultation considers the full clinical picture, with recommendations grounded in the best available evidence and careful clinical judgment. When appropriate, this may include a thoughtful deprescribing strategy. A written summary is provided and may be shared with an existing care team.
Psychotherapy
An ongoing therapeutic relationship grounded in the core principles of acceptance and commitment therapy and informed by enduring insights from Eastern and Western spiritual traditions.
A Note to Referring Providers
Dear Colleague,
This practice was developed with fellow clinicians and their patients foremost in mind. If you are a therapist, primary care physician, or other treating clinician in New Hampshire working with an adult who could benefit from a comprehensive psychiatric evaluation, a careful review of their medication history, or psychiatrist-led psychotherapy, please encourage them to reach out
For psychiatric consultations, I provide the client with a written report intended to support the existing treatment team, not replace it. With the client’s consent, that report can be shared with you. If you are working with someone whose care involves diagnostic complexity, polypharmacy, trauma, or a long history of partial treatment response, I may be able to provide some clarity.
You are also welcome to contact me for a clinician-to-clinician conversation if that would be helpful. Prospective clients can learn more and contact me directly through this site.
This practice was developed with fellow clinicians and their patients foremost in mind. If you are a therapist, primary care physician, or other treating clinician in New Hampshire working with an adult who could benefit from a comprehensive psychiatric evaluation, a careful review of their medication history, or psychiatrist-led psychotherapy, please encourage them to reach out
For psychiatric consultations, I provide the client with a written report intended to support the existing treatment team, not replace it. With the client’s consent, that report can be shared with you. If you are working with someone whose care involves diagnostic complexity, polypharmacy, trauma, or a long history of partial treatment response, I may be able to provide some clarity.
You are also welcome to contact me for a clinician-to-clinician conversation if that would be helpful. Prospective clients can learn more and contact me directly through this site.
Brian T. Paul, MD
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.