Quick answer: To start a private therapy practice in the UK in 2026, you should usually be registered with a recognised professional body such as BACP, UKCP, BABCP, BPS, NCPS or HCPC. Registration is not legally required for counsellors and psychotherapists, but in practice it is essential for directory listings, insurance, referrals and client trust. You will also need to register with the ICO, take out professional indemnity insurance, register with HMRC if your self-employed income exceeds £1,000, arrange clinical supervision, decide whether to operate as a sole trader or limited company, and set up a secure way to manage notes, bookings, payments and client communication.
I started Therasee because of what I saw from three different angles. Several of the people closest to me work in the profession, and I watched them struggle with the same tension over and over: trying to run a sustainable, profitable practice without compromising on the quality of care they wanted to give. Through my own CBT training, I came to understand that tension from the inside. And as a client trying to find a psychotherapist, I felt the third side of it: the searching, the scheduling, the back-and-forth, all of it harder than it needed to be. The gap was obvious from every direction.
One of the most preventable parts of that gap is the set-up phase. Newly qualified practitioners go through the same painful problems because there's no central guide. The information is scattered across BACP, UKCP, ICO, HMRC, indemnity providers, and a hundred forum threads. Half of it is out of date. The other half is written for a US audience that doesn't apply here.
This guide pulls everything into one place, with the actual figures for 2026, and works through the decisions in the order you'll face them. It's long because the topic is. If you're newly qualified, bookmark it. If you're already in placement, the early sections will save you time.
Is private practice right for you?
Before any of the practical steps, an honest question. Private practice suits some practitioners and not others. The difference rarely shows up in training.
You'll do well in private practice if you're comfortable being the entire business. You set the fees. You manage the diary. You handle the late cancellations, the unpaid invoices, the awkward boundary conversations. You also do all the marketing, even if you call it something gentler. Nobody hands you clients. Nobody covers your sick days. You'll feel the lonely months when the diary thins out and the financial pressure that creates.
You'll struggle if you want a fixed monthly income, predictable hours, peer support built into your day, or someone else managing the administrative load. Many excellent practitioners stay in NHS Talking Therapies, third sector services, EAPs, or private clinics for exactly these reasons, and that's a perfectly good career.
The sustainable model for most therapists in the UK is mixed. Two or three sessional days in an NHS or charity role, two days in private practice. This gives you a clinical baseline, peer contact, and steady income while the private side builds. Going fully private from day one is possible but financially harder.
The minimum you need before launching is: full qualification (or close to it), professional registration, supervision in place, indemnity insurance, and a realistic plan for at least six months of slow client growth.
Professional registration: optional in law, essential in practice
There is no statutory regulation of "counsellor" or "psychotherapist" titles in the UK. Anyone can technically use them. What clients, GPs, EAPs, insurance companies, and most directories actually look for is registration with one of the recognised professional bodies. Without recognised professional registration, you are likely to struggle with the practical foundations of private practice: directory listings, EAP and insurance referrals, client trust, and access to suitable professional indemnity insurance.
This may not stay this way for long. Statutory regulation of counsellors and psychotherapists is being actively debated in Parliament, prompted by high-profile civil cases and concerns about unregulated practice. In April 2025 the government said there were "no current plans" to introduce it, but an Early Day Motion is currently calling for HCPC oversight, and the UK Parliament briefing on the issue sets out the full state of play. Either way, registering with a PSA-accredited body is the strongest signal of competence you can give clients today.
The right body depends on your training and modality.
BACP (British Association for Counselling and Psychotherapy) is the largest, covering counsellors and psychotherapists across most modalities. From 1 April 2026, BACP membership fees increased by an average of 2 percent across all categories. Accredited membership for 2026 to 2027 is £216 a year (£108 reduced rate for those on low income or state benefits). Registered membership sits below that, and student membership is around £86. Practising members must be on the BACP Register, which carries no separate fee but requires either completion of an accredited course or passing the Certificate of Proficiency assessment.
UKCP (UK Council for Psychotherapy) is the principal body for psychotherapists, organised through training organisations and modality-specific colleges, with full registration at SCoPEd column C for psychotherapist members.
BABCP (British Association for Behavioural and Cognitive Psychotherapies) is the home for CBT and behavioural therapists. Accreditation is rigorous and is what most NHS Talking Therapies services and EAPs look for when commissioning CBT.
