With demand for mental health support remaining high, there are opportunities to build a career in the NHS, private practice, charities and other organisations.
What type of therapist do you want to be?
Therapists can work with people experiencing anxiety, depression, stress, relationship problems, bereavement and many other challenges. You may also decide to develop a particular specialism, such as trauma, addiction, couples therapy or working with children.
Having a specialism can help you understand the needs of a particular group and make it easier to establish your professional identity.
The training route will depend on the type of therapy you want to provide. The British Association for Counselling and Psychotherapy recommends a practitioner training route that includes at least a Level 4 Diploma or equivalent, supervised placement experience and at least 100 client hours.
Do you want to work for another company?
Working for an organisation can be a good way to gain experience when starting out.
You could work for the NHS, a private therapy company, charity or other mental health organisation. This can provide a structured environment, regular clients and the opportunity to learn from more experienced professionals.
For some new therapists, employment can also provide greater financial security while they build their confidence and experience.
There is clearly demand for therapy services. In 2024-25, NHS Talking Therapies received 1.81 million referrals in England, showing the scale of need for support with anxiety and depression.
Would you prefer to work for yourself?
Private practice offers a different type of freedom. Working for yourself means you can decide which clients you want to work with, what hours you offer and how you structure your practice. You can also develop your own brand and reputation over time.
However, self-employment comes with additional responsibilities. You will need to consider areas such as insurance, record keeping, supervision, data protection, marketing, accounting and finding suitable premises.
It can take time to build a steady client base, so some therapists choose to begin privately while continuing other employment.
Could you work both employed and independently?
You do not necessarily have to choose between employment and private practice.
Many therapists find that combining the two gives them a useful balance. Working for an organisation can provide regular income and experience, while private clients can allow you to develop your own practice.
This approach can also give you time to discover which type of work you enjoy most before committing fully to self-employment.
Should you offer therapy in person or online?
Another important decision is how you want to deliver your sessions.
Online therapy has become a common option, offering convenience for both therapists and clients. NHS Talking Therapies recorded 500,034 Internet Enabled Therapy sessions during 2024-25.
Zoom and similar platforms can make it easier to work with clients who live further away. There is no commute between appointments and you may be able to offer more flexible working hours.
In-person therapy still has clear benefits, however. According to Talking Health, sitting in the same room can help build a sense of trust and connection, particularly when discussing sensitive or personal experiences.
How will you build your reputation?
Once you have your training and working arrangements in place, you need to think about how potential clients will find you.
A professional website, clear specialism and strong online presence can all help. Networking with other professionals can also lead to referrals.
Most importantly, building a good reputation takes time. Providing a professional, ethical and supportive service will help you develop trust and encourage clients to recommend you.
What should you do next?
There is no single route to becoming a successful therapist in the UK. Some people begin with an established organisation, while others gradually build their own private practice.
The key is to choose a route that suits your experience, interests and lifestyle. Decide what type of clients you want to support, consider whether you prefer employment or self-employment, and think carefully about whether online or face-to-face sessions are right for you.
With the right training, supervision and approach, starting out as a therapist can be the beginning of a rewarding and flexible career.
