Is your mental health for sale?

Why qualifications, competence and accountability matter in psychological care

There are few things I get on my proverbial soapbox about, but mental health practitioners working beyond their limits of competence, or people offering mental health care unqualified is one of them. I am compelled to write this after again seeing the harm this causes only this week.

This may not be a comfortable blog for some influencers, coaches, counsellors, psychotherapists, wellbeing practitioners, retreat leaders, self-styled trauma healers, or even some psychologists to read. But I am going to write it anyway.

If you work in one of those spaces and feel defensive, irritated or dismissive reading this, it may be worth pausing to ask yourself why?. It may be worth reflecting on whether it raises questions about scope, competence or accountability in the work you are doing, hopefully ones you hadn’t considered rather than ones you did, and chose to ignore - and maybe reading this will allow you to re-evaluate to do the ethical thing.  

If you are practising ethically, transparently and within the limits of your competence, you will probably find this blog reassuring and affirmative rather than threatening.

If you are seeking support with their mental health, I hope this helps you make a more informed choice.

I am not trying to imply that every practitioner must be a clinical psychologist at all, as there are some great counsellors, psychotherapists and mental health practitioners, and I respect them fully. The issue is whether people are being honest about what they are trained to do, what they are not trained to do, qualified to hold the level of distress they are advertising themselves as able to treat, or worse still, that they are unqualified.

Seeking psychological therapy is often a significant decision. Most people do not casually wake up one morning and decide to tell a stranger about the most painful, confusing or private parts of their life. They seek help because something has become difficult to carry alone. Anxiety may have taken over. Trauma may be affecting sleep, relationships, work or self-worth. Depression may be making life feel smaller. A diagnosis may have been missed, misunderstood or poorly explained. Someone may look completely capable from the outside while privately feeling as though they are unravelling.

At that point, choosing the right professional matters enormously and I wrote about what to look for last year and if you want to have a good read of that article click here.

Unfortunately, that choice has become far more confusing. Mental health has become highly visible, highly marketable and, in some spaces, highly commercialised. Therapy language is now used everywhere: in coaching programmes, retreats, online courses, Instagram captions, TikTok videos, branded “healing” methods, nervous system resets and trauma-informed business models.

Some of this visibility is positive. People are talking more openly about trauma, neurodivergence, anxiety, depression, attachment, emotional regulation and relationships. Shame is being reduced. People are finding language for experiences they may have carried for years.

But there is also a much less comfortable side. Mental health has become big business and some people are getting it so wrong and untruths are being perpetuated

Your mental health is not a marketing opportunity

We are now surrounded by people selling “healing”, “rewiring”, “nervous system regulation”, “trauma release”, “attachment repair”, “inner child work”, “emotional reset”, “burnout recovery” and “neurodivergent coaching”.

Some of these practitioners are properly trained, registered, supervised and working within a clear scope of practice.

Others are not.

Some have completed little more than a short course or two, collected attractive but meaningless certificates, built an online following and begun speaking with enormous authority about complex psychological conditions. Some have created their own therapy model, given it an impressive name, attached it to the language of neuroscience or trauma, and started selling it to vulnerable people without a proper evidence base, clinical trials, recognised professional standards or meaningful accountability.

The question is: would you know the difference?

Would you know whether someone is qualified, registered and competent to hold your mental health?

Would you know whether their “accreditation” comes from a recognised professional body or from merely a company that sold them the course and actually qualifies them to do nothing?

Would you know whether their therapeutic model is evidence-based, or simply something they created, branded and marketed?

I find this deeply concerning because I am a senior clinician naming a public-safety issue that has been allowed to become far too blurred. I have seen the damage that can follow when vulnerable people trust the wrong person and I have had to pick up the pieces and try and repair the damage. I have worked with clients who have been retraumatised by poorly handled trauma work. I have seen people left overwhelmed after being encouraged to disclose too much, too quickly, without proper stabilisation or containment, and people feeling lost after going on 'find-yourself' retreats. I know of people that had massive abreactions and the practitioners sent them away distressed. I have seen dissociation misunderstood, risk missed, neurodevelopmental differences misread, emotional dysregulation oversimplified, and complex trauma reduced to a neat online explanation.

