Adult psychotherapist
Adult psychotherapists work with adults to assess and treat a range of emotional, social or mental health issues.
You’ll help adults tackle problems such as behavioural issues, common challenges such as anxiety and depression or more complex or severe issues, such as psychosis or a personality disorder diagnosis.
Working life
Treatment usually begins with an assessment which takes place over a number of sessions between you and the patient.
Having trained in one or more psychotherapeutic approaches, you will provide therapy to help people change the ways they think and behave or find better ways to cope. This therapy will provide space for them to express their feelings and gain a deeper insight into the issues they face. This could include group sessions.
Where will I work?
You are likely to work in:
- hospitals
- local clinics and health centres
- in the community
- an Improving Access to Psychological Therapies service
You’ll also work in a multi-disciplinary team including mental health nurses, psychiatrists and a range of other psychological professionals.
Entry requirements
To practise as an adult psychotherapist, you’ll need to undertake appropriate recognised training. You’ll usually need an undergraduate degree in a relevant subject and/or be a qualified and experienced healthcare practitioner, such as a psychiatrist, psychologist, mental health nurse or social worker.
To secure a place on a psychotherapy training course, you will also need to be able to demonstrate that you have relevant experience.
Employers will indicate through the job description/person specification exactly which qualifications they will consider when selecting applicants for psychotherapist roles.
Training
Training usually takes four years, combining study with clinical training under supervision and provided by a number of organisations, which are usually accredited by the UK Council for Psychotherapy (UKCP), the British Association for Counselling and Psychotherapy or the British Psychoanalytic Council.
Clinical training consists of intensive treatment of patients carried out under supervision. Clinical discussions combining theory and practice are held throughout the period of training. Alongside your training, you will be expected to undertake your own personal therapy to build your self-awareness and expand on your ability to relate to others.
The application process for psychotherapy training is administered directly by the individual organisations running the courses.
Must-have skills
You’ll need a range of skills to be a psychotherapist, including:
- a keen awareness of people and their behaviour
- a capacity for study and continued learning
- the ability to relate to a wide range of people
- excellent communication skills
- the ability to work on your own as well as in consultation with others
- a responsible, professional approach, respecting the confidentiality of patients
- emotional resilience and maturity
-
self awaren
ess
-
the ability to empathise with others and make positive relationships
-
an openness to addressing issues of prejudice and oppression
You’ll need to complete:
- a degree in psychology or a related subject like nursing, medicine or social work
- an accredited postgraduate qualification
- 450 hours of practice to be registered as a licensed psychotherapist by the United Kingdom Council for Psychotherapy (UKCP)
Your course should be one recognised by the:
Courses can take up to 4 years to complete.
To become a child psychotherapist, you will need to complete 4 years of training with the Association of Child Psychotherapists (ACP).
You’ll also need experience of working with children or vulnerable adults.
Some courses may expect you go into therapy yourself during your training. This is to help you deal with any issues that may affect you as a therapist, as well as to experience therapy from a client’s point of view.
Entry requirements
You’ll usually need:
- 2 to 3 A levels, or equivalent, for a degree
- a degree in a relevant subject for postgraduate study
More Information
FAQs about careers in the psychological professions
This page has some frequently asked questions about careers in the psychological professions.
There are lots of career options to choose from in the psychological professions. Different areas of expertise are needed in different counselling and psychotherapist roles, or you could work as a CBT therapist, in one of the psychologist roles or in a practitioner role supporting children and young people. If you have lived experience of mental health challenges, being a peer support worker could be right for you. See what you could do.
Most staff in the NHS that provide psychotherapy are clinically qualified healthcare professionals, such as psychiatrists, clinical psychologists, social workers or art, music or dramatherapists who have undergone appropriate training.
Find out more about training to be an adult psychotherapist, child and adolescent psychotherapist or family and systemic psychotherapist.
The NHS employs clinical, counselling, forensic and health psychologists. The training and financial support is different for each. The NHS usually supports a number of students on approved postgraduate clinical psychology courses, whereas students on other courses usually self-fund. However, it is always worth checking with employers and course providers directly.
The NHS offers a limited number of child psychotherapy training posts which are offered by a small number of NHS trusts, or as a partnership between an NHS trust and one of the training providers. These posts provide varying levels of financial support for trainees, in exchange for clinical practice, usually undertaken at an NHS site. Further information on NHS training posts and grants, is available directly from NHS trusts or from the individual training organisations.
Find out more about training in the psychological professions.
IAPT is an initiative to provide greater public access to the talking therapies. Specifically, within IAPT there are opportunities to train as psychological wellbeing practitioners and high intensity therapists.
Find out more about IAPT
However, if you like the idea of using the talking therapies, you might also want to look at opportunities for working as a counsellor, psychotherapist, psychiatrist, clinical psychologist, social worker, mental health nurse, or occupational therapist.
If your degree isn’t in psychology, you can study for an approved conversion course which will give you eligibility for Graduate Basis for Chartered Membership of the British Psychological Society (BPS). This membership then allows you to apply for postgraduate courses in clinical, counselling, health or forensic psychology
See our pages on the role of counsellor and counselling psychologist for more information about how to train.
