Psychotherapists work with individuals, couples, families and groups to help them overcome a range of psychological and emotional issues. Psychotherapists use personal treatment plans and a variety of non-medical-based treatments to:
- address the client's thought processes, feelings and behaviour;
- understand inner conflicts;
- find new ways to deal with, and alleviate, distress.
Types of psychotherapist
Psychotherapists take a number of approaches according to the theoretical models they adopt and the therapy they practise.
These 'talking therapies' include:
- cognitive behavioural therapies;
- psychoanalytic and psychodynamic therapies;
- humanistic and integrative psychotherapies;
- systemic therapies;
- experiential constructivist therapies.
Psychotherapists work with individuals on a one-to-one basis, with couples and families, and with groups of clients. The client is an active participant in the therapies.
Duties typically include:
- conducting a series of individual sessions with a client - normally lasting between 30 minutes to an hour, one or more times per week. These assess need, build trust (a therapist may work with clients for just a few sessions or over a longer period of two or three years) and explore issues;
- encouraging the client to talk about and explore their feelings and behaviour;
- running group sessions with people undergoing therapy in a clinical setting;
- conducting group sessions in a training capacity for other professionals, such as social workers, nurses and teachers, who are interested in learning more about how groups work and how they function within them;
- keeping abreast of developments in theory and research;
- networking within the health professional community and other potential business areas to maintain continuity of work and client base;
- evaluating therapy outcomes and writing reports;
- in certain settings, such as The National Health Service (NHS), working to targets, such as seeing a number of clients over a particular period in order to meet service expectations and performance management targets;
- undergoing supervision (in order to raise personal issues and professional concerns arising from work) with another appropriately qualified person, as well as supervising other psychotherapists.
The role of psychotherapist can overlap with the role of counsellor. To find out more about the work of a psychotherapist, see the UK Council for Psychotherapy (UKCP).
- The range of typical starting salaries for a trainee psychotherapist falls between £21,692 and £28,180.
- Qualified psychotherapists' salaries range from £26,041 up to £47,559 with several years' experience.
There is no standard scale of fees and private practice rates vary considerably; usually charging between £40 and £100 per hour depending upon the circumstances of the client.
Salaries vary according to experience.
For NHS salaries, see the Agenda for Change (AfC) Pay Rates.
There is no nationally recognised grade for psychotherapists working with adults.
Income figures are intended as a guide only.
Working hours are typically Monday to Friday, 9am to 5pm but can often involve extended working days, particularly in private practice, as clients come before or after working hours. If employed in a residential setting, working shifts may be necessary. Part-time work is possible. Career breaks are feasible, although those in private practice would have to rebuild a client base.
What to expect
- Self-employment and freelance work is possible. However, building up a client base takes time, and many do not achieve a full-time practice. Issues such as overheads, insurance, supervision and support groups have to be taken into account before considering self-employment or freelance work.
- Self-employed practitioners work from home, in an office or from shared premises.
- There are currently more women than men working in this role.
- A support framework is essential, as the work is emotionally demanding. It can also be solitary.
- Travel within a working day, absence from home at night and overseas work or travel are uncommon, although there may be work available abroad in places such as war zones and disaster areas.
Although this area of work is open to all graduates, the following subjects may increase your chances:
- social work;
Entry with an HND only is not possible. Applicants will need a good honours degree in the relevant subjects and have previous experience from working in a related area, such as social work, mental health professions, psychology and psychiatry.
A pre-entry postgraduate qualification is essential. Details of the requirements necessary for students and trainees are available from the UK Council for Psychotherapy (UKCP). The usual requirement is a Masters degree in psychotherapy. Search for postgraduate courses in psychotherapy.
Courses are normally part time and take four to six years to complete. They include theory, supervised clinical work and clinical seminars. Training in an established institution will almost always include undergoing personal therapy.
Not all training programmes necessarily give clearance to practise as a psychotherapist, so check course content and qualifications carefully.
For a recognised position with a public institution, training that conforms to standards set by the UK Council for Psychotherapy (UKCP) or the British Psychoanalytic Council is usually required. Prospective employers usually specify which psychology qualification they seek in their job adverts, so it can be useful to consult job postings on NHS Jobs before deciding on a training course.
For private practice psychotherapy, there is currently no registration or licensing of psychotherapists in the UK and so there are no specific qualifications required.
Psychotherapists need to be able to separate their own feelings and emotions from those of the patient, with the resilience not to be overwhelmed by the clients' problems.
The selection process is rigorous and some training courses are heavily oversubscribed.