At best, this can leave people thinking therapy does not work.

At worst, it can significantly worsen someone’s mental health and even lead to suicidality, which is something that needs proper training to handle.

Psychological suffering is not an area where confidence should be mistaken for competence. An Instagram account full of validating posts that people can relate to, and big charisma does not make someone clinically trained. Saying “trauma-informed” does not mean someone is qualified to treat trauma. Talking about the nervous system does not mean someone understands risk, dissociation, diagnosis, safeguarding, formulation or treatment planning. Having personally found something helpful does not qualify someone to sell that method as treatment for other people.

When people are vulnerable, they deserve better than persuasive marketing.

They deserve to know who is properly qualified, what different titles actually mean, who is regulated, what level of training a practitioner has completed, whether the treatment being offered has evidence behind it, and whether the person offering it has any genuine business attempting to treat the difficulties they are advertising for.

I am writing this not from a place of professional hierarchy (I have always believed in being competent to do the level of work from the start of my training journey, and I know some truly amazing practitioners at all levels) but from a place of feeling that people really need to understand this to stay safe and to receive the best possible care.

The therapeutic relationship matters, but it does not cancel out competence

The relationship between you and your therapist matters. In fact, it is one of the most important parts of psychological therapy.

Therapy requires trust. You need to feel safe enough to speak openly, sometimes about experiences you have never fully spoken about before. You need someone who listens carefully, understands nuance, and does not make you feel judged, rushed or reduced to a set of symptoms.

When people tell me previous therapy did not work for them, they often say things such as, “I never felt that they really understood me,” “I could not be completely honest,” or “I felt as though I was being given techniques without anyone understanding why I was struggling in the first place.”

That matters. The right therapist should be warm, human and able to create a relationship in which you feel safe enough to do difficult psychological work.

But it is dangerously naïve to suggest that a good connection is enough.

A person may be warm and still be inadequately trained. They may be empathic and still misinterpret trauma. They may be validating and still miss serious risk. They may make you feel understood and still lack the knowledge to distinguish between anxiety, trauma, depression, obsessive-compulsive symptoms, neurodevelopmental difference, personality difficulties, medication effects, physical health factors or a combination of these.

I have heard many people say they think they would be a good therapist because people open up to them. But being easy to talk to is not the same as being trained to know what to do next.

Sometimes feeling immediately understood can even be misleading. A person who gives you a very quick, very confident explanation for your distress may feel reassuring. They may tell you that your problems are all caused by childhood trauma, a narcissistic parent, attachment wounds, stored emotion, masking, limiting beliefs or a dysregulated nervous system. Some of those ideas may eventually form part of a careful psychological understanding. But responsible psychological work does not begin by forcing everyone through the practitioner’s favourite theory.

A good relationship is essential. It is not a substitute for training. You should not have to choose between warmth and competence. You deserve both.

What is in a name?

One of the most important things to understand when choosing a therapist is that titles do not all mean the same thing.

Words such as therapist, counsellor and psychotherapist can sound reassuring, but they do not automatically tell you a person’s level of education, clinical training, registration, competence or accountability.

The same applies to titles such as trauma therapist, trauma specialist, nervous system practitioner, attachment coach, wellbeing therapist, somatic healer, emotional release practitioner, psychological mentor, coach or transformational guide. These titles may sound impressive and highly relevant to your difficulties. In themselves, however, they may mean very little.

The uncomfortable reality is that someone can use or create any of these titles for themselves, even counsellor or psychotherapist which sound official, build a brand around it and begin marketing themselves to vulnerable people and it isn’t illegal! The public often doesn't know whether the title reflects years of regulated professional training or little more than clever wording or branding. You can check this out but most people don't know how to, or assume they don't have to if someone is using these titles.

