Portugal’s mental health care system is generally seen as a positive model in Europe. The WHO singled out the Serviço Nacional de Saúde (SNS) for its use and incorporation of new methods, such as cognitive behavioral therapy. Portugal ensures mental caregivers are highly trained and experienced in their fields. This is done via rigid credentialing standards and criteria at the University of Lisbon and beyond.
People’s attitudes toward therapy in Portugal
Portuguese psychologists have a positive attitude toward internet interventions. They are willing to use them in their practice but face some barriers, such as lack of training, technical support, and reimbursement.
Portuguese nurses have more positive attitudes toward mental health than nurses from other European countries (Spain, UK, Finland and Italy), especially regarding stigma reduction, recovery orientation, and patient empowerment². Women and senior nurses tend to have more positive attitudes than men and junior nurses.
Portuguese psychiatric patients prefer psychotherapy over medication for most mental health problems, except for schizophrenia and bipolar disorder³. They also have a high level of acculturation (adaptation to the host culture) and a low symptom load compared to other immigrant groups.
These studies suggest a general openness and acceptance of therapy in Portugal among different populations. However, they also highlight some challenges and limitations that may affect the availability and quality of therapy services in Portugal. For example, there may be a need for more training, support and incentives for therapists who want to use internet interventions or work with diverse cultural groups. There may also be a need for more public awareness and education about mental health issues and treatment options.
Online vs. Offline Therapy Sessions in Portugal
| BetterHelp | In-person therapy |
| $60 to $90 per week (one live session per week, unlimited messaging) | $100 to $200 per session |
| $240 and $360 monthly Get 15% off for Healthy Minded visitors |
How much does a therapy session cost in Portugal?
Costs in Portugal depend on the type of therapy and the experience level of the therapist. Typically, these range from €50 to €150 per session. Additional costs may be associated with the treatment, such as travel or specialized equipment (e.g. CBT triangles).
It’s important to discuss these costs with your therapist before beginning treatment. This ensures you can afford the therapy and clearly understand what’s included in the fees. Treatment is a process; mental health issues can seldom be treated in a single session.
It’s also worth noting that many health insurance plans in Portugal cover some or all of the cost of therapy sessions. We recommend that you check with your provider before booking that first session.
Therapy in Portugal can be considered expensive — particularly in this time of national austerity. But with careful planning and research, you can find mental health professionals who meet your needs at an affordable price.
How can I tell if a therapist is right for me?
Cost and insurance coverage are relatively superficial factors when considering mental health treatment. Those aside, there are key questions you should ask yourself to determine if a therapist is right for you. Four of the most important include:
- Do you feel comfortable and safe in their presence? A good therapist will ensure that your environment is non-judgmental and compassionate. You should always feel like your therapist respects your thoughts, feelings, and experiences.
- Does your therapist have experience in the area you are seeking help for? It’s key that a therapist has expertise in your specific issue. They should be able to provide relevant knowledge and multiple approaches that support your progress.
- Do you feel heard during your sessions? A good therapist will actively listen to your story and validate your experience. They should also strive to provide unbiased opinions, offering helpful and constructive feedback.
- Do you feel the therapy is helping? A good therapist should be able to co-create an action plan with measurable goals and objectives. This enables the both of you to track and assess your progress. A positive therapeutic relationship will help you gain insight into yourself and grow self-awareness.
How does cognitive behavioral therapy (CBT) work?
CBT is a form of psychotherapy focused on understanding the relationship between thoughts, feelings and behaviors. CBT works by breaking down the problem into smaller steps that can be addressed in therapy. Therapists help clients identify patterns of thinking that may be causing distress. These include negative thoughts about themselves or others.
Once identified, therapists work with clients to find alternative, more rational and helpful ways of thinking. Additionally, unhelpful behaviors are identified and replaced with healthier ones. Examples of these include relaxation techniques or problem-solving skills.
CBT aims to give clients greater control over their emotions and behaviors. This is primarily accomplished by teaching them how to better manage irrational thoughts. Ultimately, CBT techniques reframe problematic thought-emotion-behavior patterns into more positive ones.
Foreigners face challenges finding therapy in Portugal
Language barriers: Although many Portuguese people speak English, especially in urban areas and tourist destinations, finding an English-speaking therapist may not be easy. Some online directories of therapists and counselors in Portugal allow you to filter by language¹², but the availability and quality of English-speaking therapists may vary depending on the location and specialty. Alternatively, some foreigners may opt for online therapy with therapists based in their home countries or other countries where they speak the language fluently.
Cultural differences: Some foreigners may find adjusting to Portuguese culture and lifestyle difficult, especially if they come from very different backgrounds. For example, some foreigners may experience culture shock, homesickness, loneliness, discrimination or prejudice while living in Portugal. These issues may affect their mental health and well-being and require professional support.
However, finding a therapist who understands their cultural background and needs may not be easy. Some foreigners may prefer to seek therapy from someone who shares their nationality or ethnicity, while others may look for a therapist who has experience working with diverse cultural groups¹
Legal issues: Some foreigners may face legal challenges with accessing healthcare in Portugal, especially if they are not residents or citizens of Portugal or another EU/EEA country. For example, some foreigners may need to apply for a visa or a residence permit to stay in Portugal legally. Others may need to register with the Portuguese health system (SNS) or get private health insurance to access subsidized or free healthcare services. These processes may be complicated and time-consuming and require various documents and fees. Some foreigners may also encounter difficulties obtaining tax or social security numbers necessary for accessing healthcare services.
These are some possible challenges foreigners may have with finding therapy in Portugal. Of course, these challenges are not insurmountable and there are ways to overcome them with proper research and preparation. If you want to know more details or sources.
Our top five in-person CBT therapists in Lisbon, Portugal
Please note that this is not a definitive ranking or endorsement of any therapist but rather a list of options for you to explore further:
Lea Pereira is a licensed clinical psychologist and certified psychotherapist who offers psychotherapy and counseling services to the international community in Lisbon. She has experience with psychodynamic psychotherapy and intensive short-term dynamic psychotherapy (ISTDP), both evidence-based approaches that address issues such as anxiety, depression, phobias, somatization and personality disorders.
Denisse Revés is a licensed clinical and counseling psychologist with extensive practice in assessing and treating various psychological disorders. She works with adults, adolescents, and children using cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), and mindfulness-based interventions³.
Luigi Palomino is a psychologist and theologian with international experience in counseling and clinical psychology. He works with individuals, couples, and families using an integrative approach that combines humanistic-existential therapy, cognitive-behavioral therapy (CBT), and systemic family therapy.
Leao Miranda is a medical doctor specializing in the treatment of psychiatric disorders. He offers counseling services for individual and family therapy using various modalities such as psychodynamic psychotherapy, cognitive-behavioral therapy (CBT), and interpersonal psychotherapy (IPT).
Jennifer Mancera is a psychologist who offers individual therapy for adults using cognitive-behavioral therapy (CBT), schema therapy, mindfulness-based cognitive therapy (MBCT), and eye movement desensitization and reprocessing (EMDR). She has experience working with anxiety, depression, trauma, stress management, self-esteem, and life transitions.