NCPS (National Counselling and Psychotherapy Society) is a Professional Standards Authority Accredited Register, often chosen by counsellors and psychotherapists looking for an alternative to BACP. It's increasingly common and equally recognised by clients and most insurance company panels.
BPS (British Psychological Society) sits behind chartered psychologist status. It is the membership body, but legal protection of titles like "Clinical Psychologist" or "Counselling Psychologist" sits with the HCPC.
HCPC (Health and Care Professions Council) is the only statutory regulator on this list. It holds protected titles for practitioner psychologists (clinical, counselling, forensic, educational, health, occupational, and sport) and for arts therapists. If you trained as a clinical or counselling psychologist, HCPC registration is what makes you legally allowed to use the title.
A note on SCoPEd. You'll see SCoPEd (Scope of Practice and Education) referenced on the websites of BACP, UKCP, NCPS, BPC, HGI and ACC. It's a shared standards framework jointly developed by these six Professional Standards Authority accredited bodies, mapping training, practice and competence to three columns labelled A, B and C. As of February 2026, all six bodies are aligning their membership categories to the framework, with agreed mechanisms for members to move between bodies and columns. For a newly qualified therapist, the practical upshot is that competency standards are increasingly portable across the bodies in this partnership, which makes choosing between them more about modality fit, fee, and culture than about whether your training will be recognised. BABCP and HCPC are not part of the SCoPEd partnership.
Most counsellors and psychotherapists usually have one main professional body or register that best reflects their training, modality and professional identity. For example, CBT therapists who originally trained as nurses, social workers, psychologists or other recognised mental health professionals may also hold registration or accreditation with more than one organisation, such as their original regulator or professional body alongside BABCP. In most cases, it is best to choose the body that most closely matches your training, modality and the standards you practise under. Joining several bodies is not usually necessary unless there is a clear professional, regulatory, employment or accreditation reason to do so.
Register with the ICO: the £52 your insurance won't cover
Every private therapist in the UK who holds client records in any electronic form is a data controller under the Data Protection Act 2018 and UK GDPR. That includes your appointment diary, your session notes, your client emails, and your invoicing records. If any of that lives on a computer, a phone, or in cloud software, you are processing personal data, and you must register with the Information Commissioner's Office (ICO).
The ICO fee is set in three tiers. For a sole therapist or a small practice with fewer than ten staff and turnover under £632,000, you fall into tier 1, which is £52 per year. Pay by direct debit and you get a £5 discount, bringing it to £47. (Source: ICO data protection fee guidance)
Failing to register is not a paperwork oversight. The ICO actively cross-references HMRC and Companies House data, and issues monetary penalties to unregistered businesses each year. Fines for non-registration range from £400 to £4,000, with a statutory maximum of £4,350 (150 percent of the top-tier fee) for the most serious cases.
Pay it, set up the direct debit, and forget about it. It's the cheapest piece of compliance you'll ever buy.
A second related point worth flagging now, though I'll cover it in depth in next week's post on UK GDPR for therapists: registering with the ICO is the start of your data protection obligations, not the end. You also need a privacy notice for clients, a lawful basis for processing their data, a clear retention policy for notes (BACP does not stipulate a retention period, but the working convention informed by indemnity insurers and the Limitation Act 1980 is seven years post-discharge for adults, and for minors until the client reaches age 25 or 26), and a breach response plan. The ICO fee buys you the regulatory permission. The other obligations are unfunded.
Professional indemnity insurance: what cover, and from whom
Indemnity insurance protects you if a client sues you for professional negligence, breach of confidentiality, or financial loss caused by your work. It is required by all the major professional bodies as a condition of practising membership. It is also required by Counselling Directory, Psychology Today UK, most insurance company panels, and any EAP contract you'll ever see.
For 2026, market rates for therapy-specific indemnity start around £80 a year for a basic single-cover policy at £1 million indemnity limit. Specialist providers like Balens, which provides a special rate policy for BACP members, alongside Howden, Holistic Insurance, Towergate Professional Risks, and PPS (the Psychologists Protection Society, a not-for-profit membership scheme rather than a commercial insurer) pitch around the £80 to £180 range for most counsellors and psychotherapists. Generalist providers like Simply Business and Hiscox quote similarly, though they price by trade and may not always have therapy-specific wording.