Clinical Psychologists give some reassurance as in the UK, Clinical Psychologist is a legally protected title. A person cannot simply decide to call themselves a Clinical Psychologist because they have studied psychology, completed a counselling course, taken a trauma workshop or built a successful mental health brand. They must complete extensive training and be registered with the Health and Care Professions Council.

Clinical Psychologists are trained in psychological assessment, formulation, diagnosis, evidence-based therapies, research, ethics, risk, safeguarding, supervision and working with complex mental health presentations. Their training is not simply academic. It is doctoral-level clinical training.

That distinction matters.

However, the word psychologist by itself is not a protected title. Someone may call themselves a psychologist in media, coaching, research or online spaces without being an HCPC-registered Clinical Psychologist, Counselling Psychologist or other regulated practitioner psychologist.

They may be using the title appropriately in an academic or research context.

But if someone is offering psychological therapy, psychological assessment or mental health treatment or advice, you need more than the broad word psychologist, which is meaningless on it's own.  Only these listed below are protected titles and give you reassurance because if someone uses these titles without training and registration then they are breaking the law.

• Practitioner Psychologist

• Registered Psychologist

• Clinical Psychologist

• Counselling Psychologist

• Educational Psychologist

• Forensic Psychologist

• Health Psychologist

• Occupational Psychologist

• Sport and Exercise Psychologist

If someone is benefiting commercially from the authority conveyed by psychological language while avoiding clarity about whether they are clinically qualified, that should make you cautious.

So what about training, certification, accreditation?

One of the most confusing things for the public is that the language of competence can sound very convincing, even when there is little substance behind it.

Words such as trained, certified, accredited, trauma-informed, neurodevelopmental, anxiety specialist, practitioner, coach or therapist can all sound reassuring. They give the impression that someone has been properly assessed, supervised and held to a recognised professional standard.

But this is not always the case.

A certificate is only as meaningful as the system behind it.

There is a significant difference between being accredited by a recognised professional body and being “certified” or ''accredited'' by a private training company that has created its own course, certificate and title. One suggests external standards, accountability, ethics, complaints procedures, supervision requirements and continuing professional development. The other may simply mean someone paid for a course and received a badge at the end.

This is where the public can be badly misled.

You may see titles such as accredited neurodevelopmental coach, certified anxiety therapist, trauma recovery practitioner, emotional regulation specialist or nervous system expert. Some people using these titles may be well-intentioned. Some may have valuable lived experience. Some may have completed useful training.

But the key questions are:

• Accredited by whom?

• Certified by whom?

• Recognised by whom?

• Accountable to whom?

If the answer is simply “the company that sold the training,” then we need to be honest about what that means.

It would be rather like me setting up my own weekend course, calling it the Rainbow Institute of Advanced Psychological Healing, creating a certificate that says “Accredited Complex Trauma Transformation Specialist,” and then awarding that title to anyone who attends. The title might sound impressive. The certificate might look polished. The training may even be informative.

But unless that training is recognised within a credible professional framework, externally regulated, ethically governed and linked to proper supervision and competence standards, it is essentially a title I made up myself and is meaningless in the realms of mental health treatment.

That is not professional accreditation.

Proper psychological training is not just about attending a course. It is about years of structured education, assessed practice, supervised clinical work, ethical accountability, evidence-based knowledge and knowing the limits of one’s competence. It involves being challenged, observed, examined, supervised and sometimes told, quite rightly, that you are not yet competent to do something.

That process is not always glamorous, but it exists for a reason: to protect the public.

Sadly, I see so many online courses by companies selling courses with these fancy titles and people buy them really believing they are going to become an ‘’accredited coach’’, or a ‘’trauma informed therapist’’ in just a few short weeks, and it feels misleading to the buyer and the general public.

