Psychotherapist

You'll need to complete accredited training to become a psychotherapist and should look to register with a relevant professional body

As a psychotherapist you'll help clients explore and express their thought processes, feelings and behaviour. Sessions with clients can cover a range of issues, including:

• addiction
• behavioural issues
• eating disorders
• emotional issues, such as anger or grief
• learning difficulties
• mental ill health, for example anxiety and depression
• sleep disorders
• work difficulties, redundancy and job loss
• relationship difficulties and divorce.

During sessions you'll use psychotherapeutic approaches to help clients understand the issues they're facing and find new ways to alleviate and deal with distress. You'll also support them to make positive changes to the way they think and behave. Depending on their circumstances, you may see clients over a few sessions or for a longer period of several years.

As well as working with individuals, couples and groups, some psychotherapists focus on work with families, children and adolescents.

Types of psychotherapist

As a psychotherapist you can take a number of approaches to your work, depending on the theoretical models you adopt and the therapy you practise.

Therapies include:

• constructivist and existential psychotherapy
• family and systemic therapies
• humanistic and integrative psychotherapy
• outcome-oriented and hypno-psychotherapies
• psychotherapy for children and young people
• psychoanalysis.

For a list of therapy approaches, see the UK Council for Psychotherapy (UKCP) Types of psychotherapy and Psychotherapy approaches.

Responsibilities

As a psychotherapist, you'll need to:

• conduct a series of sessions with a client to assess need, build trust and explore issues
• encourage the client to talk about and explore their feelings, attitudes and behaviours
• run group sessions with people undergoing therapy in a clinical setting
• help clients to develop strategies for coping with issues and for making positive changes to the way they think and behave
• evaluate therapy sessions and outcomes and write reports
• conduct 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
• undergo supervision with a qualified supervisor in order to reflect on sessions, and to raise personal issues and professional concerns arising from work
• keep abreast of developments in theory and research
• network within the health professional community and other potential business areas to maintain continuity of work and client base
• work to targets (in some cases, e.g. if working for the NHS)
• supervise other psychotherapists (with appropriate training).

Some work activities can overlap with the work of a counsellor, although the training route is different.

Salary

• Starting salaries for trainee psychotherapists in the NHS usually start at around £35,392 (Band 6 of the Agenda for Change (AfC) pay rates).
• Qualified NHS psychotherapists typically earn £43,742 to £50,056 (Band 7). Salaries for principal psychotherapists can rise to between £50,952 and £68,525 (Bands 8a and 8b). Salaries for consultant psychotherapists can be higher.
• There's no standard scale of fees for private practice work and rates vary considerably. Psychotherapists typically charge between £40 and £100 for a 50 minute session depending on a range of factors, including location. You may offer a limited number of reduced rate sessions for clients on a low income.

Salaries outside the NHS may vary.

Income figures are intended as a guide only.

Working hours

Working hours are typically Monday to Friday, 9am to 5pm. However, you may work outside these hours, particularly in private practice when you may arrange sessions for clients during early mornings or late evenings to accommodate their working patterns.

Part-time roles are available. It is also possible to take a career break but if you work in private practice you will need to rebuild a client base on your return to work.

What to expect

• If you're employed by the NHS you'll 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.
• Self-employment and freelance work is possible. However, it takes time to build up a client base and it's not always possible to achieve a full-time practice. You'll need to take into account issues such as overheads, insurance, supervision and support groups before considering self-employment or freelance work.
• Jobs are available throughout the UK.
• If you're a self-employed practitioner you may work from home, in an office or from shared premises. You may offer sessions in person, via the telephone or online (via Zoom, for example).
• You'll need a good support framework, as the work can be emotionally demanding.
• 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.

Qualifications

To practise as an adult psychotherapist, you should complete an accredited psychotherapy training programme.

The UK Council for Psychotherapy (UKCP) accredits a number of postgraduate psychotherapy training programmes. Taught training usually takes four years part time, with potentially another two years to meet all requirements for practice with clients for accreditation. This includes evidence of approximately 450 hours of practice, theory and skills.

Before choosing a course, consider which psychotherapy approach ('modality') you want to train in as different training providers focus on particular psychotherapies. Contact the relevant professional organisation for the specialist area you're interested in to identify training and accreditation options.

Courses include a mix of written theory assignments, supervised clinical work and clinical seminars. You'll be required to undertake therapy yourself and have periods of supervision throughout the course. For a list of recognised courses, see UKCP - Train as a psychotherapist.

