Finding an English-Speaking Therapist in Lisbon

The public route: your centro de saúde and the SNS

Portugal's public health service, the SNS, does cover mental health. The way in is your centro de saúde (local health centre). So the first step is being registered there with a número de utente, your SNS patient number. If you haven't done that yet, our guide to registering with the SNS and adding private cover walks you through it.

Step 1: see your family doctor

Book an appointment with your médico de família and explain how you've been feeling. They can assess you, talk through options and refer you on if needed. For psychology, that's usually a referral within your local group of health centres. For psychiatry, it's usually a referral to a hospital psychiatry service.

No family doctor yet? You're not alone, since the wait in Lisbon can be long. If you're registered at a centro de saúde, you can still book a consulta de reforço, an extra appointment, when your health centre releases slots. You book it through SNS 24, in the app, on the website or by phone on 808 24 24 24. If you'd rather not wait, an English-speaking family doctor in Lisbon can see you privately.

Step 2: be realistic about waits

Public psychology is the thin part of the system. Portugal's health regulator, the ERS, looked at this in a study. It found psychologist numbers in public primary care were far below the target Parliament had set, one for every 5,000 people, in every region. What's on offer also varies from one health centre to the next.

So ask your health centre two things: whether it has a psychology consultation, and how long the wait usually is. It's perfectly reasonable to stay on the public list and see someone privately in the meantime.

Step 3: use the SNS 24 counselling line

Even before any appointment, there's a public service you can use today. Call SNS 24 on 808 24 24 24 and choose psychological counselling (aconselhamento psicológico). It's free and it runs 24 hours a day, every day. Psychologists answer, and the service is also available in English.

It's support and guidance, not ongoing therapy. The psychologist can help you through a hard moment, and point you to the right part of the health service if that's what you need. If they think you or someone else is in danger, they pass the call to the emergency medical services.

Language at the health centre

Don't count on English at the centro de saúde. Some staff speak it, many don't. It helps to write down what you want to say in Portuguese before you go, or to bring a friend who speaks it. Talking about feelings through a translation app is hard, which is one reason many expats look for therapy in English privately.

The private route

Going private in Lisbon is usually quicker, and it's where you'll find the widest choice of therapists who work in English. You don't need a referral to book a psychologist privately, you just get in touch. Therapy is a regular cost, so budget for it alongside everything else. Our guide to what it really costs to live in Lisbon helps with the bigger picture.

In person or online

• In person suits a lot of people, especially at the start. Think about getting there, too. A weekly session across the river or out in Cascais adds up when you live in the centre.
• Online is flexible, and it widens your choice of English-speaking therapists. You'll need a private, quiet space, which isn't always easy in a shared Lisbon flat.
• A mix works well for some people, starting in person and moving online when life gets busy.

What to ask in a first call

Many therapists offer a short first call, or a first session to see if you're a good fit. These are fair questions, and a good therapist won't mind any of them.

• Are you a registered psychologist or psychiatrist, and what's your cédula number?
• What's your training, and how do you usually work?
• Have you worked with people going through what I'm going through?
• How comfortable are you working in English? Did you train in English?
• How long are sessions, how often would we meet, and what do they cost?
• What's your cancellation policy?
• Can you give me an invoice with my NIF?
• What should I do if I'm struggling between sessions?

There's no official price table for psychology in Portugal. The OPP says so itself, since each psychologist sets their own fees. So ask about the price before you book, and expect an invoice or receipt for every payment.

Fit matters as much as credentials. The OPP's own advice is to choose someone you feel comfortable with. If it doesn't click after a few sessions, it's fine to say so and try someone else.

Confidentiality

Psychologists in Portugal have a duty to keep what you tell them confidential. The main exception is when there's an immediate risk to someone's life. A good psychologist will explain how they handle that at the start, so you know where you stand.

Does health insurance pay for therapy?

It depends entirely on your policy. Some private health plans in Portugal include psychology and psychiatry consultations. Others leave psychology out, or cap mental health care with a yearly limit. When the consumer association DECO PROteste compared policies, psychiatry was covered more often than psychology.

Inside the insurer's network, you usually pay a reduced, agreed price. Outside it, some policies let you pay the therapist and claim part of it back. Before you choose a therapist, check these things with your insurer, ideally in writing.