To become a psychological practitioner takes years, not weeks.  Counsellors usually train for 3-4 years, clinical psychologists up to 12 years.  That tells you that a 40 hour, or 6-week online course isn’t going to be credible for working professionally but these courses appear to make the suggestion that you will be trained to work with clients and some people do after such flimsy training. Sadly some people are working with no training at all!.

Registration and accountability matter

A qualified practitioner should be registered with an appropriate professional body.

Registration matters because it gives the public some reassurance that a practitioner is working within a recognised ethical framework. It can also provide a route for complaint if something goes wrong.

However, it is important not to be dazzled by logos alone. Some “professional bodies” are more robust and legitimate than others. Some memberships simply mean someone paid a fee to a 'made up' group. Some certificates come from private training companies rather than recognised regulators.

Relevant bodies to check the person is registered with may include:

• Health and Care Professions Council - psychologists

• British Psychological Society – look for chartered status and still check those titles

• British Association for Counselling and Psychotherapy – check for accredited register

• UK Council for Psychotherapy – check for accredited

• British Association for Behavioural and Cognitive Psychotherapies

• Society for Dialectical Behaviour Therapy – check to ensure therapists status

• National Counselling and Psychotherapy Society

These are the main bodies in the UK and they have registers so you can check to see if your practitioner is on there.  I would suggest being careful about anyone not registered and accredited with one of these bodies.  Go to the websites and most will have registers you can access to check.

So always ask: what does this registration actually mean? What standards does it require? Is there a complaints process? Does it require supervision? Does it require ongoing professional development? Is it independently checkable?

A credible professional should not be offended by those questions. They should welcome them.

There is a real hierarchy of training

There is also a genuine professional hierarchy in psychological care and pretending that all practitioners are equivalent is not kind, progressive or client-centred. It is misleading.

• Someone who has completed a short online course is not equivalent to someone who has undertaken recognised professional training and supervised practice.

  
  

• A registered coach trained in goal-setting and performance is not qualified to work with trauma, depression, risk, self-harm, neurodevelopmental assessment or complex emotional distress.

  
  

• A diploma-level counsellor is not equivalent to a psychotherapist who has completed several years of postgraduate training.

  
  

• A psychotherapist is not equivalent to an HCPC-registered Clinical Psychologist who has undertaken extensive psychological study, substantial clinical experience and doctoral-level clinical training.

  
  

• And an influencer with little or no training, or who has created their own “method” is not entitled to position themselves as an alternative to regulated, evidence-based psychological care simply because they are persuasive on camera.

This is not professional snobbery. It is clinical reality. Training matters because the work matters. Safety matters. Complexity matters.

Competence and Scope of Practice

I want to be very clear: there are many thoughtful, ethical and highly skilled counsellors and psychotherapists. Some are absolutely brilliant at what they do, and many people benefit enormously from working with them.

This is not an argument that only psychologists can help people.

Many counsellors and psychotherapists are highly trained, ethical and registered with reputable professional bodies.

But the issue is not professional title alone.

The issue is competence otherwise known as scope of practice. Scope of practice means the area a practitioner is genuinely trained, supervised and competent to work within. Ethical practitioners know their scope. They can explain it clearly. They do not treat every presentation, adopt every fashionable label, or imply that one method can resolve every form of distress. They know when to work, when to slow down, when to seek supervision, and when to refer on.

I am perhaps unusual in that I have trained through several different stages of therapeutic education. I started with earlier counselling and therapeutic training before progressing into clinical psychology, where most counsellors train just as counsellors or may progress to be a psychotherapist (though I often see counsellors use the title of psychotherapist when it should really signify a specific level of training), and then I trained as a psychotherapist, and then as a clinical psychologist, whereas as most psychologists train in that field alone. That journey gave me a deep respect for good practitioners at different levels, but it also made the differences very clear.

At each stage, I knew more than I had known before. And at each stage, I also became more aware of what I had not yet understood.

That is one of the most important parts of professional development: realising the limits of your knowledge and competence to treat different issues.

