Ella Janneh still remembers the moment she realised the system had failed her. It wasn’t in the therapy room, and it wasn’t in the High Court where she won a civil case against her therapist for rape and sexual assault in 2024. It came afterwards, when she discovered the man who had abused her could still legally call himself a psychotherapist. He could still open his door to vulnerable people. Nothing in law stopped him.
That revelation has become the centrepiece of a landmark report published today by the Commission for the Future of Counselling and Psychotherapy. After a year-long independent review, the commission is calling for statutory regulation of counsellors and psychotherapists across the UK — a move supporters describe as a watershed moment for a profession that has operated in the shadows of the healthcare system for decades.
A profession without a gatekeeper
Unlike doctors, midwives, nurses, or even osteopaths, the titles “counsellor” and “psychotherapist” are not protected in UK law. Anyone — qualified or not — can adopt them. There is no legal barrier to entry, no mandatory register, and no statutory mechanism to strike off a practitioner found guilty of misconduct. The current landscape relies on voluntary registers accredited by the Professional Standards Authority, but membership is optional, and removal from one register does not prevent a therapist from simply setting up shop elsewhere.
“For me, the report became a bit of a watershed moment for the profession,” said Phil Hope, the commission’s co-chair and a former Labour care services minister. “A real landmark of the opportunity there is for the government, and all its departments really, to unlock that potential.”
The potential he refers to is staggering. The report estimates a mental health treatment gap of roughly 1.8 million people languishing on NHS waiting lists. Yet practitioners who gave evidence to the commission reported significant spare capacity — enough, the report calculates, to deliver more than 370,000 additional therapy hours every week. That is a resource the state is currently unable to tap, largely because commissioners cannot verify who is qualified and who is not.
The human cost of voluntary regulation
Janneh’s testimony runs through the report like a fault line. Her therapist was struck off the voluntary register of the British Association for Counselling and Psychotherapy (BACP) after her case. But without statutory backing, that sanction carries no legal weight. He remains free to practise.
“Statutory regulation would lock abusive and unethical people out of the system,” Janneh said. “The current lack of centralised regulation allows for repeat offenders to continue practising with no oversight. That is reason enough to bring in regulation.”
She put it more bluntly in a line that has already begun to circulate in Westminster: “Currently your Friday night kebab is subject to stronger regulation than a therapist who sits in rooms alone with vulnerable people.”
It is a comparison that lands because it is true. Food hygiene inspections are mandatory, enforced, and public. The intimate, high-stakes work of psychotherapy — conducted behind closed doors, often with people at their most fragile — operates on an honour system.
Why the resistance?
If the case is so clear, why has it taken so long? The coalition government rejected statutory regulation in 2011, citing cost and proportionality. Successive administrations have echoed that hesitation. Regulation is expensive. It requires a regulator, a legal framework, a register, fitness-to-practise panels, appeals processes — all funded, ultimately, by the taxpayer or the profession itself.
Andrea Sutcliffe, the commission’s other co-chair and former chief executive of the Nursing and Midwifery Council, knows this terrain better than most. “We’ve been on a journey around regulation with counselling and psychotherapy over many, many, many years,” she said. “What the government asks for is a compelling case for statutory regulation because it costs and [it’s not] an easy thing to do … but as independent co-chairs, we feel that a compelling case exists.”
That case rests on three pillars. First, the nature of the work: complex, long-term interventions delivered one-to-one, almost always in private, with no employer oversight. Second, the vulnerability of the client base: people in crisis, often unable to advocate for themselves or assess a practitioner’s credentials. Third, the evidence of harm: the report documents a growing number of abuse and malpractice cases that the current voluntary system has failed to contain.
“We expect those things,” Sutcliffe said of the checks applied to surgeons and cardiologists. “People are in difficult, vulnerable situations, why would we expect them to be experts in working out who they should go to and who is safe?”
A profession ready to professionalise
The report does not merely demand a regulator. It argues that regulation would drive up standards in training, education, and diversity — areas where the profession acknowledges it has work to do. Currently, the multiplicity of training routes and accrediting bodies creates confusion for students and employers alike. NHS commissioners, the report notes, often have “legitimate concerns: is this a qualified psychotherapist or not?”
A statutory framework would also position the profession to engage with the next frontier: artificial intelligence in mental health. Hope warned that practitioners are “seriously concerned at the risk that people may be accessing services that are totally unregulated. And therefore, the profession needs, I think, to up its game a bit and move up the pace here because this is happening.”
There is political momentum, too. Labour MP Sojan Joseph, chair of the all-party parliamentary group on mental health and a former nurse, has pledged to raise the issue in Parliament. The major professional bodies — the UK Council for Psychotherapy and the BACP — have welcomed the report, though both stress that any new system must be co-designed with practitioners and people with lived experience to avoid creating barriers to access or diversity.
Jon Levett, UKCP’s chief executive, said he would welcome regulation that “protects the public, sets clear standards and preserves people’s choice of therapy.” Dr Lisa Morrison, BACP’s chief regulation and standards officer, echoed the call for collaboration to ensure regulation “places public protection, public benefit and public confidence at its heart.”
Why it Matters
For the 1.8 million people waiting for therapy, this is not an abstract debate about professional titles — it is about whether the person they eventually see has been vetted, trained, and held to a standard the law recognises. For survivors like Ella Janneh, it is about ensuring that no one else sits in a room with a practitioner who should have been stopped years ago. Statutory regulation will not prevent every harm, but it will create a floor below which no therapist can fall — a floor that, astonishingly, does not currently exist. The government now has the evidence, the professional consensus, and the moral imperative. The only thing missing is the political will to act.
