Why Regulation in Psychotherapy and Counselling is Essential for Trust and Safety

Today’s article in the Guardian (19th October 2024) has reinvigorated discussion around an important issue that has long needed attention, the regulation of psychotherapy and counselling in the UK. As a dual-qualified and UKCP accredited psychotherapist and EMCC accredited senior coach, I support this call for regulation within my industry. Though the majority of my peers adhere to the highest ethical standards, regulation could further enhance the credibility and safety of our profession, ensuring that those seeking support receive it from qualified, competent, and ethical practitioners.

Current industry practice

Currently, many psychotherapists and counsellors, like myself, are members of professional membership bodies such as the UK Council for Psychotherapy (UKCP), the British Association for Counselling and Psychotherapy (BACP), or the National Counselling and Psychotherapy Society (NCPS). In turn, these organisations are accredited by the Professional Standards Authority (PSA), providing a level of assurance that their members work ethically and professionally. They set standards for their members, requiring adherence to codes of ethics, ongoing clinical supervision, and continuous professional development (CPD). Being a member of such a body means I am committed to upholding these values, continuously reflecting on and improving my practice.

Evidence Based Practice and Working Within Competence

I carefully consider the evidence base for any therapeutic approach I employ, ensuring that therapy is effective and that it aligns with the specific needs of my clients.

It’s also important to note that, as psychotherapists and counsellors, we are not trained to diagnose mental health conditions. Our role is to be aware of mental health conditions, whilst providing therapeutic support within the scope of our training and competence. Recognising when a client needs more specialised or medical support is an integral aspect of working ethically. If I identify that a client may require support beyond my competence, I work to arrange an appropriate referral or signposting to a medical professional or specialist service. This approach helps clients get the right support at the right time.

This is really important when considering the comments in the Guardian from Dan Poulter, an NHS psychiatrist and former health minister who believes “it’s not always in the interests of the psychotherapist to challenge the person’s self-perceptions or refer them on to somebody else who might be more suited to helping them.” That statement is unhelpful and divisive for the public to see in the argument for regulation. Regulation is important to protect the public from a minority who operate unethically from a place of self interest and provide a base line standard of training in the profession. The majority of the industry do not work that way. An ethical psychotherapist works in the client’s best interest above all, holding ethical principles in mind like do no harm. It doesn’t matter whether we’d have liked to work with that person or if we lose the possibility of paid work, referring on is what needs to happen.

Boundaries and Maintaining an Ethical Therapeutic Relationship

Therapists work hard to maintain clear and professional boundaries. Establishing and upholding these boundaries is key when building a safe and trusting therapeutic environment, ensuring that the client’s wellbeing is held and contained, and that the relationship stays within ethical and professional limits.

Boundaries help protect clients from potential harm and allow for a consistent and secure therapeutic experience. This includes managing appropriate communication outside of sessions, avoiding dual relationships (such as becoming friends or engaging in business arrangements with clients), and ensuring that the therapeutic space remains professional and safe.

Ethical practice also requires therapists to review the therapeutic relationship continuously. If any issues arise, such as a therapist’s emotional involvement becoming too intense or inappropriate, it is vital to address these matters through supervision or, when necessary, make changes to ensure the integrity of the relationship. By adhering to these principles, therapists maintain a safe, ethical environment where clients can feel comfortable exploring their concerns.

How Can You Verify Your Therapist's Credentials?

As members of the public, it’s essential to have confidence in the professionals you turn to for support. You can check if your therapist is registered with a reputable body like UKCP, BACP, or NCPS, all of which are accredited by the Professional Standards Authority (PSA). These organisations maintain directories of their accredited members, providing peace of mind that your therapist has met the necessary standards and continues to do so through supervision and CPD. Choosing a therapist who belongs to a recognised professional body not only protects you but also strengthens the trust between client and therapist, a fundamental aspect of effective therapy.

The Benefits of Regulation for Both Clients and Therapists

While many therapists already work to high ethical and professional standards, regulation would provide a unified framework, ensuring consistency across the industry. This would help eliminate the risk posed by unqualified individuals who may misuse the title of 'therapist' or 'counsellor.' Whilst membership bodies have clear paths to follow if someone ever needed to raise concerns about their therapist’s conduct, a regulatory body would provide further accountability and protections. For example, today if a therapist is struck off from their membership body, they can still set up again and continue to practise as a therapist. 

Moreover, regulation would benefit the coaching industry as well. Currently, coaching is also an unregulated field, and while many coaches, like myself, hold professional credentials and adhere to high standards, the lack of regulation can leave clients vulnerable. By extending regulation to include coaches, there would be a focus on accountability and professional development, ensuring that coaches, like psychotherapists, are properly trained, supervised, and aware of their boundaries when it comes to working with clients.

A Positive Step Forward

Regulation is not about creating barriers; it’s about setting standards and protecting the public. It’s a step towards ensuring that every person seeking support can do so safely, knowing their therapist or coach is qualified, ethical, and accountable. As a community of professionals, we should welcome regulation as it will only strengthen the trust clients place in us and elevate our profession.

In the meantime, I encourage everyone to seek out professionals who are registered with established membership bodies. It's a positive way to ensure that you are working with someone who is committed to their development and your wellbeing. By choosing a therapist or coach who is engaged in evidence based practice, supervision, and CPD, and who adheres to clear ethical and professional boundaries, you can feel confident that you’re receiving support from someone who prioritises your safety and growth.