The public should not be misled into believing that all therapists have the same level of training, or that a practitioner trained in one model is automatically competent to assess and treat every form of psychological complexity.

They are not.

The level of difficulty someone is experiencing should influence the level of expertise they seek. A person wanting short-term support for a life stress may make a different choice from someone experiencing developmental trauma, dissociation, self-harm, repeated treatment failure, emotional dysregulation, neurodevelopmental questions, complex relational patterns or overlapping mental health problems.

A good counsellor may offer valuable support with grief, life transitions, relationship difficulties, worry, low mood or periods of personal distress. If you are newly qualified do not work beyond this.

A properly trained psychotherapist may offer more in-depth work with longstanding emotional and relational patterns.

Some counsellors and psychotherapists, with extensive additional training, supervision and experience, develop real expertise in specialist areas, including trauma.

For things involving more complex issues, assessment, formulation, diagnosis and treatment, then you need a clinical psychologist or very specialised training.

Higher complexity requires higher competence.

That is not elitism. It is common sense.

Trauma work is not just talking about trauma

This becomes especially important when we talk about trauma.

Trauma work is not simply listening while someone recounts what happened. For some clients, talking in detail about traumatic experiences too soon, or with someone who does not know how to pace the work, can leave them overwhelmed, dissociated, ashamed, emotionally flooded or more frightened of their own mind and body.

In the worst cases, poorly handled trauma work can feel like being taken back into the trauma without enough safety, containment or therapeutic repair can re-traumatise the person.

Trauma therapy requires more than warmth, empathy and good intentions. It requires an understanding of the nervous system, traumatic memory, dissociation, attachment, avoidance, shame, risk, emotional regulation and the ways traumatic experiences can be stored and triggered.

It also requires knowing when not to go into detail. When to slow down. When to stabilise. When to refer on. When a client may need more specialist treatment.

So the question is not simply, “Can a therapist work with trauma?”

The better question is: “Can this particular practitioner clearly evidence that they are competent to work with this particular trauma presentation?”

A counsellor, psychotherapist, or other practitioner working with trauma should be able to show additional and appropriate trauma training, relevant experience of ideally at least five years post-qualified, regular supervision from someone who understands trauma, and the humility to recognise when the work sits outside their scope.

A compassionate practitioner who says, “This needs specialist trauma work, and I want to help you find the right person,” is acting ethically.

A poorly trained practitioner who encourages deep trauma disclosure because they believe “getting it all out” is automatically healing may unintentionally do harm.

Therapy is not made safe by confidence, charisma, personal experience, social media popularity or a certificate from a short course. It is made safer by proper training, ethical standards, supervision, evidence-informed practice, knowing one’s limits and being accountable when things go wrong.

If you were talking about your physical wellbeing - would you let the ‘nice lady’ on reception operate on you because they seem kind and tell you they know all about it because they have worked here for ages or seen it on social media? or would you want the reassurance of a qualified and experienced surgeon, specialising in your condition?

What do NICE guidelines actually recommend?

One useful way to cut through the noise is to ask a very simple question: what does NICE recommend for this difficulty?

NICE, the National Institute for Health and Care Excellence, reviews the evidence and sets out recommended treatments for many physical and mental health conditions. It is not perfect, and clinical judgement still matters, but it gives a helpful evidence-based starting point and you can go the website and check the advice out. For common mental health difficulties such as depression, anxiety disorders and PTSD, NICE tends to recommend structured psychological therapies delivered by ''suitably trained and supervised practitioners''.

This matters because many approaches are marketed online as if they are evidence-based simply because they sound psychological, neuroscientific or “deep”. But sounding therapeutic is not the same as being recommended, tested or appropriate for complex mental health presentations.

Hypnotherapy and coaching are good examples here, as some people find them highly comforting and effective in some contexts and I am not here to say they don't work. But NICE does not generally recommend hypnotherapy or coaching as a treatment for depression, anxiety disorders, PTSD, trauma, ADHD, autism, personality disorder, self-harm or complex emotional difficulties as there is no, or not enough evidence to show efficacy.

