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

Clients could have issues such as depression, anxiety, stress, loss and relationship difficulties that are affecting their ability to manage life.  

Psychologist and patient

Working life

You’ll hold sessions with individuals and groups in a safe and confidential environment. You'll encourage them to look at their choices and find their own way to make a positive change in their life. Some counsellors specialise in working with particular difficulties such as depression, bereavement, loss or addictions. Others may 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 Improving Access to Psychological Therapy (IAPT) services. Here, experienced counsellors with specific accreditations undertake training to deliver forms of counselling and psychotherapy recommended for depression such as counselling for depression, interpersonal psychotherapy or dynamic interpersonal therapy.

Others who work in NHS-funded services may: 

  • provide help, care and support to patients with cancer and their families
  • work with individuals who have drug or alcohol-related problems
  • help individuals understand and deal with genetic disorders
  • provide counselling and support for families with an unplanned pregnancy

Your role will be to build a relationship with your clients. 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 a client's situation
  • empathising with the client’s issues, but challenging them when necessary
  • helping clients to see things more clearly or in a different way

Where will I work?

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

Entry requirements and training

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

There are many different types and levels of counselling training available including at diploma, degree and postgraduate level. Some are available on a part-time basis, others full-time. Many, but not all, lead to registration. Visit the Professional Standards Authority website for information about accredited counselling registers.

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

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

Must-have skills 

You’ll need:

  • to be able to make people feel relaxed
  • excellent communication skills
  • the ability to positively challenge people
  • to be patient, tolerant, and sensitive
  • to be empathetic and non-judgmental
  • self-awareness and the ability to examine your own thoughts and values

Experience or skills in a particular area may also be required, such as the ability to speak in multiple languages or working in mental health.

  • Most jobs in the NHS are covered by the Agenda for Change (AfC) pay scales. This pay system covers all staff except doctors, dentists and the most senior managers. 

    Counsellors are typically paid at NHS Band 5, 6 or 7 on entry, depending on the role. There may be opportunities to progress to more senior roles. Counsellors work full or part time. Terms and conditions can vary for employers outside of the NHS. 

  • Working as counsellor could lead to a number of opportunities (after further training) including psychology, mental health nursing and psychotherapy. You could also specialise in an area such as eating disorders or addiction. You could apply to be a trainee high intensity therapist or psychological well-being practitioner, enabling you to work under the Improving Access to Psychological Therapies initiative (IAPT). 

  • Most NHS organisations advertise their job vacancies on NHS Jobs, including those who run NHS services. Some advertise on their own websites. You can find a list of NHS organisations at NHS Choices.

    If you're applying for a role either directly in the NHS or in an organisation that provides NHS services, you'll be asked to show how you think the values of the NHS Constitution apply in your everyday work.

    Find out more about NHS values.

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

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