Policy position – Statutory regulation of Cognitive Behavioural Psychotherapies
- Background – what is statutory regulation?
- The current regulatory framework of the psychological professions
- The benefits and risks of statutory regulation of the profession: SWOT analysis
- The case for statutory regulation
- Conclusions
- Recommendations
1. Background – what is statutory regulation?
Statutory regulation refers to the system where certain professions are regulated under laws passed by Parliament to ensure they are safe, competent, and fit to practise. There are many professions under statutory regulation including barristers, veterinary surgeons, social workers, train drivers, teachers and doctors.
Statutory regulation is established by law with specific Acts of Parliament that create or give powers to professional regulatory bodies, e.g. the General Medical Council (GMC), Royal College of Veterinary Surgeons (RCVS), Health and Care Professions Council (HCPC).
In the UK, many healthcare professions are statutory regulated, and professional titles are protected by law under specific legislation. For example, clinical psychologists, educational psychologists or forensic psychologists are regulated by the HCPC, nurses and the term “nurse” is protected under the Nursing and Midwifery Order 2001, making it compulsory for all nurses to be registered with the Nursing and Midwifery Council (NMC). Similarly, doctors are regulated by the General Medical Council (GMC) and the term ‘Medical Doctor’ is protected under the Medical Act 1983.
The main aim of the regulators is to protect patients and maintain public trust in the profession and services. In order to do so, regulators have several powers which are set out in legislation including:
- Registration powers: regulators approve or refuse entry to the professional register and maintain and publish an official register. Healthcare professionals under statutory regulation must be registered with their relevant regulator to legally practise.
- Setting standards: set professional standards for education, clinical competence, professional conduct, ethics, and competence; codes of practice and CPD.
- Education and training oversight: approve university courses and training programmes, monitor and inspect education providers and ensure new entrants meet the education standards.
- Fitness to practise investigations and disciplinary powers: they have legal powers to investigate fitness to practice concerns, discipline professionals and remove them from the register if necessary.
- Revalidation and ongoing checks: they require professionals to regularly demonstrate they remain fit to practise (e.g. revalidation for doctors and nurses)
- Legal enforcement: regulators have the power to take action against people practising without registration (which can be a criminal offence in some professions); and in some cases, prosecute misuse of protected professional titles.
2. The current regulatory framework of the psychological professions in the UK
The UK system is hybrid and uneven. It could broadly be divided into three broad categories psychiatrists, who are medical doctors specialising in mental health and regulated by the General Medical Council (GMC); psychologists in specific applied roles who are tightly regulated by law, and counsellors, psychotherapists and CBT psychotherapists who are largely self-regulated via professional bodies in PSA-accredited registers. Art therapists are the only exception, who are regulated by the HCPC.
2.1 Psychiatrists
Psychiatrists are medical doctors who specialise in mental health. All psychiatrists receive training in delivering psychotherapy, and they can diagnose as well as prescribe medication (unlike psychologists and psychotherapists)[1]. Psychiatrists have their status and title protected as they are registered with the GMC, like the rest of medical doctors.
2.2 Psychologists
The Health and Care Professionals Council (HCPC) has regulated practitioner psychologists since 2001 when the Health Professions’ Order [2] became law. However, the term “psychologist” itself has no statutory protection, meaning anyone can call themselves a psychologist. The titles practitioner psychologist and register psychologist are protected as well as the below seven titles:
- Clinical psychologist
- Forensic psychologist
- Counselling psychologist
- Heath psychologist
- Educational psychologist
- Occupational psychologist
- Sport and exercise psychologist [3]
Using any of these titles without appropriate registration is a criminal offence.
2.3 CBT Psychotherapists, Psychotherapists and counsellors
CBT psychotherapists, psychotherapists and counsellors are not statutory regulated and these roles are not protected by law. There are no requirements for people using these titles to be registered with any professional body or to meet defined training standards, which could introduce variability of quality.
While these professions are not statutory regulated, there are voluntary registers accredited by the Professional Standards Authority (PSA) which are maintained by different professional bodies which:
- Accredit training programmes
- Enforce codes of ethics
- Provide complaints mechanisms
The CBT Register for example includes a list of accredited Cognitive Behavioural Psychotherapists (CBPs) and Wellbeing Practitioners that have met the required standards set by BABCP [4]. Accreditation with BABCP typically requires:
To achieve statutory regulation, the Government must pass new or amended legislation, placing these professions and a list of titles under the oversight of a statutory regulator. This would involve defining the scope of practice, setting entry standards, and establishing a protected register.
