Counsellors work with people experiencing a wide range of emotional and psychological problems to help them bring about effective change and/or enhance their wellbeing. 

You’ll help people with issues such as depression, anxiety, stress, loss and relationship difficulties that are affecting their lives.

Psychologist and patient

Life as a counsellor

You’ll hold sessions with individuals and groups in a safe and confidential environment. You'll encourage your patients to examine their choices and find their own way to make a positive change. 

Some counsellors specialise in working with particular problems, such as depression, bereavement, loss or addiction. Others work with particular groups, such as children and young people.

You could work in a wide range of contexts and at different levels. Within the NHS, most counsellors work in an NHS Talking Therapies for Anxiety and Depression Service (formerly known as IAPT). Here, experienced counsellors with specific accreditations are trained to deliver forms of counselling and psychotherapy particularly recommended for depression.

Other counselling roles within NHS-funded services may: 
  • provide help, care and support to patients with cancer and their families
  • work with people who have drug- or alcohol-related problems
  • help people understand and deal with genetic disorders
  • provide support for families with an unplanned pregnancy

Your role depends on building a relationship with your patients. You’ll do this by:

  • agreeing with them what will be discussed
  • encouraging them to talk about their feelings
  • listening carefully, asking questions and checking that you understand their situation
  • empathising with the patient’s issues, but challenging them when necessary
  • helping patients to see things more clearly or in a different way

You could work in community centres, GP surgeries, hospitals, schools or advice centres. You could also counsel people over the phone or by video call.

You will be provided with ongoing supervision to help you engage in self-reflection, seek and respond to feedback, and develop your professional knowledge and skills.

How much can I earn? 

If you’re employed by the NHS, you’ll be on a national pay and conditions system called Agenda for Change (AfC). 

There are nine pay bands and you’ll usually be paid at bands 5, 6 or 7 on entry, depending on the role and you’ll have opportunities to progress with experience. 

Terms and conditions can vary if you are employed outside the NHS.

How about the benefits?  

As a counsellor you can:
  • make a difference
  • work flexible and part-time hours

If you’re employed by the NHS you’ll also have good holiday entitlement and access to:

  • an excellent pension scheme
  • NHS discounts in shops and restaurants

Must-have skills 

As a counsellor, you’ll need to:
  • be able to make people feel relaxed
  • have excellent interpersonal and communication skills
  • be able to positively challenge people
  • be patient, tolerant and sensitive
  • be empathetic and non-judgmental
  • have good self-awareness and the ability to examine your own thoughts and values

Depending on the specific role, you may need further experience or skills in a particular area, such as the ability to speak multiple languages or a background working in mental health.

You'll also need to be able to demonstrate the values of the NHS Constitution.  

Entry requirements 

To work in the NHS as a counsellor, as a minimum you will need to be on a counselling or psychotherapy register accredited by the Professional Standards Authority (PSA). Some services, such as NHS Talking Therapies require further accreditation and may expect you to undertake additional training in a particular therapy delivered by the service. See the NHS Talking Therapies Manual for details. 

For some counselling roles, employers may also ask for a clinical/professional qualification, such as being a registered nurse, occupational therapist or social worker. For other roles you may need a scientific background – in genomic counselling, for instance.

Each employer will indicate their individual requirements so make sure to check the person specification for the role.

How to become a counsellor

There are many different types and levels of counselling training available, including at diploma, degree and postgraduate levels. Some are available on a part-time basis, others full-time. Many, but not all, lead to registration. Visit the PSA website for information about accredited counselling registers. You can also see some current vacancies below.

Where a career as a counsellor can take you

Working as a counsellor could lead to a number of opportunities (after further training) in, for example, psychology, mental health nursing or psychotherapy.

You could apply to become a high intensity therapist or psychological wellbeing practitioner, or specialise in an area such as eating disorders or addiction.

There is currently a pilot running for a three-year salaried and funded training for trainee psychotherapeutic counsellors to work in NHS Talking Therapies for adults with depression. Any future NHS-funded psychotherapeutic counsellor training will be determined following evaluation of the current pilot.

It’s important to note that a two-year psychological professions funding rule policy was implemented on 1 April 2022. This means that if you start NHS-funded psychological professions training from April 2022, you won’t be eligible for NHS funding for further psychological profession training for two years from the expected completion date of your first training, where it would lead to a change in your job role.     

Visit the funding for psychological professions training programmes web page for more information about NHS funding.  

  • Find a vacancy

  • For a list of organisations accredited by the Professional Standards Authority to deliver education and training in counselling, visit:

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