The NHS also employs staff in a broad range of roles using the talking therapies, including psychological wellbeing practitioner, CBT therapist, psychiatrist, clinical psychologist and others. See our role pages for details.
See our CBT therapist information for all you need to know about training and working in this field.
Yes, it is possible to work as an assistant psychologist. You might also be interested in becoming a clinical associate in psychology. See the information on our clinical psychologist page.
Take a look at our role pages to find out more about working in the psychological professions. There’s lots to choose from!
Increasing access to psychotherapy has long been a strategic objective and charitable goal for UKCP. We are determined that everyone should have access to a full range of psychotherapies, regardless of their circumstances. As such, we have spent the past three years lobbying Ministers, MPs, Peers, civil servants and NHS policymakers to expand the role of psychotherapy across all NHS and other publicly funded settings.
New roles
We are therefore delighted at the recent announcement that funded trainee places will be made available in NHS Improving Access to Psychological Therapies (IAPT) services. The majority of these will be non-CBT roles and all of them will be recruited from outside the existing IAPT workforce.
This is an opportunity we have been calling for and it is fantastic to see NHS England respond. We hope this is part of a new wave of opportunities for psychotherapists to work across NHS settings, turning the tide after many years of structural barriers obstructing their progress.
Anyone interested in applying for these roles can find out how to apply here.
Addressing barriers to NHS work
Over recent months, we have been working alongside Health Education England (HEE) on a project to identify and address the barriers psychotherapists and counsellors face entering the NHS workforce, or progressing their careers once employed. We are thankful to the many members who have given up their time to inform this work.
We have identified consistent barriers to psychotherapists across NHS work settings, including:
- inconsistent pay
- failure to recognise existing competencies, resulting in repetitious training requirements
- exclusion from progression to supervisory, managerial or leadership roles
- misunderstanding of psychotherapy among commissioners, managers and sometimes psychologist colleagues
- failure to replace retiring psychotherapists
- lack of a fully funded training route (in contrast to clinical psychology).
We are hugely grateful to HEE for working with us and other professional bodies to begin to address these issues. The announcement of new IAPT roles is a much-welcome sign that this work is already having a positive impact, leading to a genuine choice of therapies for those referred to IAPT and creating good quality job opportunities for psychotherapists and counsellors. We are hopeful there will be similar progress in other areas, such as NHS services for people with severe mental health issues.
In our submission to the government’s Spending Review last autumn, we called for investment in HEE to support workforce recruitment and training, accompanied by an increased deployment of the psychotherapy workforce in NHS primary and secondary care settings. We are delighted that this ask was met and that this additional investment has enabled this recruitment to take place.
Why IAPT?
IAPT is the avenue to free-to-access talking therapies for a vast number of people in England. In 2019/20, 1.7m people were referred to IAPT services for support with depression and/or anxiety. There is a commitment in the NHS Long Term Plan to substantially increase the number of people accessing IAPT services and, in the wake of COVID-19, the demand for support is likely to increase.
Some psychotherapists and counsellors have historically raised concerns about elements of the IAPT model such as the limited number of sessions, the manualised models of therapy, the marginalisation of non-CBT therapies and, in some instances, the requirement for self-funded top-up trainings. However, at this moment of expansion, it is critical that the millions of IAPT service users have access to a choice of therapies and the best chance of finding what works for them.
Working in an IAPT service is by no means for everyone. But we know from speaking to members that many psychotherapists are eager to find NHS work at this level, particularly if a smooth pathway into these roles is created. The opportunity to work with a diverse range of clients, work within a team environment and the potential for supervisory training is attractive to many. Furthermore, if we wish to bring about further positive changes to IAPT, our professions will need to establish a stronger foothold within it.
To this end, we are very pleased that the psychotherapy and counselling professions will now be formally represented within the IAPT Expert Advisory Group, having previously been excluded from this influential setting. This is further testament to the benefit of a more collaborative model of working.
Our calls answered
We have consistently called for both the expansion of non-CBT therapies in IAPT and the creation of paid training routes into these therapies – which include Dynamic Interpersonal Therapy (DIT), Counselling for Depression (CfD), Couples Therapy for Depression (CTfD) and Interpersonal Therapy (IPT). These asks are essential to achieve a choice of therapies for IAPT service users and a viable pathway for psychotherapists and counsellors to enter the workforce.
We are therefore delighted that both these asks have been met with the recent announcement.
In the coming weeks, IAPT services across all regions of England will be advertising High Intensity Therapist posts in DIT, CfD, CTfD, IPT and CBT. Successful applicants will receive training in the relevant therapy model and all posts are salaried and training fees fully funded.
In addition to the models of therapy more closely aligned with typical UKCP trainings, NHSE have emphasised that they are also encouraging any interested psychotherapists and counsellors to apply for CBT roles.
