Ministers should introduce statutory regulation for counsellors and psychotherapists to protect the public from abuse, according to a report that has been hailed as a “watershed moment” for the profession.

Unlike most other healthcare roles, including doctors, midwives and osteopaths, “psychotherapist” and “counsellor” are not protected titles nor statutorily regulated professions in the UK.

This means that anyone can call themselves a therapist without a qualification, and can continue to practise even after an episode of misconduct, under a system that is poorly understood by the public.

For the first time, the professional bodies that represent counsellors and psychotherapists, and which run the current voluntary accreditation scheme, are calling for statutory regulation to boost confidence in the profession and protect the public from the growing number of cases of abuse and malpractice.

The report, the culmination of an independent review launched in October 2025 by the Commission for the Future of Counselling and Psychotherapy, argues that counsellors and psychotherapists are an untapped resource that could fill a mental health treatment gap estimated at about 1.8 million people on waiting lists. Practitioners told the commission they had extra capacity, which the report estimated could cumulatively provide more than 370,000 hours of additional therapy appointments every week.

The commission co-chair Phil Hope, a former Labour minister for care services, said: “For me, the report became a bit of a watershed moment for the profession, a real landmark of the opportunity there is for the government, and all its departments really, to unlock that potential.”

Ella Janneh, who successfully sued her therapist in the high court for rape and sexual assault in 2024, and has campaigned for regulation with the support of the law firm Leigh Day, welcomed the “collective call for regulation”. She said it had taken “years and a lot of honest and difficult conversations between victims, other campaigners and conscientious professionals”.

“Statutory regulation would lock abusive and unethical people out of the system. The current lack of centralised regulation allows for repeat offenders to continue practising with no oversight. That is reason enough to bring in regulation,” Janneh said.

The report cites her “powerful testimony” as an illustration of the “devastating, ongoing impact” the absence of statutory regulation can have, since her therapist is still able to practise despite the outcome of her civil case.

“One of the main reasons why the lack of government regulation has skated under the radar of public awareness,” said Janneh, “is that most people assume it’s already in place. They only realise it’s not when something’s gone wrong … Currently your Friday night kebab is subject to stronger regulation than a therapist who sits in rooms alone with vulnerable people.”

The report’s co-chair Andrea Sutcliffe, the former chief executive of the Nursing and Midwifery Council and an expert on regulation, said: “We’ve been on a journey around regulation with counselling and psychotherapy over many, many, many years, and the coalition government set its face against statutory regulation in 2011.

“We heard some really powerful testimony about the risk and the fact that people have been harmed. 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.”

Regulation was especially important for counselling and psychotherapy because they were complex interventions requiring years of training to practise, Sutcliffe said. Therapy takes place in a one-on-one setting; most practitioners are independent, meaning there is no employer oversight; and their patients are typically vulnerable people.

“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? That’s not what we do for choosing a brain surgeon or a cardiologist. We expect those things,” she said, adding that the lack of regulation contributed to misconceptions and mistrust, which prevented people from seeking help.

Regulation would also be helpful in setting standards for education, training and development, Sutcliffe said. The report noted that this would also improve diversity in the profession, which is much needed.

The report further argues that the evidence base for counselling and psychotherapy should be improved, and notes that its lack is resulting in “insufficient and unsustainable public commissioning and investment”. Hope said commissioners in the NHS and local government often had “legitimate concerns, is this a qualified psychotherapist or not?”

A more coordinated, professionalised industry could better inform the government’s approach to regulation and guardrails around the growing use of AI for mental health support. “[Psychotherapists 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,” said Hope.

The commission hopes the report’s call will be taken up by policymakers. The Labour MP Sojan Joseph, the chair of the all-party-parliamentary group on mental health and a former nurse, said he supported the case for statutory regulation and would raise the issue in parliament.

Jon Levett, the UK Council for Psychotherapy’s chief executive officer, said he would welcome statutory regulation that “protects the public, sets clear standards and preserves people’s choice of therapy”, though he argued that “any new system must be developed with practitioners and people with lived experience”.

Dr Lisa Morrison, the British Association for Counselling and Psychotherapy’s chief regulation and standards officer, agreed that collaboration was key to ensure regulation “places public protection, public benefit and public confidence at its heart, while avoiding barriers to access, diversity and established practice”.