There is no legal minimum indemnity limit for therapists. Most professional bodies recommend £1 million minimum, with £2 million increasingly common. The marginal cost of going from £1 million to £2 million is small (typically 30 to 50 percent more), and the marginal protection is substantial. If you can stretch the budget, take £2 million.
A few things to check that matter more than headline price:
The policy should be specifically worded for counselling, psychotherapy, or psychology. Some general professional indemnity policies exclude or quietly limit cover for emotional harm claims, which is exactly what therapy work creates risk of. UKCP publishes a list of insurers offering rates to its members, which is a useful starting point for comparing therapy-specific policies even if you're not a UKCP member.
Public liability is usually a separate component, often bundled. If you see clients face to face anywhere, including a hired room or your home, you want public liability of at least £1 million. If a client trips on your stairs, this is what pays the claim.
Run-off cover matters when you stop practising. Therapy claims can be brought years after the original work. Run-off keeps your old work covered after you've closed the practice. Most policies offer it as a continuation product. Don't ignore it when you eventually retire or change career.
Sole trader or limited company: the decision in plain English
Most newly qualified therapists in private practice start as sole traders. In plain English, this means you are self-employed. You do not create a separate company at Companies House. Instead, you register with HMRC for Self Assessment as self-employed, keep records of your income and expenses, and pay Income Tax and Class 4 National Insurance on your profits.
You can read HMRC’s guidance here:
https://www.gov.uk/set-up-sole-trader
The other option is a limited company, where the business is a separate legal entity. You become a director and shareholder. The company pays corporation tax, you pay yourself a combination of salary and dividends, and the legal liability of the business is, in most cases, separate from your personal assets.
Here's how to think about it.
Sole trader is the right choice if your practice income will be below roughly £40,000 to £50,000 a year, you want the simplest possible accounting, and you're comfortable with personal liability. You'll pay 20 percent income tax on profits above the personal allowance of £12,570, then 40 percent above £50,270, with Class 4 National Insurance on top. The standard personal allowance for 2026 to 2027 is £12,570. You only need to register with HMRC once your gross income from self-employment exceeds £1,000 in a tax year, but in practice if you're running a private practice you should register from day one. MoneyHelper has a clear breakdown of self-employed tax thresholds if you want to double-check the maths.
Limited company starts to make sense if your annual profits comfortably exceed £50,000, you want to leave money in the business to reinvest, you're concerned about personal liability, or you're planning to bring in associates and grow. Tax efficiency through dividend extraction is real but smaller than it used to be. The administrative load is higher: you'll need an accountant, you must file annual accounts at Companies House, you have director responsibilities, and the year-end paperwork is non-trivial. Budget £600 to £1,500 a year for accountancy.
A common pattern is to start as a sole trader for the first one or two years, then incorporate once income justifies it. The transition is straightforward. Switching the other way is harder.
One important 2026 change to flag: Making Tax Digital for Income Tax starts rolling in from 6 April 2026 for sole traders and landlords with combined gross income over £50,000. If that's you, you'll need HMRC-recognised software and quarterly digital updates rather than the old single annual return. The threshold drops to £30,000 in 2027 and £20,000 in 2028. Plan ahead.
Setting your fees: what the UK market actually looks like
Pricing your sessions is the decision most therapists struggle with most. Set too low and you'll resent the work within a year. Set too high and you'll lose clients to the practitioner down the road who's £20 cheaper and no less qualified. The right answer depends on your modality, your location, your experience, and what value you can articulate.
The 2026 ranges across the UK look roughly like this:
Counsellors typically charge £50 to £80 per session outside London, £70 to £100 in London. A substantial share of BACP directory listings sit in the £40 to £60 band, though this tends to be weighted towards newer practitioners and online-only therapists.
Psychotherapists typically charge £60 to £100 outside London, £80 to £150 in London. The premium reflects longer training and depth of work, particularly for psychodynamic and integrative practitioners.
CBT therapists typically charge £70 to £110 outside London, £85 to £150 in London. BABCP-accredited CBT therapists in particular can command higher fees because of the EAP and insurance company demand for accredited CBT.
