Society for Existential Analysis (SEA)

Submission to the Future of Counselling and Psychotherapy Commission – 27 March 2026

The Society for Existential Analysis (SEA) is a professional body representing around 700 members, including practitioners, trainers, supervisors and researchers in existential psychotherapy. In addition to being one of the founding organisational members of the United Kingdom Council for Psychotherapy, we represent an international professional membership and are cognisant of the reality that developments in the UK will influence the future of psychotherapy across Europe and perhaps beyond. We therefore welcome the opportunity to contribute to the Commission’s work.

Existential psychotherapy draws on phenomenological and existential traditions and is concerned with human existence and lived experience, often centring on questions of meaning, freedom, responsibility, uncertainty and relationship. These themes are not abstract philosophical interests but embodied issues that regularly arise in therapeutic work and are often central to the kinds of emotional and physical difficulties people bring to therapy. The embodied, relational, dimension of existential psychotherapy is increasingly important in a technological era characterised by telehealth, online therapy and artificial intelligence.

Our view is that there are genuine challenges within the sector that need addressing. At the same time, any reforms – including the possibility of statutory regulation – need to be approached carefully and with attention to the diversity of the field. The future of the profession should not be defined only in terms of tighter systems of control. Good therapeutic practice also depends on qualities that are harder to standardise: reflective capacity, ethical seriousness, the quality of the therapeutic relationship and the ability to work responsibly with complexity.

1. Counselling and psychotherapy: the state of the sector

Counselling and psychotherapy in the UK is a large and diverse field. Practitioners work across private practice, the NHS, education, social care, voluntary organisations and community settings. The profession also contains a large number of different therapeutic traditions, each with its own theoretical foundations, training routes and ways of understanding therapeutic work.

This diversity can make the field harder for the public to navigate, but it is also one of its strengths. Different modalities offer different ways of understanding distress how to attend to that within the therapeutic relationship. In practice, this allows the profession to respond to a wide range of needs.

There are nevertheless some clear challenges within the current system. These include:

public confusion about titles, qualifications and accreditation
variation in training routes and qualification thresholds across the field
uneven recognition of modalities within statutory services, such that certain modalities are championed and others ignored
increasing demand for therapy happening alongside increasingly complex client needs
concerns about the accessibility and cost of training, including unpaid placements

From our perspective, these issues deserve attention. However, they should not automatically be taken as evidence that the profession has fundamentally failed or needs a radical alteration in its oversight, structure or conduct. They also reflect the way the field has developed historically – through a wide range of traditions and institutions rather than a single professional pathway – that, although not ideal, has resulted in a rich landscape of ways of addressing human suffering that matches the diverse needs of society.

For that reason, the key task may be to improve clarity and accountability while preserving what is valuable about the field’s diversity.

2. Counselling and psychotherapy: is there a case for statutory regulation?

SEA believes that there is a valid argument for statutory regulation, primarily centred on public safety, professional accountability and enhancing trust through raising the status of the profession. Statutory regulation might offer:

clearer public assurance about minimum standards of training and practice
stronger and more recognisable complaints procedures
reduced confusion about professional titles
greater recognition of counselling and psychotherapy within statutory services

These are serious considerations and they should be examined carefully.

At the same time, the case for statutory regulation cannot simply be assumed. The complexity of the current system does not in itself determine what form of reform will be most helpful. In a field as varied as counselling and psychotherapy, the details of any regulatory framework would matter greatly.

Therefore, our concern is not with regulation as such, but with whether a particular model would be proportionate, workable and beneficial to the public.

If statutory regulation is pursued, it would need to be designed in a way that:

is clearly linked to public protection
is proportionate rather than overly bureaucratic
is transparent about its aims and the justification of those aims
supports professional judgement as grounded in minimum standards
recognises the plurality of the field in practice as well as in principle
preserves the integrity and recognisability of established therapeutic modalities, including existential psychotherapy

This last point is important. If a regulatory framework becomes too generic in practice, there is a risk that significant differences between therapeutic traditions are gradually flattened. We do not think that would serve either practitioners or the public well.

For these reasons, we see statutory regulation as a legitimate and important topic for discussion, but not a straightforward solution to the sector’s current challenges.

3. Counselling and psychotherapy: the evidence base

SEA welcomes the Commission’s attention to evidence. At the same time, evidence in psychotherapy is complex and should not be framed too narrowly.

There is substantial research showing that counselling and psychotherapy can be beneficial across a range of difficulties and settings. However, the evidence base includes many different forms of research, including:

quantitative outcome studies
qualitative and phenomenological research
process research
practice-based evidence
naturalistic and service-level data
research on therapeutic relationship factors

From an existential perspective, this breadth matters. As noted above, existential therapy often works with questions of meaning, identity, freedom, responsibility and uncertainty. These concerns can be central to therapeutic change but are not always fully captured by short-term symptom measures alone.

For that reason, we would encourage the Commission to adopt a broad and methodologically plural understanding of evidence.

It is also helpful to distinguish between several different questions that sometimes become blurred in public debate.

First, there is the evidence that psychotherapy can be helpful.

Second, there is the question of harm. Therapy can sometimes be ineffective, poorly matched, poorly delivered or, in some cases, harmful.

Therefore, it is important to distinguish between serious misconduct, poor practice, therapy that is simply ineffective for a particular client, and the fact that some forms of therapy may involve discomfort or difficulty as part of meaningful work. This is why ethical standards, good training, supervision and accessible complaints procedures are essential.

Third, there is the separate question of whether a particular form of regulation would improve safety or public confidence. That question requires its own argument and evidence.

4. Counselling and psychotherapy: the future of the professions

Looking ahead, we would like to see counselling and psychotherapy develop in ways that are both publicly accountable and professionally thoughtful.

The professions need to be easier for the public to understand. People should be able to find out clearly what training a practitioner has, what standards apply and where they can turn if something goes wrong.

We would particularly highlight the importance of:

improving clarity around titles and standards
strengthening public trust without assuming that greater standardisation automatically improves practice
maintaining space for a range of therapeutic modalities
improving access to training and addressing structural barriers, including financial ones
ensuring that counselling and psychotherapy are more thoughtfully integrated into the NHS, education and community services

Smaller modality-specific professional communities also play an important role in sustaining the intellectual and clinical traditions that underpin the profession. These traditions should not be treated as historical leftovers but as ongoing contributions to therapeutic thinking and practice.

Recommendations

SEA would encourage the Commission to consider the following:

Recognise counselling and psychotherapy as a plural field and approach reform in ways that support diversity of modality.
Improve public clarity around titles, training routes, standards and complaints procedures.
If statutory regulation is pursued, ensure that it is proportionate, evidence-informed (in a pluralistic way) and clearly linked to public protection.
Design any regulatory framework in ways that preserve the integrity and recognisability of established therapeutic traditions, including existential psychotherapy.
Adopt a broad and methodologically plural understanding of evidence.
Distinguish carefully between evidence of therapeutic benefit, evidence of harm and evidence relating to regulatory models.
Support a more sustainable profession by addressing issues such as training costs, unpaid placements and barriers to entry.

SEA Submission to the PCPB