The title of this briefing was updated in November 2025, to clarify that this briefing focuses specifically on psychological professionals working in mental health care.

DOI: https://doi.org/10.58248/RR85

Introduction

Examples of psychological professionals include clinical psychologists, psychotherapists, and counsellors. Psychological professionals deliver mental health care across the NHS, education, employment, third sector, criminal justice system and private practice settings. There are 12 psychological professions funded in NHS healthcare.

Different psychological professionals are trained in different interventions (for example, cognitive behavioural therapy). They may specialise in more than one type of intervention. The most suitable psychological professional and intervention depends on the specific needs of the person receiving care, rather than the professional’s job title or seniority.

There is no single regulatory model that applies across all roles. Some titles are legally protected and regulated, but others are not. This can lead to confusion among the public and variability in standards of training, supervision, care and accountability.

Current regulatory landscape

Title protection and statutory regulation

In the UK, some health professions (such as doctors) are regulated by law. This includes the protection of the professional title and the requirement for professionals to be registered with a designated regulator to practise. For example, only those registered with the General Medical Council (GMC) can legally refer to themselves as a “medical practitioner,” and only those on the Nursing and Midwifery Council (NMC) register can use the title “registered nurse.” In May 2025, the government announced plans to introduce legislation to fully protect the title of “nurse.”

Psychiatrists

Psychiatrists are medical doctors specialising in mental health. They can prescribe medications. Psychologists, however, are not medically trained and do not prescribe medication. This distinction is often misunderstood by the public. All psychiatrists receive training in delivering psychotherapy, and some psychiatrists specialise as ‘medical psychotherapists’. Psychiatrists and medical psychotherapists have their medical practitioner status protected and are regulated by the GMC.

Psychologists

The Health and Care Professions Council (HCPC) regulates certain psychologists under the Health Professions Order 2001. Using any of these titles without appropriate registration is a criminal offence.

Examples of psychological professional titles that have statutory protection and regulation through the Health and Care Professions Council.

Practitioner psychologists
  • Clinical psychologist
  • Forensic psychologist
  • Counselling psychologist
  • Heath psychologist
  • Educational psychologist
  • Occupational psychologist
  • Sport and exercise psychologist

The terms “practitioner psychologist” and “registered psychologist” are also protected terms, which describe the roles above.

Art therapists
  • Art therapist
  • Art psychotherapist
  • Drama therapist
  • Music therapist

Professionals must meet approved education and training requirements, and abide by the HCPC’s standards of proficiency, ethics, and conduct. The HCPC has powers to audit professionals’ continuing professional development, investigate concerns and apply sanctions, including removal from the register.

The term “psychologist” itself has no statutory protection, meaning anyone can call themselves a psychologist. Other titles, including “psychotherapist” and “counsellor,” are not protected by law. There are no requirements for people using these titles to be registered with any professional body or to meet defined training standards. This has prompted calls from some campaigners to extend title protection or introduce statutory regulation for these roles.

Voluntary regulation

For practitioners whose titles are not protected by law, regulation is voluntary. Several professional bodies maintain membership registers and apply codes of ethics and practice, including:

The examples above are not an exhaustive list.

Each organisation sets its own requirements for training, supervision, and conduct.  For example, the BACP requires members to complete a minimum standard of training, adhere to a detailed ethical framework, and undertake regular supervision and professional development.

As registration is voluntary, some psychological professionals may practise without regulation.

Role of the Professional Standards Authority (PSA) in regulating regulators

The Professional Standards Authority for Health and Social Care (PSA) is an independent body that oversees statutory regulators and accredits voluntary registers. Accreditation is based on standards that cover governance, education and training, complaints handling, and public protection. Accredited registers are listed on the PSA website, but the PSA does not have the power to investigate individual practitioners or enforce sanctions. Its remit is limited to assessing the performance of the organisations operating the registers.

Challenges and possible risks

Public understanding

The lack of legal protection for some terms such as ‘counsellor’ may confuse people seeking psychological support. There is no single register for the public to consult, and it may be difficult to distinguish between practitioners with different levels of training or regulatory oversight.

Research on public understanding of psychological professionals is limited. A 2025 BACP public survey of 5,000 UK adults found that 48% of people mistakenly thought that ‘therapist’ is a regulated title like doctor, midwife or dentist.

Studies involving interviews indicate that the public is aware titles such as ‘counsellor’ may be different from ‘psychotherapist’, but they are unsure how. There are also misconceptions about the ability to prescribe medications and the cases that different professionals are able to treat.

Variation in standards

The training and supervision requirements across voluntary registers vary. There is no nationally agreed minimum standard for education, placement hours, or ethical conduct for people practising under non-protected titles.