Counselling psychologists and clinical psychologists typically charge £100 to £180, with London and specialist work pushing higher. HCPC registration and doctoral-level qualifications support the premium.
Couples and relationship therapy is consistently 20 to 50 percent above individual session rates because of the longer session length (often 75 to 90 minutes) and the more demanding clinical work.
A few practical points on fee-setting that newly qualified therapists routinely get wrong.
First, set your starting fee with reference to the range, not the floor. Pricing yourself at £40 because you're newly qualified is understandable but rarely necessary. Most clients aren't comparison-shopping to the pound, and a fee that's clearly the lowest in your area can read as a signal of inexperience rather than affordability.
Second, build in concession slots from the start rather than retrofitting them later. A typical pattern is two or three concession spaces at a reduced rate (often 30 to 50 percent off) for clients on low income, students, or trainees in personal therapy. This matches BACP's ethical guidance on access without dragging down your average rate.
Third, budget for what you'll actually keep. Take an £80 session as a worked example. After income tax and Class 4 National Insurance (a combined marginal rate of about 26 percent on profits between the personal allowance and the higher-rate threshold), you're already down to about £58. Take off £8 a session amortised for supervision (at £60 to £80 every fortnight), £1 for indemnity, £1 for your professional body subscription, and £3 to £8 for room hire if you see clients in person. That leaves a real take-home of around £40 to £50 per session, not £80. Run those numbers honestly before committing to a fee that won't sustain the practice.
Fourth, plan annual fee reviews into your practice from year one. Inflation since 2022 has been significant, your skills will grow, and a once-a-year letter to clients explaining a £5 increase is much easier than a 30 percent jump after five years of held fees.
Clinical supervision: what's required and how to find a supervisor
Supervision is a regulatory requirement, not a clinical luxury. All BACP, UKCP, BABCP, NCPS and BPS members are required to be in supervision as a condition of practising membership. What changes is the ratio of supervision to client work, which is stricter when you're newly qualified.
The supervision ratios you actually need to know:
If you're a trainee on placement, BACP recommends one hour of supervision for every eight hours of client work, with a minimum of 1.5 hours of supervision per month and supervision delivered fortnightly. Some training providers and supervisors tighten this further for the first 50 client hours, often to a 1:6 ratio, easing to 1:8 afterwards. Check your specific course's requirements against your professional body's, and resolve any difference upwards (the stricter ratio always wins).
If you're a qualified counsellor or psychotherapist in private practice, the minimum across BACP, UKCP, NCPS and BABCP is 1.5 hours of supervision per calendar month. If you're seeing more than four clients a week, BACP and most ethical frameworks recommend moving to fortnightly supervision. Above larger caseloads (say, 20 or more clients a week), monthly is rarely enough.
Group supervision counts proportionally. In a group of up to four supervisees with a two-hour session, each member can claim a full hour towards their requirement. In larger groups, the time is divided between supervisees. Group supervision is valuable and cheaper, but doesn't fully replace individual supervision in the early years of practice.
The Hawkins and Shohet seven-eyed model is one of the most widely used supervision frameworks in the UK and is worth understanding when you're choosing a supervisor.
How to find a supervisor. This is a known pain point, especially for newly qualified therapists who can't reuse their training supervisor. The reliable starting points are:
Counselling Directory's supervisor search, which is large and searchable by location and approach
The BACP Therapist Directory, filtered to those who offer supervision
For psychotherapists, UKCP runs a supervisor directory for members in the logged-in members area at psychotherapy.org.uk
For CBT, the BABCP CBT Register lists accredited members who also supervise
Counselling Tutor's supervisor directory at counsellingsupervisors.co.uk, a specialist online supervision directory run by Counsellor Tutor Ltd, with a strong focus on supervisors who work online
What to look for in a supervisor. Modality match is the single most important criterion. A psychodynamic therapist supervised by a strictly CBT supervisor will struggle. Beyond that: relevant supervisor training (a postgraduate certificate in supervision is the usual standard), at least five years of post-qualification clinical experience, accreditation with the same body you're registered with, and a personal sense of fit. Have a free 20-minute chat before committing.