One of the clearer NICE references to hypnotherapy is in irritable bowel syndrome, where psychological interventions such as CBT, hypnotherapy and psychological therapy are discussed particularly in relation to refractory IBS symptoms. Coaching-style methods, such as goal setting, planning, accountability and behaviour change support, do appear within some NICE guidance, particularly around health behaviour change, workplace wellbeing and structured support.

However, this is not the same as NICE recommending hypnotherapy or coaching as a treatment for mental health conditions.

That does not make hypnotherapy or coaching bad. It means they have a limited scope. The difficulty arises when coaching or hypnotherapy starts to sound like psychological treatment, using language around trauma, nervous system regulation, inner child wounds, attachment, burnout recovery or neurodivergence without the clinical training to assess and manage complexity safely. Or when practitioners work beyond their scope of practice.

Coaching can be powerful. Hypnotherapy can be powerful. Psychology can be powerful.

But they are not the same thing, and the public deserve to know the difference.

So the issue is not whether a technique can ever help anyone feel calmer. Many things can feel calming. The more important question is whether the person offering it is appropriately trained to assess risk, understand complexity, recognise when something else is going on, and deliver an intervention that has a credible evidence base for the problem being treated.

For someone with significant trauma, dissociation, self-harm, severe anxiety, depression, obsessive fears, neurodivergence-related distress or complex relational patterns, the question should not be “does this sound powerful?” It should be: “Is this recommended for my difficulty, has it been properly tested, and is the practitioner trained to work safely with the level of complexity I am bringing?”

The problem with people creating their own therapeutic models

There is nothing wrong with innovation. Psychology, psychotherapy and mental health practice all develop over time. New ideas can be valuable. Good clinicians often integrate knowledge from different models, reflect on what works, and adapt interventions thoughtfully to the person in front of them.

But there is a very important difference between thoughtful clinical integration and simply inventing a model, giving it a name, designing a logo and selling it as treatment.

Increasingly, people are offering branded approaches to trauma, anxiety, nervous system regulation, burnout, emotional healing, neurodivergence or self-worth. These models often sound polished. They may have attractive names, neat diagrams, catchy phrases and convincing testimonials. They may blend bits of neuroscience, attachment theory, mindfulness, somatic language, coaching, inner child work and trauma vocabulary.

On the surface, they can look modern and deeply informed. But the key question is not whether a model sounds good. The key questions are:

• Has it been properly tested?

• Has it been researched?

• Has it been evaluated independently?

• Has it been compared with existing evidence-based treatments?

• Are there published studies?

• Do we know who it helps, who it does not help, and when it may be unsuitable?

• Are there clear contraindications?

• Is there a recognised training pathway?

• Is there proper supervision?

• Is there an ethical framework?

• Is the practitioner accountable to a professional body if something goes wrong?

Because without that, we are not looking at an evidence-based therapy. We are looking at a personal theory.

And personal theories can be wrong.  Horribly wrong.

A method can sound compassionate and still be clinically unsafe. A practitioner can be warm, persuasive and passionate while working beyond their competence. A model can produce powerful emotional experiences and still lack evidence that it leads to safe, lasting change.

This is where the public can be misled. People may assume that because something uses psychological language, it has psychological evidence behind it. They may assume that because a practitioner is confident, they are competent. They may assume that because a method has a name, it has been validated.

• But a name is not evidence.

• A framework is not research.

• A testimonial is not a clinical trial.

• A personal breakthrough is not a treatment protocol.

• A training company is not a professional regulator.

This does not mean every new idea should be dismissed. It means new ideas should be held to a standard. If someone creates a model, the ethical route is not to immediately sell it as a cure, certify others in it and market it to vulnerable people. The ethical route is to test it, evaluate it, define its limits, seek peer review, collect outcome data, be transparent about the evidence and avoid making claims that go beyond what is known.