However, the UK Government stated in March 2026 there are currently no plans to introduce statutory regulation for CBT psychotherapists, counsellors or psychotherapists, favouring proportionate approaches such as voluntary registers [6].
Core professions
While CBT Psychotherapists are not regulated, many of those who practice CBT and who may or may not be in the CBT Register, may be regulated with a different statutory regulator as they may have a “core profession”. Some examples include clinical psychologists, psychiatrists or mental health nurses who are also practising CBT and whose activities are regulated by the statutory regulator they are registered with – e.g. the NMC, GMC or the HCPC.
The role of the PSA
The PSA is an independent body that oversees statutory regulators and accredits voluntary registers. Accreditation is based on standards that cover governance, education and training, complaints handling, and public protection and organisations have to demonstrate these in order to achieve PSA-Accreditation. Accredited registers are listed on the PSA website. [7]
The PSA oversees the activity of the accredited registers and the statutory regulators, but it does not have the power to investigate individual practitioners or enforce sanctions – this lies with the regulators themselves. Its remit is limited to assessing the performance of the organisations operating the registers. [8]
In 2025, the PSA also issued a document Right-touch regulation [9] in which they outline how they approach their work overseeing both statutory and voluntary registers and regulators. In the document, they outline how statutory regulators and the PSA registers are now subject to the same standard under good regulation.
2.4 Art therapists
In the UK, art therapists are fully statutorily regulated healthcare professionals. The profession is regulated by the Health and Care Professions Council (HCPC), and the titles “art therapist” and “art psychotherapist” are legally protected [10], alongside “drama therapist” and “music therapist”.
They are one of the newest health professions to enter registration as the HCPC opened its register for arts therapists in 2003. [11]
| Profession | Statutory regulation | Main regulator/body [12] | Notes |
|---|---|---|---|
| Psychologists (applied) | Yes –protected titles only | HCPC | Protected titles: Practitioner psychologist Registered psychologist Clinical psychologist Forensic psychologist Counselling psychologist Health psychologist Educational psychologist Occupational psychologist Sport and exercise psychologist |
| Psychologists (general title) | No | — | “Psychologist” not a protected title |
| Chartered psychologists | No | BPS (voluntary) | |
| Clinical Associate in Psychology (CAP) | No | BPS (voluntary) | PSA-accredited register |
| Clinical Associate in Applied Psychology (CAAP) – Scotland | No | BPS (voluntary) | PSA-accredited register |
| CBT psychotherapists | No | BABCP (voluntary) AREBT (voluntary) | PSA-accredited register |
| Wellbeing practitioners (PWP, CWP, EMHP, MHWP) | No | BABCP (voluntary) BPS (voluntary) | PSA-accredited register |
| Psychotherapists (including Child Psychotherapists) | No | BACP (voluntary) NCPS (voluntary) UKCP (voluntary) ACP [13] (voluntary) COSCA (voluntary) | PSA-accredited register |
| Psychoanalysts (including Child psychoanalysts) | No | BPC (voluntary) | PSA-accredited register |
| Counsellors | No | BACP (voluntary) NCPS (voluntary) ACC (voluntary) COSCA (voluntary) | PSA-accredited register |
| Arts therapists | Yes | HCPC | |
| Play therapists | No | PTUK (voluntary) | PSA-accredited register |
| Hypnotherapist | No | HS (voluntary) | PSA-accredited register |
3. The benefits and risks of statutory regulation of the profession: SWOT analysis
3.1. Benefits of statutory regulation
Enhanced legal public protection: statutory regulation may ensure that only those with appropriate training, specialist additional training where needed and those who are registered with the regulator are able to treat people using the appropriate evidence-based interventions for the presenting issues. This includes the need to ensure that there are clear and consistent criteria for additional and/or specialist training and supervision to work with people who have more complex needs. If all psychological professions are regulated under one body this could also enhance public protection as the public can assume all professionals are regulated without the need to check individual registers, such as the CBT Register maintained by BABCP. One drawback of voluntary registration is that it relies on employers or independent practitioners valuing and requiring registration with a PSA-accredited register. It also relies on members of the public being well informed about what registration means, so that they seek a registered practitioner; this drawback would be mitigated with statutory regulation.