• Whether psychology, psychiatry or both are covered.
• The yearly limit, and any limit on the number of sessions.
• Whether there's a waiting period (período de carência) before cover starts.
• Whether you need a doctor's referral or report.
• Whether online sessions count.
• Which English-speaking therapists are in the network, if any.

Invoices, your NIF and the tax deduction

Always ask for an invoice (fatura) with your NIF, your Portuguese tax number. If you don't have one yet, here's how to get a NIF in Portugal.

Here's why it matters. Psychologists' services are exempt from VAT, and VAT-exempt health services can count as health expenses on your Portuguese income tax, the IRS. When we checked, the tax code let you deduct 15% of what you spend on health, up to an overall limit of €1,000. That limit covers all your health costs together, not just therapy.

A few conditions apply.

• The invoice has to reach Finanças through the e-Fatura system, which is why your NIF needs to be on it.
• The provider has to be registered for a health activity, so a coach's invoice usually won't count.
• Any part your insurer pays back doesn't count.
• An invoice from a therapist based abroad usually won't show up in e-Fatura.

Check your invoices on the Portal das Finanças during the year, so there are no surprises when you file.

Therapy in English: finding the right fit

Being understood is a big part of therapy. Even with good Portuguese, many people find it easier to talk about feelings in their first language. That's a perfectly good reason to look for therapy in English.

• Ask about their English honestly. Fluent conversation isn't the same as being at ease doing therapy in English. Ask whether they trained in English, or regularly work with English-speaking clients.
• Ask about their training and approach. Therapists use different methods, and it's fine to ask what theirs is and why. You don't need to know the jargon to ask.
• Think about culture, not just language. Someone who's worked with expats will understand the strain of a move, a new job or a relationship under pressure in a new country.
• Consider your other languages. If you're more at home in another language, ask around. On Locallista alone, Lisbon therapists list languages from Spanish and German to Russian, Ukrainian and Arabic.
• Think ahead about medication. If you might also need a psychiatrist, a therapist who can work alongside your doctor, in Portuguese if needed, makes things easier.

Where to get urgent help in Portugal

Save these numbers in your phone now, before you need them.

• 112, for emergencies. If you or someone else is in immediate danger, call 112. It's free and works 24 hours a day, from a landline or a mobile.
• 1411, the national suicide prevention line. It's for thoughts of suicide or self-harm. It's free and open 24 hours a day, every day of the year. Psychologists and specialist mental health nurses answer, and if a life is at risk the call goes straight to the emergency medical services.
• 808 24 24 24, SNS 24 psychological counselling. It's for anxiety, stress, low mood or a hard moment you want to talk through. Choose the psychological counselling option. It's free, open around the clock and available in English.
• SOS Voz Amiga, for a listening ear. It's a volunteer helpline where you can talk anonymously. It's open every day from 3.30pm to 12.30am, on 213 544 545, 912 802 669, 963 524 660 or 930 712 500. Volunteers answer mainly in Portuguese, so English isn't guaranteed.
• Hospital emergency departments. In a mental health emergency, you can also go to the urgência (emergency department) of a public hospital.

If you're worried about someone else and they're in danger, call 112. Stay with them if it's safe to do so.

A simple order that works

• Save 112, 1411 and 808 24 24 24 in your phone.
• Get your número de utente at your centro de saúde, if you haven't yet.
• Think about what you're looking for: therapy, medication or both. If you're not sure, your family doctor or a psychologist can help you work it out.
• Shortlist two or three English-speaking therapists, in person or online.
• Check each one on the OPP or Ordem dos Médicos register.
• Book a first call and ask the questions above.
• Check your insurance before you start, and ask for an invoice with your NIF every time.

How Locallista helps

Looking for help is hard enough without doing it in a second language. We're a directory of English-speaking local service providers, and Lisbon is one of our cities, so you can find someone you can actually talk to.

Every business is screened before it's listed, reviews are phone-verified, and the ranking reflects real expat experience, not who paid the most. It's free to browse and free to get in touch. When you're ready, look through our English-speaking psychologists in Lisbon, many of whom also offer online sessions. You'll find more options among our English-speaking mental health professionals in Lisbon. And if it's your relationship that needs some care, try couple counselling in Lisbon. Whoever you choose, here or anywhere else, take two minutes to check the register before your first session.