Taking that first step towards working with a therapist can feel like an achievement in itself and daunting too. But how much do we really know about our therapists, and what we should be looking for when seeking help?

Conversations around mental health have become much more commonplace. Whether it’s workplaces offering help and support or chatting with friends and family over coffee or on a walk, we’re becoming more open and honest about how we’re feeling. But are we as careful with our mental health as we are with our physical health?

Chances are, you wouldn’t consider going to see an unregistered doctor or nurse. But is that through conscious choice, or because we’re all so used to knowing that the NHS is there to offer us access to fully qualified, experienced healthcare professionals? When we’re at our lowest, are we really in the right place to be asking tough questions about the support that is available to us?

The state of mental health support in England

In June 2024, Rethink Mental Illness called for the government to ‘fix the mental health system’, as the majority of those who had attempted to access mental health services within the last two years felt they weren’t seen quickly enough. Four in five seeking help felt they experienced a deterioration in their mental health. This, in turn, led to a third turning to private mental health treatment.

Adults aren’t the only ones left waiting for treatment. In March 2024, the Children’s Commissioner revealed that over a quarter of a million children and young people (270,300) were still waiting for mental health support. While the majority of children and young people accessing support waiting 35 days, nearly 40,000 children waited over two years for mental health support.

With an estimated 1.2 million people waiting for mental health services, long wait times, often limited treatment options, and a shortage of qualified therapists in the NHS, it’s no wonder private therapy has become an important alternative. But how many of us know how private therapy works, what what regulations are in place?

Is therapy regulated?

In October 2024, ministers faced new calls for the regulation of all psychotherapists and counsellors, as lawyers reported a rise in lawsuits by patients for alleged harm done during therapy. While many healthcare professionals have protected titles (only someone with very specific qualifications could call themselves a doctor or a midwife, for example), many mental health related titles are not protected – and that’s something not everyone realises

Although some specific titles are protected, general terms including ‘psychotherapist’ and ‘counsellor’ are not protected or statutorily regulated in the UK. Without regulation, this means that, in theory, anyone without a qualification can use these titles – and keep practising after an episode of misconduct.

Back in 2020, the UK Government announced that they had no plans to introduce statutory regulation of counsellors or psychotherapists. When responding on behalf of the Government, Lord Bethel commented: “While statutory regulation is sometimes necessary where significant risks to users of services cannot be mitigated in other ways, it is not always the most proportionate or effective means of assuring the safe and effective care of service users.”

One of the concerns raised by the idea of statutory regulation is that it may only lead to a shift in the problem (practitioners changing their title and continuing on) or to experienced professionals leaving altogether at a time when waiting lists are still long and many of us are still seeking help.

So, what does this mean for those of us seeking therapy? Can anyone really call themselves a counsellor? What protections are out there, and how can we navigate the multitude of professionals offering their help while keeping ourselves safe?

Counselling: Can anyone do it?

Working with a counsellor or therapist is an intimate process that can leave you feeling vulnerable. Designed to create an environment where you can feel comfortable exploring your thoughts, feelings, and deep-seated emotions without fear of judgement, it’s important to find someone you feel comfortable opening up to and that you can trust. But how do you know the therapist you’ve found will provide a high standard of care?

Currently, there are no laws against anyone operating as a therapist, psychotherapist, or counsellor in the UK. A BBC investigation in early 2020 revealed that thanks to cheap online courses that are easy to cheat, many qualifications could be ‘meaningless’.

While there are no laws in the UK regarding counselling and psychotherapy, there are guidelines in place. According to these guidelines, practising counsellors should have at least an appropriate diploma, or have completed a course with 400 or more hours of therapy training. They may have further qualifications, such as a BSc or BA (Hons) degree, a postgraduate diploma, MA, or MSC, or even a PhD.

At this time, it is completely voluntary for counsellors, therapists, and psychotherapists to become a member of a professional body. Designed to ensure that their members are working to a high standard of practice, professional bodies are there to help reassure us that counsellors and therapists are who they say they are - and that they have the experience and qualifications they say they have.

What are professional bodies?

As explained by Counselling Directory, professional bodies exist to help self-regulate counselling and psychotherapy. Whilst not a legal requirement, professionals who chose to join must meet certain requirements and abide by a code of ethics and complaints procedure, as set out by each individual professional body. Each professional body has a different set of requirements, varying in their degrees of standards. Some offer a single membership type, while others may offer a variety of options, such as Associate Member, Member, or Accredited Member.