Recognition of the profession: Statutory regulation often comes with a broader recognition of professional activities as part of the professionals’ core identity – for example nurses or psychiatrists. The lack of statutory regulation of CBT Psychotherapy means it is often seen as an “add on” rather than a profession in its own right. However, given the largest proportion of clinicians graduating from accredited courses in recent years do not have a core profession before applying for BABCP accreditation, and that many with a core profession relinquish their statutory registration, a majority of the Accredited on the CBT Register likely identify first and foremost as a CBT Psychotherapist.
Protection of title: Statutory regulation would also ensure that only those meeting agreed professional standards would be able to use protected professional titles. Currently, the titles Cognitive Behavioural Psychotherapist (CBP) or CBT Psychotherapist are not regulated. This means that anyone can use these titles despite not being trained in CBP, causing concern for public safety and protection. Title protection could also result in higher status and authority for members.
Enforcement mechanisms: Statutory regulation provides legal protection and enforcement, while voluntary regulation provides professional standards and credibility but not legal compulsion. Statutory regulation has processes for holding people to account, keeping records of sanctions and publishing outcomes of disciplinary and fitness to practice processes, but these are also part of PSA-accredited voluntary registries. So, while there are enforcement mechanisms built into voluntary registers which are robust, this often relies on employers, practitioners themselves and the public being aware of the complaints procedure of the PSA-Accredited register.
Training standards: statutory regulation of the profession would ensure safeguarding of training standards for CBPs as only those who have met the standards will be allowed to enter the register (as it is now the case with the CBT Register) but with equity for all of those delivering mental health support (psychotherapist, psychologist, therapist, counsellor) as they will all be submitted to the same scrutiny. However, it will be important for the statutory regulator to work with professional organisations which have expertise in the training and competency standards for that modality and should be responsible for defining its own requirements.
3.2. Risks of statutory regulation
Less PSA oversight: The PSA oversees the 10 UK healthcare professional regulators and the Accredited Registers of health and care practitioners. The biggest strength of the current voluntary registration system is the PSA’s oversight of the voluntary registers which allows for a robust enforcement mechanism as well as the knowledge that each professional body and register has of its individual discipline. Currently, PSA-Accredited registers ensure public protection, by setting and promoting ethical standards of conduct and professional practice as well as providing the public with clear complaints and fitness to practice route enforcement mechanisms. While they oversee both statutory and Accredited registers, they have more oversight of the voluntary registers and higher scrutiny which can lead to higher standards. PSA can remove voluntary-registers accreditation if their set standards are not upheld. They cannot do this with statutory regulators, they would have to take the case to court.
Additional cost for members: All statutory regulators charge an annual retention fee for members which is the equivalent to BABCP accreditation maintenance fee, but more expensive. Currently, BABCP accreditation maintenance fee is £82 per year, while the HCPC annual fee is £123.34 [14], the NMC is £143 [15] and the GMC is £481 [16].
Potential dilution of the profession: while statutory regulation will include the protection of titles, it isn’t clear or guaranteed which titles will be protected. The Government may consider that they wish to protect two titles “counsellor” and “psychotherapist” in which case there would be a dilution or a lack of recognition of the title “Cognitive Behavioural Psychotherapist”, or even excluded from the term “psychotherapy”.
Generic regulator: if statutory regulation for the psychological professions is introduced, it will be very likely that the regulation of the profession will be given to the HCPC, as it already regulates clinical psychologists. Currently, the different psychological professions are regulated by their specific membership bodies, e.g. BACP, BABCP which have specialist knowledge of the professions and may be better equipped to deal with the complaints arising from practice.
4. The case for statutory regulation
4.1. Statutory regulation in Ireland, CORU
CORU is Ireland’s statutory regulator for a range of health and social care professions established in 2005. Similar to the HCPC in the UK, it regulates professions through legally protected titles, setting professional standards, education approval and fitness-to-practise procedures [17].
While currently not in regulation, CORU has been tasked with regulating psychologists, counsellors and psychotherapists [18]. Once CORU starts the regulation of psychotherapists and counsellors only people registered with CORU will legally be able to use the protected titles “psychotherapist” or “counsellor”. Regulation will take place via two separate registers, one of counsellors and one of psychotherapists.
CORU will therefore regulate the professions by title and not by therapeutic modality without distinction between different approaches such as psychoanalytic psychotherapy, CBT or systemic/family therapy.