Training in psychotherapy is expensive (personal therapy and fees) and grants are few. As many of the courses are part time, students often work during their training. There is a limited number of training posts in adult psychotherapy in the National Health Service (NHS) offering varying degrees of financial support in exchange for clinical practice, usually at an NHS site.
The NHS Improving Access to Psychological Therapies (IAPT) programme, for example, has led to an increase in training posts in cognitive behavioural therapy in many NHS trusts. Vacancies are advertised on NHS Jobs.
You will need to have:
- self-awareness, sensitivity and empathy;
- a broad-minded, non-judgemental attitude and a respect for others;
- a genuine interest in the emotional problems faced by people;
- common sense;
- an understanding of the importance of confidentiality and also an awareness of its limitations;
- a belief in people's inherent ability to change and develop;
- an energetic and positive approach;
- an ability to establish rapport with others;
- a sense of humour;
- an understanding of equality and diversity issues;
- confidence to explore difficult and painful aspects of a patient's life.
Pre-entry experience is required. Life experience is essential for prospective psychotherapists in order to cope with the extremes of human emotion, ambiguity and vulnerability that they are likely to encounter.
Psychotherapy is commonly a second career with many people coming from clinical psychology, psychiatry, mental health or social work backgrounds.
Psychotherapists work in a variety of environments in the National Health Service (NHS), including:
- community-based clinics;
- hospitals (within in-patient areas);
- general practice surgeries;
- student health services;
- social services departments.
Psychotherapists in the NHS usually work as a member of a multidisciplinary team made up of psychiatrists, social workers, psychologists, family therapists, occupational therapists, mental health nurses and therapists.
Some psychotherapists are employed by universities and training institutions where they teach, conduct research or facilitate training for groups of medical professionals and other health workers, for example nurses and social workers.
Some psychotherapists set up in independent private practice, where competition is strong. Building a practice, especially in the early years, is difficult and many do not achieve a full-time professional career.
Look for job vacancies at:
Recruitment agencies rarely handle vacancies.
A psychotherapist may be a medical health professional who has done further specialist training in psychotherapy, or a non-health professional who has undertaken in-depth training in this area.
Irrespective of their background, all psychotherapists are required to participate in continuous professional development (CPD) and keep abreast of clinical and theoretical papers, which can be done by regular attendance at conferences, courses or meetings.
For a list of training locations that are approved by the British Association for Counselling and Psychotherapy (BACP) see the BACP Accredited Course Search. Their courses are organised and led by experienced BACP psychotherapists and are presented in a number of formats, ranging from introductory lecture/discussion groups, to post-qualification workshops.
This ensures that courses remain accessible to psychotherapists from a range of professional backgrounds and who are at different stages in their careers.
Training routes vary between different areas of psychotherapy. Contact the relevant membership organisation for the specialist area you are interested in to identify training and accreditation options.
For example, some psychotherapists may specialise in hypnotherapy. Information about this can be found at:
Individual BACP membership
If you have successfully completed and graduated from a minimum of a one year full-time or two year part-time counselling and/or psychotherapy qualification, that included a supervised placement with a minimum of 100 contact/client hours as an integral part of the course you are eligible to join BACP as an Individual Member.
You will then have 24 months to progress to the Registered Member MBACP category.
Registered BACP membership
Registered members have their details placed on the BACP Register of Counsellors and Psychotherapists, in order to attain this level of membership you must have graduated from a BACP accredited course, or have graduated from your course and have successfully completed the BACP Certificate of Proficiency.
Opportunities for advancement will vary depending on the interest and expertise of the individual, as well as geographical mobility.
Managerial responsibility is possible within NHS mental health services, although this usually means a reduction in clinical work as the emphasis moves to managing individuals and services.
Lecturing and clinical teaching in universities or training institutions is an attractive career development route to some practitioners.
With extensive experience, it is possible to become a training therapist, training student psychotherapists, or a supervisor, providing support to other psychotherapists.
A growing number of therapists undertake research and also act as consultants to allied professional and community organisations.
Psychotherapists can undertake 'trainings' in more than one area of psychotherapy. For example, training first in psychodrama psychotherapy and then later in group analytic psychotherapy.
Some psychotherapists specialise as child psychotherapists.
It is important for all psychotherapists to access sources of professional support and to keep up to date with new developments in psychotherapy. This can be achieved through membership of a relevant professional body, such as the:
- British Association for Counselling and Psychotherapy (BACP)
- UK Council for Psychotherapy (UKCP)