Thinking of a career in therapy? Here are your options

The route towards a career in counselling or therapy is baffling. When I began my journey eight years ago, I was struck by the jargon and lack of clear, streamlined advice: would I need a PhD, masters or diploma? Should I specialise or generalise? Work with adults or children, individuals or groups, families or couples? Pursue humanistic, psychoanalytic or cognitive behavioural training?

I couldn’t even comprehend the difference between a counsellor, psychotherapist and psychologist, let alone the difference between a psychoanalyst and a psychoanalytic psychotherapist.

The process is convoluted and can quickly become overwhelming. But after many years of self-funded study, training, therapy, work experience and personal investigation I have developed a good understanding of the various routes into the profession. If you are thinking of a career in counselling or therapy, here’s a guide to getting started.

Pick your route

There are five main established paths into this career. In order of the minimum time it takes to qualify, they are: counselling, psychotherapy, cognitive behavioural therapy (CBT), clinical or counselling psychology, and psychiatry.

Psychiatry requires training as a medical doctor first, which you can find out more about here. Clinical and counselling psychology are legally protected terms that cannot be used by anyone who is not officially trained in these. It is unethical to call yourself a counsellor, psychotherapist or CBT therapist without appropriate training – and recruiters will not consider you unless you are a registered member of a recognised regulatory body.

Each route has its own leading body: for counselling it is the British Association for Counselling and Psychotherapy; for psychotherapy it is the UK Council for Psychotherapy; for CBT it is the British Association for Behavioural and Cognitive Psychotherapies (BABCP); and for clinical or counselling psychology it is the British Psychological Society. Each of these bodies accredits courses, so save time by choosing an accredited one. While there are other accrediting bodies, not all are recognised by recruiters.

Getting into counselling

Professional counsellor training takes three to five years and can be diploma or degree level. Qualification requires a minimum number of client hours acquired through a work placement.

The training begins with an introduction to counselling. This takes up to three months, but it can be waived if you have some previous experience. You then apply for a certificate in counselling skills (one year), followed by a diploma in counselling (two to three years). Alternatively, you can train through a university counselling degree. Every course is rooted in an academic theory that informs the way counselling is conducted in practice. There are numerous counselling theories, and all courses list their theoretical approach in advance – once trained, you become a counsellor of your chosen approach, which has an impact on your style of counselling and the way you work with clients.

These can be broadly placed into five categories: psychoanalytic/psychodynamic , which takes the view that a person’s issues are rooted in the past; humanistic , which takes the view that a person’s issues are rooted in their environment; transpersonal, which is more spiritually focused; cognitive, behavioural and cognitive-behavioural, which are more practically-focused, goal-orientated and concerned with the interrelationship between thoughts, feelings and behaviour; and integrative, which is a mix of them all based on what works best for the client.

How does this differ from psychotherapy training?

Psychotherapy is a post-graduate qualification, but your first degree does not have to be in a related field. The training is more academically rooted and can take around five years or more, leading to at least a masters degree.

As with counselling, there are different practices that reflect the different theories. The main difference between a counsellor and psychotherapist is in the academic training. In theory, counsellors work shorter term with life issues, such as bereavement and relationships, while a psychotherapist works over a longer period of time with more complicated or enduring mental health issues. In reality, there is a huge overlap and in practice you will see counsellors and psychotherapists doing both.

What’s involved in cognitive behavioural therapy training?

CBT training is also at post-graduate level but requires a previous degree in a mental health-related field in addition to some experience.

There are two ways into this: through a post-graduate diploma in CBT (listed on the BABCP website), or via the Improving Access to Psychological Therapies (IAPT), an initiative to help improve access to mental healthcare within the NHS. This is a cost-effective way to train as it is funded by the government and trainees earn a salary. If you don’t already have a prior qualification in a mental health related field, your professional experience may still count for something if you work in a setting where counselling skills are used, or if you have volunteered, for example, for a helpline.

You can either train to be a low intensity/psychological wellbeing practitioner, working with mild anxiety and depression or a high intensity CBT therapist, working with people with more complex symptoms.

What is clinical/counselling psychology?

A clinical or counselling psychologist acquires a PhD and registration with the Health and Care Professions Council. You must have a degree in psychology first, though you can do a conversion course to obtain one. The job involves research, coordinating teams, formulating treatment plans, as much as it does working directly with clients and patients. The psychologists typically work alongside psychiatrists, who are the only ones allowed to make diagnoses or prescribe drugs, when assessing clients.

Be prepared for intensive training

Whichever route you choose, the financial and emotional investment is substantial. For some courses you may have to attend therapy throughout your training. Additionally, you need to pay extra for disclosure checks, indemnity insurance and supervision. The courses are also intense and emotionally triggering, which is important to know before making a decision to undergo training. It isn’t an easy journey to make but it’s a fulfilling career and the rewards are worthwhile.

Looking for a job? Browse Guardian Jobs for your next career step.