That is the difference between professional development and therapeutic entrepreneurship. Creativity is welcome in mental health. But when people are suffering, creativity must be anchored by evidence, ethics, competence and accountability.

The mental health influencer problem

One of my biggest concerns is the growing number of people presenting themselves as mental health experts, trauma healers, nervous system specialists or therapeutic guides without recognised training, proper supervision, regulation, evidence-based practice, risk awareness or clear professional accountability.

The online mental health world is full of people who speak with enormous confidence about psychological suffering.

They may make short videos telling you why you are anxious, why your relationship failed, why your parent behaved as they did, why you cannot regulate your emotions, why you are exhausted, why you struggle with motivation, why you fear rejection or why you have never felt good enough.

The content can be compelling because it is designed to be compelling. It reduces complex emotional experiences to highly recognisable patterns. It gives people language. It often provides immediate relief: “Finally, someone understands me.”

• But recognition is not assessment.

• A social media audience is not a clinical caseload.

• Lived experience is not professional qualification.

• Reading widely about trauma is not the same as being trained to assess and treat trauma.

• Completing courses in coaching, breathwork, attachment, somatic work or nervous system regulation is not the same as regulated professional training in complex mental health care.

There is a particular danger when influencers use psychological language not simply to educate, but to establish authority and sell treatment. A person may post repeatedly about trauma responses and then begin offering trauma healing. They may talk about ADHD or autism in a way that draws people towards paid assessment-like services without being qualified to assess neurodevelopmental conditions. They may speak about emotional abuse and narcissism, then encourage people to reinterpret family or relationship histories through diagnoses they are not qualified to make. They may describe the nervous system in simplified terms and then sell a programme claiming to reset or rewire it. They may tell people that conventional therapy did not work because it failed to reach the “real” problem, while conveniently selling the method that supposedly can.

This is not harmless simply because the language is validating or the brand appears compassionate. This is usually snippets of information regurgitated from other influencers or psychologists without real understanding.

Even well-meaning individuals with lived experience is not enough. Lived experience can bring empathy, insight and humanity. It can help practitioners understand shame, stigma and the courage it takes to seek help. But lived experience is not the same as clinical training. Having survived trauma does not automatically qualify someone to treat trauma. Having ADHD or autism does not automatically qualify someone to assess neurodevelopmental conditions. Having recovered from burnout does not automatically qualify someone to treat complex occupational, relational or trauma-linked burnout in others.

It is authority without proper accountability. And the public should be far more sceptical of it.

What should you check before choosing a therapist or practitioner?

Choosing a therapist is personal, but it should also be informed.

First, check their core professional qualification. Do not be distracted by a long list of workshops, certificates or branded memberships. What is the main qualification that enables them to offer therapy, and at what level was it completed?

Second, check whether the title they are using is protected or unprotected. If they describe themselves as a Clinical Psychologist or Counselling Psychologist, check their HCPC registration. If they say only that they are a psychologist, ask precisely what that means.

Third, check professional registration. Where counsellors or psychotherapists are concerned, look for reputable, independently checkable registration or accreditation rather than a logo you cannot verify.

Fourth, ask about their experience with the difficulty you are bringing. Someone may be a good therapist in one area and entirely unsuitable in another. Ask how long ago they qualified and about additional training.

Fifth, ask about the treatment they are offering. What is it? What is the evidence for it? What training have they completed in it? If it is their own approach, has it been independently tested, or are you being asked to pay for a treatment whose effectiveness exists only in their marketing?

Sixth, ask about supervision, insurance, confidentiality, data protection, safeguarding and complaints. Proper professionals will not be surprised by these questions. They will expect them.

Finally, pay attention to the relationship. Qualifications do not guarantee that someone will feel right for you. But a good connection should come after basic professional safety has been established, not instead of it.

Final thoughts

I feel strongly about professional competence because I have seen, both personally and professionally, that different levels of training are not interchangeable.