Fees and the supervision contract. UK supervision fees in 2026 sit at £40 to £80 an hour for individual supervision, lower for group supervision pro rata. Agree a written contract covering frequency, fees, cancellation, recording of sessions, confidentiality boundaries, and what happens if either of you needs to end the arrangement. Most professional bodies publish a contract template you can adapt.
Finding your first clients
This is the part that takes longest and worries everyone most. The honest truth is that most successful private practices take three to six months to fill, and the early months are genuinely uncomfortable.
The major UK directories that reliably bring clients are:
Counselling Directory is the largest by traffic and the one most members of the public reach for. Listing fees as of 2026 sit around £24.50 a month or £245 annually. A good profile with a clear photo, specific specialisms, and warm copy outperforms a generic one by a wide margin.
Psychology Today UK has high domain authority and ranks well in Google for many searches. Listings are around £19.95 a month at current exchange rates.
The body-specific directories. Listed members can usually advertise on their professional body's own directory for an additional fee or, in some cases, free. The main ones are the BACP Therapist Directory, the UKCP Find a Therapist tool, the BABCP CBT Register, and NCPS's Find a Counsellor. They convert well because clients arriving there are usually already vetting credentials.
Beyond directories, the work that compounds is local. Build relationships with two or three local GP surgeries. Most have a list of private therapists they refer to when NHS waiting times are long, and getting on that list takes a polite letter, a clear explanation of your specialisms, and sometimes a coffee. Connect with other local therapists who are full or who don't take your specialism. Therapists routinely refer to each other when they're at capacity or when a client's needs don't match their training.
A simple website helps even if it's not where most clients find you, because they will look you up before booking. It needs to do four things: confirm you're real, show your face, list your specialisms in plain language, and make booking easy. Therasee customers use our client portal and online booking for the booking step, but any clean booking flow works.
EAP work, insurance company panels (Aviva, Bupa, AXA, Vitality, WPA), and university counselling services are slower routes that pay regular work once you're on the panel but typically pay 30 to 50 percent less than your private rate. Worth pursuing once you're established. Probably not worth chasing in month one.
Setting up the practical infrastructure
The infrastructure you need is smaller than people assume but should be in place before you take your first client.
A confidential consulting space. Hire a room by the hour from a local therapy collective or rent a room weekly. £15 to £35 per hour is typical outside London, £30 to £60 in London. Working from home is an option if you have a genuinely separate space with privacy and soundproofing, but be realistic about whether your home meets the test. Online sessions cut this cost entirely.
A way to deliver online sessions safely. This is now expected by most clients and many EAPs explicitly require it. You need a platform that is encrypted in transit and at rest, UK or EEA hosted for GDPR comfort, doesn't require client downloads, and produces no recordings unless you've explicitly arranged that with consent. General-purpose video tools like Zoom or Microsoft Teams are not designed for therapy and shouldn't be your default; healthcare-specific tools like Doxy.me solve the privacy piece but are video-only.
Client contracts, intake forms and consent. Every client needs a written agreement before their first session. This typically covers your fees, cancellation policy, confidentiality limits, data handling, supervision arrangements, and complaints procedure. You may also want a way to capture initial assessments (PHQ-9, GAD-7, CORE-10 or similar) and any clinical history before session one. Doing this on paper or by email is workable for a handful of clients but quickly becomes a GDPR liability as your caseload grows.
Clinical supervision in place. Supervision is covered in detail in the section above, but practically: you need a contracted supervisor confirmed before you see your first client. Use Counselling Directory's supervisor search, your professional body's directory, or one of the specialist supervision directories like counsellingsupervisors.co.uk.
A simple records and notes system. Whatever you use, ensure it supports the note format you were trained in, whether that's SOAP, DAP, BIRP, person-centred, or any other structure that suits your modality and style. It should also give you a way to redact third-party information for Subject Access Requests, and let you back up or export client records at any time so you're never locked in.
A note on consolidating your stack. You can stitch all of this together from separate tools: Doxy.me for video, a forms builder for intake, a notes app for clinical records, a calendar for scheduling, Stripe directly for payments. The admin overhead and the GDPR risk add up faster than most people expect. Practice management platforms exist precisely to consolidate this in one place. We built Therasee specifically for UK therapists and counsellors, with built-in video, digital forms with e-signatures, secure document storage, clinical notes, scheduling and online booking, and billing and online payments under one GDPR-compliant roof, and a free-forever plan. Other UK options like WriteUpp, Kiku and Konfidens are worth comparing depending on your needs; our comparison pages lay out the differences honestly.
