First we give a number-theoretic proof for the direction you did not deal with. After that, we give a couple of proofs for the other direction. These are similar to the proof that you described, but fill the gap mentioned in the comment by @Jyrki Lahtonen.
As much as possible, your notation is used. The primality of $p$ is nowhere used, and is not needed. I do not think that assuming primality allows for any real simplification.
Suppose that $q \not \equiv 1 \pmod{p}$, and $a^p \equiv b^p \pmod{q}$. We will show that $a\equiv b \pmod{q}$. We can assume that neither $a$ nor $b$ is congruent to $0$ modulo $q$.
Since $q\not\equiv 1 \pmod{p}$, the numbers $q-1$ and $p$ are relatively prime. By Bezout's Theorem there exist integers $m$, $n$ such that $m(q-1)+np=1$. Thus
$$a=a^1=a^{m(q-1)+np}=a^{(q-1)m}a^{pn}\qquad\qquad\text{(Equation $1$)}$$
By Fermat's Theorem, $a^{(q-1)m} \equiv 1\pmod{q}$.
From Equation $1$, we conclude that
$$a\equiv (a^p)^n \pmod{q}.$$
Similarly,
$$b \equiv (b^p)^n \pmod{q}.$$
It follows that if $a^p \equiv b^p \pmod{q}$ then $a \equiv b \pmod{q}$.
Note: The integers $m$ and $n$ are not both positive. As usual, we interpret a negative power as the inverse modulo $q$ of the corresponding positive power.
The other direction: Suppose that $q \equiv 1 \pmod{p}$. We show that there exist $a$, $b$ which are incongruent modulo $q$ such that $a^p \equiv b^p \pmod{q}$. As in your proof, let $pk=q-1$.
Let $b=1$. We show that there exists $a$ not congruent to $1$ modulo $q$ such that $a^p \equiv 1^p \pmod{q}$.
By Fermat's Theorem, the natural candidates for $a$ have shape $c^k$, with $c$ not congruent to $0$ modulo $q$. This is because
$(c^k)^p =c^{kp}=c^{q-1}\equiv 1 \pmod{p}$.
So all we need to do is to show that there exists $c$ not congruent to $0$ such that $c^k$ is not congruent to $1$ modulo $q$.
(i): If we are allowed to use a little information about fields, this is immediate. For the equation $x^k=1$ has at most $k$ solutions in the integers modulo $q$. Since $k \le (q-1)/2$, there are indeed many $c$ with the desired property.
If we are not allowed to use that fact, we can prove it. The fact that in our field (or indeed any field) a polynomial of positive degree $k$ has at most $k$ roots can be proved by induction on degree. If we don't want to use field-theoretic language, the induction step is that if $r$ is a root modulo $q$ of the polynomial $P(x)$, then there is a polynomial $Q(x)$ with integer coefficients such that $P(x)\equiv (x-r)Q(x) \pmod{q}$. The proof is essentially the same as the high school proof of the Remainder Theorem. Divide $P(x)$ by $x-r$ in the usual way, and prove that the remainder is congruent to $0$ modulo $q$ by putting $x=r$.
(ii): If we are allowed to use the fact that $q$ has a primitive root, meaning, in group-theoretic terms, that the multiplicative group modulo $q$ is cyclic, any primitive root of $q$ can be taken as $c$.