The lack of distinction between the different modalities has had an impact on reaching an consensus regarding the Standards for Education and Training of Psychotherapies as different modalities have different requirements. For example, the requirement for personal therapy which features in some counselling and psychotherapy training does not align with CBP/CBT evidence-based. Instead, the CBT /CBP curriculum includes learning evidence-based interventions, skills development and assessment of competence under supervision; as well as reflective practice. Regulation under one ”supra-regulator” can therefore dilute professional standards.
4.2 BABCP accreditation and registration
Currently, BABCP maintains alongside AREBT, the CBT register, a PSA-Accredited register [19]. As a voluntary regulator, BABCP has similar powers than those the statutory regulators have including:
- Registration powers to approve or refuse entry to the professional register and maintain and publish an official register.
- Setting professional standards for education, clinical competence, professional conduct, ethics, and competence.
- Education and training oversight including approving university courses and training programmes, and ensuring new entrants meet the education standards.
- Conducting fitness to practice investigations and disciplining registrants, including potential removal from the register if necessary.
- Revalidation and ongoing checks: they require professionals to regularly demonstrate they remain fit to practise (e.g. revalidation for doctors and nurses). On this, BABCP may arguably have higher standards as in order to maintain accreditation we require clinicians to show they are in active clinical practice and to show competence on the relevant modality (CBT) while statutory regulated professions may only have to show general competence and not as specific or client facing.
However, as we are not a statutory regulator CBPs are not legally obliged to register with us and the title Cognitive Behavioural Psychotherapist is not legally protected. This means we do not have the power to take action against people practising without registration (which can be a criminal offence in some professions).
In England, most employers, and notably the NHS generally, require BABCP accreditation and registration to gain employment. However, this is not the case in Scotland, Northern Ireland and Wales. By ensuring BABCP accreditation and registration, employers and therefore clients and patients are guaranteed the gold-standard of CBT practice.
5. Conclusions
Statutory regulation – if done appropriately and in consultation with BABCP and other membership bodies has the potential to offer further benefits for public protection and to enhance the profile of CBT Psychotherapists. However, the main benefit of public protection and safety is already embedded in the CBT Register which serves the same purpose with PSA oversight.
We believe that for statutory regulation to be successful, the framework will have to be developed in collaboration with professional bodies representing each therapeutic modality and with members of the public, particularly those with lived experience. This is particularly important for training pathways and standards where professional organisations have expertise in the training and competency standards for that modality and should be responsible for defining its own requirements if proceeding with statutory regulation.
The biggest weakness of the current voluntary model allows for non-registered practitioners to call themselves CBT psychotherapists, even if they have only done a two-day training course, or even none. This can bring the profession into disrepute and mislead or harm people seeking help.
There is a case for statutory regulation as expressed in point 5 above but given the lack of political appetite for it, it is crucial that the public receives appropriate education from professionals, organisations – including the NHS – and the Government so that they are appropriately informed about the accreditation and registration status of their psychotherapists and the complaints process that they can adhere to if any issues arise.
We believe that both statutory and voluntary registration models have advantages and can provide high protection for the public.
6. Recommendations
6.1. To the UK Department of Health and Social Care, the Department of Health in Northern Ireland, the Department of Health and Social Care in Scotland and the Welsh Government
- In the absence of statutory regulation, BABCP accreditation and registration must be mandated to work in the NHS in Scotland, Wales and Northern Ireland as a CBT psychotherapist.
- In the absence of statutory regulation, develop an awareness campaign so that clients and patients have the necessary knowledge to check their CBT psychotherapist credentials on the available voluntary register.
- CBT Psychotherapists or anyone providing CBT- informed psychotherapy working in education, community or clinical settings must be accredited or registered with BABCP or be able to demonstrate that they are held accountable for their CBT practice by another professional statutory body or to be working towards accreditation.
- If proceeding with statutory regulation, the framework will need to be developed in conjunction with BABCP as the professional body with the knowledge and expertise for CBT Psychotherapy including the required training and competency standards.
6.2. To employers –including NHSE, Trusts and third sector organisations- and management
- Ensure that BABCP accreditation is included in employment and recruitment processes; including checking the CBT Register as part of pre-employment checks.
- Give information about the clinician’s accreditation and registration to patients and clients making them aware of the complaints process available to them and how to check clinicians’ status on the CBT Register. This could be displayed in waiting rooms or as part of the information disseminated to patients and clients.
6.3 To Practitioners
- Ensure that you are appropriately accredited with BABCP and that you keep your status up-to-date.
- Always display your accreditation credentials with a link to the CBT Register if possible.
- Make clients or patients aware of the BABCP complaints procedure if they are dissatisfied with the service received.