Cancellation, refund, and complaints policies
Have these written and on your website before you see your first client. Without them, every difficult conversation becomes a negotiation from scratch.
A standard UK cancellation policy is 48 hours' notice for full fee waiver, with the full session fee charged for late cancellations or no-shows. Some therapists use 24 hours, some 7 days. The right number is whatever you'll actually enforce. A policy you don't enforce is worse than no policy.
Refunds are rare in therapy, but you need a position. The defensible answer for most is: prepaid blocks are non-refundable but can be rescheduled within 90 days; individual paid sessions are not refunded once attended; cancellations following the cancellation policy are not charged.
Your complaints procedure should be simple, in writing, and visible. Tell clients how to raise a concern with you directly first, give them the contact details for your professional body's complaints procedure, and keep a record of any complaint received and how it was handled. BACP, UKCP, BABCP, NCPS and HCPC all publish standard complaints procedure language you can adapt.
Marketing without losing yourself
Most therapists hate marketing, and most therapy marketing is awful. The two facts are connected.
What works is straightforward. Be findable, be clear, be specific, be human.
Findable means you're listed in the directories that matter, your name shows up when someone Googles you, and you have a website that loads in under three seconds.
Clear means a client can read your profile and answer two questions: "Does this person help with the thing I'm struggling with?" and "Do I want to talk to them?" Generic copy ("I provide a safe, non-judgemental space") fails both tests because every therapist says it. Specific copy ("I work with adults in their thirties and forties navigating burnout, mid-career anxiety, and the long shadow of perfectionist parenting") passes both.
Specific means picking a niche, even if loosely. The therapists who fill their practices fastest tend to be the ones who can complete the sentence "I work especially well with people who..." Your niche can be a presentation (eating disorders, OCD, complex trauma), a population (LGBTQ+ adults, new parents, neurodivergent professionals), a modality (EMDR, schema therapy, IFS), or a context (high-conflict couples, expat clients, returning veterans). It does not have to be narrow forever. It just gives clients a reason to choose you.
Human means you sound like a person, not a service. Photographs that look like the therapist actually does. Copy that uses "I" and "you" rather than "the therapist" and "the client". Honest mention of your training, your modality, and what working with you actually looks like.
The marketing channels that work for most UK therapists, roughly in order of return on time:
Directory listings (already covered)
A simple website with strong copy
Two or three local GP relationships
A LinkedIn presence if your client base is professional
Referral relationships with other local therapists
Local press, blogs, or podcasts on topics you care about
Paid Google Ads (only once everything above is in place)
Social media is rarely the highest-return channel for therapists. If you genuinely enjoy it and have something to say, by all means use it. If you don't, skip it without guilt. The compounding work is in directories, website, and local relationships.
Frequently asked questions
Do I need to be registered with a professional body to practise privately in the UK? Strictly speaking, no. The titles "counsellor" and "psychotherapist" are not protected in law. In practice, yes. Without registration with BACP, UKCP, BABCP, NCPS, BPS or HCPC you cannot list with the major directories, cannot accept most insurance referrals, cannot get reasonably priced indemnity insurance, and most clients will rule you out. The titles "Clinical Psychologist" and "Counselling Psychologist" are protected and require HCPC registration.
How much does it cost to start a private therapy practice in the UK? Between £500 and £1,200 in year one for the regulatory and infrastructure essentials. That breaks down roughly as: ICO fee (£52), professional body fee (£86 to £216 depending on category), indemnity insurance (£80 to £200), supervision (£600 to £1,200 a year depending on whether you're fortnightly or monthly), directory listings (£300 to £400), basic website (£0 to £500 depending on whether you DIY on Squarespace or Wix or hire a designer), and practice management software (£0/month on a free plan, or roughly £20 to £35 a month for most UK paid platforms). Room hire, marketing, accountant fees and any further training are on top.
Do I need to register with HMRC immediately? Not immediately, but most private therapists should register as soon as they have firm plans to take private clients. The legal deadline is by 5 October following the end of the tax year in which your gross self-employment income first exceeded £1,000. The £1,000 trading allowance is rarely useful for a working therapist, and registering early avoids both the deadline and the temptation to under-report.