To get a place on a postgraduate training course, you'll usually need a degree in a relevant subject such as:

• psychology
• nursing
• medicine
• social work
• teaching.

You'll also need experience of working in a 'helping' profession, such as nursing, social work, mental health, probation work or teaching.

If you want to work in psychoanalytical psychotherapy, you can complete a postgraduate training programme accredited by the British Psychoanalytic Council (BPC). For a list of member organisations providing training, see BPC Training.

You can also train as a psychotherapist via a course accredited by the British Association for Counselling and Psychotherapy (BACP). Search for a BACP-accredited psychotherapy course.

Psychotherapy is often a second career with many people coming from clinical psychology, psychiatry, mental health, education, nursing or social work backgrounds.

There is currently no statutory registration for psychotherapists in the UK, but in practice you should have a UKCP, BACP or BPC-recognised qualification, and within the NHS this is usually mandatory. This allows you entry onto their voluntary registers, which are accredited by the Professional Standards Authority for Health and Social Care. Registration shows employers and prospective clients that you have a certain standard of education, knowledge and skills.

If you'd like to work with children the training route is different. Find out more about training to become a child psychotherapist.

Skills

You'll need to have:

• self-awareness, sensitivity and empathy
• a broad-minded, non-judgemental attitude and a respect for others
• emotional resilience and maturity to deal with difficult issues
• the ability to work well and think clearly under pressure
• good verbal and written communication and presentations skills
• an ability to establish rapport with others
• time management skills
• the ability to work well as part of a multidisciplinary team
• 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
• a sense of humour and an energetic and positive approach
• an understanding of equality and diversity issues
• confidence to explore difficult and painful aspects of a patient's life.

Work experience

You'll typically need relevant experience of working with either adults or children in an area such as nursing, social work, mental health, probation work or teaching. Previous counselling experience at any level is also advantageous.

Life experience is important as a prospective psychotherapist in order to cope with the extremes of human emotion, ambiguity and vulnerability that you’re likely to encounter.

Find out more about the different kinds of work experience and internships that are available.

Employers

As a psychotherapist it's possible for you to find work in a variety of environments, including:

• hospitals (within in-patient areas)
• community-based clinics and health services
• general practice surgeries
• Improving Access to Psychological Therapies (IAPT) services (England)
• psychiatric units
• residential children's homes
• special educational needs schools
• student health services
• social services departments
• businesses
• prisons.

Another option is to set up your own private practice. This can provide a greater degree of flexibility but it may take time for you to get established with a client list. You may provide services to individuals, couples, families, groups, companies and private hospital referrals.

Employment is also possible with a university or training institution, where you could teach, conduct research, or facilitate training for groups of medical professionals and other health workers, for example nurses and social workers.

Look for job vacancies at:

• British Association for Counselling and Psychotherapy (BACP) Jobs
• British Psychoanalytic Council (BPC) Jobs and opportunities
• Community Care Jobs
• NHS Jobs and NHS Scotland Jobs

Professional development

Once qualified, you should register with the UKCP, BACP or BPC. Registration provides assurance to clients that you've fulfilled the qualifying standards of training and experience and it is usually mandatory for jobs in the NHS. You can also become a member of a professional body relevant to your area of psychotherapy.

You'll need to undertake continuing professional development (CPD) throughout your career. Professional bodies provide a range of CPD activities, including events, member forums, seminars, courses and special interest groups to help increase your knowledge and build a network of contacts. Being a member of a professional body will also help you to keep up to date with new developments in psychotherapy. Postgraduate training providers may also provide CPD courses.

You'll also undergo periods of supervision to help enhance your practice, which involves presenting your client work to a supervisor in order to reflect on the psychotherapy process. With experience you can undergo training to become a supervisor yourself.

If you are setting up in private practice, you may take courses in areas such as business administration, finance and marketing.

Career prospects

Your career prospects will be determined to a certain extent by your interests and expertise. With experience, you could move into more senior psychotherapist or specialist roles and take on a greater amount of responsibility.

There are some opportunities to take up a managerial position within the NHS mental health services, where you would spend less time on clinical work and more time on managing a particular service and team.

Within private practice you'll work on building your reputation and client base, expanding your business as you become more established.

Lecturing and clinical teaching in universities or training institutions is another career development route. Also, with extensive experience, it's possible to become a training therapist, where you'd train student psychotherapists, or act as a supervisor, providing support to other psychotherapists.

You may be able to undertake research in order to become a consultant to allied professional and community organisations, or to deepen your specialisation in a particular area of psychotherapy.