Only the beginning
With such ambitious plans for the expansion of IAPT and other NHS mental health services, the greatest challenge to deliver these is workforce. As we have been saying for years, the NHS will only be able to meet its targets if it taps into the existing, highly trained workforce of psychotherapists and counsellors. We are glad to see this message has landed and we are looking forward to working alongside the NHS on similar initiatives in the coming months, not just in IAPT but in all NHS mental health services across the four nations.
Adam Jones
UKCP Policy and Public Affairs Manager
Frequently asked questions
The Improving Access to Psychological Therapies (IAPT) programme was launched in 2008 to provide NICE-recommended psychological therapies for adults with mild, moderate and severe depression and anxiety disorders. In the past year alone more than one million people accessed NHS IAPT services for help to overcome their depression and anxiety, and better manage their mental health. IAPT services are provided directly by the NHS, as well as by third sector providers commissioned by the NHS.
IAPT offers a ‘stepped care’ system. At Step 2, qualified Psychological Wellbeing Practitioners (PWPs) provide high volume, low intensity CBT-based interventions, for people with mild to moderate depression and anxiety disorders. At Step 3, qualified High Intensity Therapists deliver a range of NICE-recommended evidence-based therapies, including:
- Cognitive Behavioural Therapy (CBT)
- Counselling for Depression (Person Centred Experiential Counselling for Depression)
- Couple Therapy for Depression
- Brief Dynamic Interpersonal Therapy (DIT) – for depression
- Interpersonal Psychotherapy for Depression (IPT) – for depression
Therapists need to have been trained in the particular therapy or therapies that they deliver in IAPT, with linked professional accreditation with the relevant professional body.
NHS England and Improvement and Health Education England is now investing an additional £20 million in the training and recruitment of new High Intensity posts in IAPT services across England as part of a special initiative to accelerate the expansion of services. These trainee posts are open to people with a core profession (including many qualified counsellors and psychotherapists) who are not currently working within an IAPT service.
The training posts are salaried, training fees are funded and services will be strongly encouraged to make the posts permanent. Nationally, posts will cover several IAPT modalities (CBT, Counselling for Depression, IPT, DIT and Couples Therapy for Depression) and will be available in every region of England. The majority of posts and associated training will start in June 2021.
The NHS Long Term Plan set out ambitious plans to see the number of people with anxiety disorders or depression who can access talking therapies through IAPT increase by an additional 380,000 per year to reach 1.9 million by 2023/24. In addition, the COVID pandemic has led to an increase in need, especially for the High Intensity therapies. This will require a rapid and substantial expansion in the IAPT workforce and bringing in new talent to our NHS-funded services.
This initiative is specifically focussed on recruiting people from outside of IAPT with a core profession to support expansion of IAPT as set out in the NHS Long Term Plan. However, in addition to this specific initiative services recruit for High Intensity Therapist Trainees all year round and all of these posts are also open to people with a core profession (see more detail on who can apply below). If these roles are of interest to you, but timing is not right there will be further opportunities beyond this specific initiative and we would very much encourage you to contact your local IAPT service for more information.
Counsellors and psychotherapists interested in applying for these posts will need to meet the professional accreditation requirements set out in the IAPT Manual for the specific modality training.
To apply for a High Intensity therapist trainee role in a non-CBT modality (e.g. Counselling for Depression, DIT, IPT, Couple Therapy for Depression) you will need of one of the following professional accreditations:
- UKCP Registered Psychotherapist or Psychotherapeutic Counsellor
- ACC Accredited
- BACP Accredited
- BPC Registered
- NCS Accredited Professional Registrant
To apply for a High Intensity CBT trainee post you will need a BABCP-recognised core professional qualification as set out here (counselling, psychotherapy/psychotherapeutic counselling, social work, mental health nursing, occupational therapy, clinical, counselling, health, educational or forensic psychology, medicine or art therapy).
Further details will be set out in the job descriptions of advertised posts.
Potential applicants must apply directly for a trainee High Intensity role with an IAPT service, who are the employing organisations. Posts will be advertised by IAPT services on the NHS Jobs website. Some roles may also be advertised on local job sites or other recruitment platforms such as Indeed.
To find a trainee post in your region, search using keywords ‘IAPT’, ‘Trainee’ or the name of the modality you are interested in (eg High Intensity CBT, Counselling for Depression). Individual posts will set out further details about the eligibility criteria for applying.
Services are already starting to advertise posts and will be continuing to do so over the next few months, so do keep an eye out on the NHS Jobs website. Some roles may also be advertised on Indeed or other recruitment platforms.
Outside this specific initiative, IAPT services recruit to High Intensity Trainee posts across the year and are always looking to recruit people from outside the existing IAPT workforce with core professions. Keep an eye on jobs.nhs.uk or the website of your local IAPT service to find these roles in the future.
In addition, the NHS offers a huge range of exciting and challenging opportunities for people who are passionate about making a difference. NHS services (including IAPT services, GP surgeries, secondary care mental health services and physical healthcare services) are always looking for talented people to join their workforces and contribute to the delivery of quality care for service users, families and carers. Posts are advertised on the NHS Jobs Website. For details of careers in the psychological professions see https://www.ppn.nhs.uk/resources/careers-map.