Do I have to register with the ICO if I only see a few clients? Yes. The ICO threshold is not based on practice size but on whether you process personal data. Sole therapists with one client and a calendar app are still data controllers. The fee is £52, payable annually.
How much indemnity insurance do I actually need? At minimum £1 million, ideally £2 million. The marginal cost of doubling cover is small and the protection is meaningful. Make sure the wording is therapy-specific rather than generic professional indemnity, and that public liability is included or added if you see clients face to face.
Should I start as a sole trader or set up a limited company? Sole trader for almost everyone in year one. It's simpler, cheaper, and easier to wind up if private practice turns out not to be for you. Revisit when your annual profits clear roughly £50,000 or you take on associates.
How long does it take to fill a private practice? Three to six months for most practitioners. Some fill faster through existing networks, EAP work, or strong specialism. Some take longer, especially in saturated city markets or unusual specialisms. Plan financially for at least six months of slow growth.
Can I work as both a sole trader privately and an employed therapist? Yes, this is the most common UK pattern. Your employer handles PAYE on your salaried income, you handle self-assessment on your private income, and HMRC ties them together at year end. The personal allowance is usually used by your employed role, so private earnings are taxed from the first pound. Set aside 25 to 30 percent of private fees for tax to avoid an unpleasant January.
Do I need a separate business bank account? Sole traders are not legally required to. You'll thank yourself for having one anyway. It massively simplifies bookkeeping and Self Assessment. Limited companies must have a separate business account. Most digital banks (Starling, Monzo Business, Tide) offer free or low-cost accounts that work fine for therapy practices.
What about working with clients overseas? Yes, but with care. UK indemnity policies have territorial limits. Many will cover EU clients; fewer will cover the US, Canada, or Australia. Some countries restrict who can practise as a therapist remotely. Check your indemnity wording before accepting overseas clients, and check the regulatory rules of the country your client is in. UKCP and the European Association for Psychotherapy both publish useful guidance for therapists working with international clients.
How often do I need supervision, and what ratio applies if I'm newly qualified? The minimum for qualified counsellors and psychotherapists in private practice is 1.5 hours of supervision per calendar month across BACP, UKCP, NCPS and BABCP. If you're a trainee on placement, BACP recommends one hour of supervision for every eight hours of client work, with supervision usually delivered fortnightly. Some training providers and supervisors use a 1:6 ratio for the first 50 client hours, easing to 1:8 afterwards. If you're seeing more than four clients a week, move to fortnightly supervision even once you're qualified. Group supervision counts proportionally and is valuable, but doesn't fully replace individual supervision in the early years.
When should I raise my fees? Annually, in small increments. A £5 rise once a year is barely noticed; a £25 rise after five years feels like a betrayal. Diarise the conversation, write a clear letter at least eight weeks before the change, and consider applying the new rate to new clients straight away while giving existing clients a notice period.
A short note on what comes next
Setting up the practice is the easy bit. Sustaining it well over years is harder. The practitioners I see thriving five and ten years into private practice all do similar things. There are seven habits in particular: they manage their caseload carefully and stop adding clients before burnout, not after; they stay in their own therapy long after training requires it; they invest in genuine CPD rather than the box-ticking kind; they say no to work that doesn't fit, even when the diary is light; they treat the business side of practice with the same care they bring to clinical work; they keep deliberate peer relationships, whether through peer supervision groups, modality-specific networks or simply trusted colleagues to text on a hard day; and they review their fees annually rather than letting them drift. None of that is glamorous. All of it compounds.
The field needs more thoughtful, well-set-up practitioners, and the best time to start is now.
If you'd rather not stitch all of this together yourself, Therasee is what we built for that. Free to start, no credit card. Or take the guide and go.
Coming next week: UK GDPR for Therapists: Complete Compliance Guide (2026). Everything from lawful bases and retention periods to subject access requests and breach reporting, written for working clinicians rather than data lawyers.
About the author
Nick Evans is the Co-founder of Therasee, a UK-built practice management platform for UK therapists, counsellors and psychologists.
Therasee Ltd is registered in England and Wales (Companies House 14298758) and based in Bristol.