I have trained through different stages of therapeutic education before becoming a Chartered and HCPC-registered Clinical Psychologist. That experience has given me a deep respect for good practitioners at different levels, but it has also made the differences very clear.

Basic counselling training, coaching certification, short specialist courses, postgraduate clinical training and doctoral-level psychology training are not the same thing. They do not involve the same depth, breadth, assessment, supervision, clinical responsibility or accountability.

That does not mean everyone needs a clinical psychologist. Many people benefit enormously from counsellors, psychotherapists, coaches, wellbeing practitioners and other helping professionals. The important issue is not whether one profession is good and another is bad. The important issue is whether the person is working within the limits of their competence and being honest about what they are trained to do.

Psychological work can be powerful. It can help people understand themselves, change patterns, process painful experiences and build a more liveable life. But because it is powerful, it also carries responsibility.

Working with trauma, anxiety, depression, neurodivergence, self-harm, emotional dysregulation, attachment wounds, burnout or complex distress requires more than warmth, confidence and persuasive language. It requires proper training, supervision, evidence, ethical practice and an ability to recognise when something is outside one’s scope.

• This is why qualifications matter.

• Training matters.

• Regulation matters.

• Evidence matters.

• Knowing how to assess complexity matters.

• Knowing the limits of one’s competence matters.

• Not believing that these rules don't apply to you.

• And being accountable when working with vulnerable people matters.

We should not be embarrassed to say that there is a hierarchy of training within psychological care. We accept this in medicine and other professions where poor judgement can cause harm. Psychological care should not be treated as the exception simply because someone can create a reassuring website, use therapeutic language or build a large online following.

And someone offering confident promises to vulnerable people is not necessarily providing a harmless alternative. They may be delaying proper treatment, misunderstanding risk, reinforcing shame, increasing distress or giving people explanations about themselves that have no proper clinical or research basis.

This is not about frightening people away from seeking help. It is about helping people make informed choices.

The right therapist or practitioner should feel like someone you can talk to. They should be warm, respectful, thoughtful and able to understand you as a whole person. The relationship matters enormously. But it should not be the only thing you look at.

Before trusting someone with your mental health, it is reasonable to ask:

• What are they actually qualified to do?

• Who trained them?

• Who regulates them?

• What professional body are they accountable to?

• What evidence sits behind the approach they are using?

• What happens if something goes wrong?

  
  

A credible practitioner should not be offended by those questions. They should welcome them.

Red flags to look out for

Include:

• They cannot clearly explain their core qualification.

• Their accreditation comes only from the company that trained them.

• They claim to treat trauma, ADHD, autism, depression, anxiety, burnout and relationships with one branded method.

• They use lots of neuroscience language but cannot explain their clinical training.

• They promise transformation, healing, rewiring or guaranteed recovery.

• They discourage evidence-based treatment or imply that regulated professionals “do not understand the real issue”.

• They encourage deep trauma disclosure without assessment, stabilisation or risk planning.

• They seem offended when asked about qualifications, supervision, insurance or complaints.

Your mental health deserves care that is compassionate, honest and properly held. I would urge you to do your research and not be dazzled by social media. I would also urge anyone offering support beyond their scope of practice to re-assess what they are doing.

As a Chartered Clinical Psychologist, I will always support people seeking help from the practitioner who is right for them. I do not believe everyone needs to work with a clinical psychologist, nor do I believe that one profession has all the answers. There are many excellent counsellors, psychotherapists, coaches and wellbeing practitioners doing thoughtful, ethical and valuable work within the limits of their competence.

But I do believe people deserve clear information before trusting someone with their mental health. They deserve to know whether a practitioner is properly qualified, appropriately registered, genuinely experienced, adequately supervised and working within a recognised ethical framework. They deserve to understand the difference between support, coaching, therapy, psychological treatment and specialist clinical care. Most importantly, they deserve care that is honest, safe and properly held.

As always until next time

Carla