The Scope of Practice and Education for Counselling and Psychotherapy (SCoPEd) aims to align training, practice and competence requirements for counsellors and psychotherapists. It outlines the minimum training, practice, and competency requirements for members of the Partnership of Counselling and Psychotherapy Bodies, including various accredited bodies.

Some systems, such as Australia, Canada, and some European countries, set legal minimum standards of training and ethical compliance for offering therapeutic services. Commentators have proposed that this allows regulation that is not title-specific and protects against unregulated professionals practising under alternative titles to avoid statutory restrictions.

There is limited research investigating the relationship between regulation standards and quality of treatment. This could include whether unregulated professionals are trained in evidence-based therapy and/or adhere to evidence-based psychological practice, as well as effects on treatment outcomes.

Safeguarding and complaints

People receiving care from an unregulated practitioner may have limited options for raising concerns or reporting harm.

While voluntary organisations have complaints procedures, these lack the statutory powers available to regulators such as the HCPC. The HCPC has discussed the role that regulation can play in protecting the public, but emphasised that this would be a government decision. A removal from an Accredited Register means removal and inability to join other Accredited Registers. However, somebody could be removed from all voluntary registers and still practice using their unregulated title.

There is currently no centralised public data on the number of psychological professionals removed from Accredited Registers each year. The UKCP, which has over 11,000 members, has removed 17 people from its register since October 2020, with four people still under investigation.

Research by campaign group Unsafe Spaces found that, between 2005 and 2015, 72 people or organisations were struck off from either the BACP or UKCP. Their investigation found that at least 17 people (24%) continued to practise with a business website after being struck off.

Parliamentary activity

In 2007, the then government proposed extending statutory regulation to psychotherapists and counsellors, aiming to enhance public protection and align these professions with other regulated healthcare roles. The proposals were not implemented.

In 2024, the public petition “Enact legislation to make ‘psychologist’ a protected title” received over 12,000 signatures, prompting a formal government response. The Department of Health and Social Care stated that there were no plans to introduce statutory regulation for psychotherapists and counsellors but acknowledged ongoing concerns about standards and public understanding. The response highlighted the role of accredited voluntary registers overseen by the Professional Standards Authority (PSA) in providing assurance to the public.

In previous government consultations, regulation was not extended based on the rationale that regulation would prevent many psychologists who do not deliver mental health support (such as academic researchers) from using the title, despite such psychologists having legitimate claim to the title and limited safety risks to the public.

In April 2025, Karin Smyth MP, Minister of State (Department of Health & Social Care), stated “there are no current plans to extend statutory regulation to therapists and counsellors, and no recent assessment has been made of the potential impact of the lack of statutory regulation on patient safety.”

In May 2025, during the House of Commons debate on the Mental Health Bill, Chris McDonald MP addressed the issue of unregulated psychotherapy. He stated “[…] anyone can call themselves a therapist. In 2007, the previous Labour Government considered some form of regulation for therapists, and I encourage the Government to include such regulation in the Bill; it would be the ideal place for it. there has been a strong increase in private practice, and in legal cases arising from issues to do with psychotherapy.”

Commentary from psychological professionals

Some counsellors have said they would welcome increased regulation to enhance credibility and ensure greater consistency for people seeking treatment.

NCPS have said that accredited registers strike the balance of protecting the public while maintaining flexibility in the profession. NCPS have cautioned that using statutory protection would not prevent unregulated practitioners from using alternative terms, such as “wellbeing coach” or “talking therapist”. Similarly, practitioners changing terms could cause greater confusion among the public. They propose that public information campaigns would be more effective.

The UK Council for Psychotherapy (UKCP) proposed the creation of a dedicated statutory regulator for the profession. It suggest that “an alternative approach would be for UKCP itself – or another body representing the sector – to be granted statutory powers by legislation,” forming a bespoke regulator with direct professional input. The UKCP outlined other approaches, including:

In 2022, the BACP stated that, “if the government were to explore the possibility of statutory regulation of counsellors and psychotherapists, it would need to be in collaboration with all the relevant professional bodies and proposals would need to be proportionate to risk.” It also proposed that an enhanced accredited register scheme could deliver strengthened public protection, alongside increased awareness of the registers with the public, employers and commissioners.

POST is grateful to Dr Stephen Naulls, a Parliamentary Academic Fellow and NIHR-funded Academic Clinical Fellow from Brighton and Sussex Medical School, for his support in researching and writing this briefing.

POST would like to thank the following organisations for kindly giving up their time during the preparation of this article:

  • The British Association for Counselling and Psychotherapy
  • The British Psychological Society
  • The National Counselling and Psychotherapy Society
  • Dr Bradley Powell, clinical psychologist

Photo by:  KayJoint/peopleimages.com, via Adobe Stock

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