Different professional bodies have different requirements for their members, and may even have different levels of membership. For example, one such body, the British Association for Counselling and Psychotherapy (BACP) requires members to have completed a minimum of 450 hours of formal training, in addition to 450 hours of supervised practice with clients (at least 150 of which was completed after receiving a diploma).

Offering a form of self-regulation for counsellors and therapists, while there is no legal obligation to belong to a professional body, being a member can provide not only valuable benefits for the therapists themselves, but for their clients as well. Members of many professional bodies must meet and follow strict codes of ethics, as well as complaints procedures. Finding a therapist who is registered or accredited with a professional body can be a sign of significant levels of training and experience,however, it’s important to remember that not all professional bodies have the same standards or expectations. You can find out more about professional bodies and counsellor registers and their individual requirements, their code of ethics, and how you can get in contact with them if you are concerned via their websites.

How to find a qualified, experienced, accredited therapist

If you are looking for a private therapist or counsellor, there are some steps you can take to help you feel safer and more comfortable.

Ask about their accreditation. Ensuring the professional you are considering working with is a member of a professional body is an important first step. Once they have told you which body they belong to, follow-up by double-checking they are listed with the body that they say they are.

Many of the major accredited bodies, such as the BACP, the UK Council for Psychotherapy (UKCP), and the National Counselling and Psychotherapy Society (NCPS) allow you to check their list to ensure counsellors are indeed members as they say they are. In order for counsellors to have joined these bodies, they will have had to have shown their credentials and qualifications. By finding a therapist on one of these lists, there is also the option to complain officially if things do go wrong.

Some websites such as Counselling Directory only list therapists who have shown proof of membership with a professional body. As explained by Counselling Directory, “Our verification policy is at the centre of everything we do. Therapists joining Counselling Directory must hold individual registration with a robust professional body, with transparent qualifying and experience criteria, and a clear policy for investigating complaints. We display the therapist’s professional organisation on their profile, so anyone wanting to learn more can do quickly and easily.”

Ask about their experience. Knowing if your therapist has worked with similar issues in the past can help to give an extra layer of reassurance and confidence. The more comfortable and confident you feel in their experience, the more likely you are to feel able to open up about issues that are really affecting you. Many therapists and counsellors will offer one or two areas in which they specialise. If there is something you are looking for specific help with, it can be worth considering working with someone who has experience with that area.

Ask about their sessions. Getting to know more about the structure a therapist uses for their sessions can help you to get a better idea of if you will be able to engage with the process itself. With so many different types of counselling available, not every approach will work for everyone. If you’re new to an approach, asking your potential therapist about it and how they incorporate it in their sessions can be a good way to get a feel for whether or not it could be the right option for you.

Have an informal chat. Many therapists will offer an introductory call to have an informal chat about what you are looking for from therapy. As therapist Reuben Heller, Dip. Integrative Counselling, MBACP explains, a free introductory call can be a great way to get a sense of whether a therapist is someone you would be happy to see.

“There is no such thing as a stupid question. A good therapist will answer your questions in simple terms, without using jargon. At the end of the call, you might want to go ahead and book a session, take some time to think it over, or simply not go any further. Trust your instincts.”

Having a short, informal conversation can help you to better understand your potential counsellor’s approach, as well as to see if you feel like this may be someone you feel comfortable opening up to. It’s ok to not click with every type of therapy or with every therapist. Finding the right approach and therapeutic relationship can be key to getting the most out of your sessions.

Take time to reflect. Finding the right counsellor isn’t just about them - it’s about you, too. Ensure you take the time to ask yourself the big questions: What am I comfortable with? Do I know what I need help with? Does a certain ‘type’ of therapy appeal more to me - or are there any that I really don’t want to try? You don’t need to know everything, but having a rough idea of what you feel comfortable with, and what you hope to achieve with therapy can help you to narrow down all of the options out there, and find a professional who’s the right fit for you.

Once you’ve found a therapist you feel comfortable working with, there are still some things to keep in mind. As Counselling Directory member and Counsellor Graeme Orr explains, a good therapist isn’t just there to listen - they’re there to work with you towards getting out of therapy.

“Good counselling is about making clients independent of therapy, not dependant on it. A great therapist will offer you genuine encouragement that you can change. They develop your confidence and independence, noting changes and successes.

“By helping you become independent, a great therapist is making sure that you have confidence in yourself and the future. A great counsellor will help you to make changes in your life. Take your time to choose; call a few therapists. Ask questions. Great therapists will be happy to help you find the right counsellor for you.”

Original publication date: 15 November 2021
Updated: 22 October 2024