Therapy is the ‘profession of the century’ according to a Financial Times report that asked ‘Why are so many people retraining as therapists?’1 BACP student membership has increased by 21.06% since 2021, and BACP general membership is at an all-time high of 75,263.
It’s perhaps not surprising given that awareness of the importance of mental wellbeing has risen, and having therapy has become destigmatised to the point of almost becoming a status symbol in some circles. The UK has also never been more therapy-literate, with information about emotional and psychological health now widely available via social media channels and AI. Therapeutic thinking and theories such as attachment styles, trauma, projection, anxiety and neurodiversity are no longer confined to the therapy room – they’re discussed in the workplace, schools and further education institutions, and in wider society, validating the relevance of our expertise.
Some therapists are experiencing a boom time as a result – over a third (36%) of respondents to a recent BACP Mindometer survey described demand at their practice as overcapacity, resulting in a waiting list or referral of clients to other services.2 But something more surprising is also happening in response to this changing professional landscape – many have seen enquiries slow down. ‘I’ve been a lot quieter this year in my private practice, and sometimes wonder if AI is the reason’, ‘Is anyone else finding it ridiculously quiet at the moment?’ and ‘Enquiries have dropped – is anyone else constantly anxious it’s all going to disappear?’ are just a selection of recent posts in therapist Facebook groups. Although there are no hard data, it’s been suggested that an increased number of people qualifying as therapists means more competition, with some areas reaching saturation point with private practitioners. Factor in the cost of living crisis and the AI effect – people turning to chatbots instead of therapy for support – and you begin to see why even established practitioners are reporting a noticeable decrease in new client enquiries.
It’s not just competition with colleagues that is presenting challenges – we’re also struggling to stay visible. Traditional therapist directories now have to compete with the marketing budgets of the large subscriptionbased online therapy platforms. Private practitioners are also navigating everchanging algorithms to remain findable when clients search for support on Google, social media platforms and via AI.
Therapists are also reporting a shift in clients’ perception and experience of therapy. Clients expect to ‘know, like and trust’ a therapist before they even book, and are shopping around for therapy. They’re just as likely to choose a practitioner from their social media presence than their directory listing. When they turn up for their first-ever therapy session it’s often with a preset agenda, to discuss or confirm (for example) a ‘TikTok self-diagnosis’ of parentification, narcissistic abuse or anxious attachment.
If there is one word that describes what’s happening in the current therapy landscape it’s ‘disruption’, and although change is often unsettling, disruption can create growth and new opportunities. Digitalisation has opened up new ways for therapists to reach more clients and scale up their practices. Social media allows therapists to clearly communicate their specialisms to the clients they work best with. And thanks to the normalisation of seeking help for mental health issues, there are potentially more clients out there than ever before.
The question for us as a profession is how do we respond and adapt to this changing landscape without sacrificing professional ethics and losing the essence of what we do? The answers aren’t straightforward, but to offer some insight, I talked to key practitioners and academics about the emerging trends impacting our profession, and how we ethically and practically navigate the challenges facing us right now and in the immediate future.
Ambient culture
The days when the only option for mental health support was seeing the counsellor at your GP’s surgery, or choosing from the few private practitioners working locally, are long gone. Clients can now draw on a broader range of resources – they can book online sessions with therapists throughout the country while also using a moodtracking app, participating in an online peer community, following several mental health influencers on social media and regularly talking to ChatGPT about their worries.
Therapy is everywhere now as ‘ambient culture’, says therapist, academic and author of the Liminal Lab Substack Dr Chris Hoff. ‘People are “holding space”, they’re “trauma-informed”, they’re talking about “nervous system activation”.’ Hoff calls the phenomenon the ‘great dispersion’ and says what he’s noticed is that clients who present as fluent in ‘therapy speak’ are also more likely to be stuck: ‘I’d be in supervision or consulting with colleagues and we’d notice clients coming in already fluent in therapeutic discourse – trauma-informed, attachment styles, nervous system regulation – but somehow they were more stuck than ever. They’d done all this ambient therapeutic work through podcasts, self-help books, Instagram and TikTok and were arriving exhausted, having self-diagnosed and selftreated but unable to actually shift anything.’
The challenge for our profession, says Hoff, is that an entire generation expects therapy to feel good, to be empowering, to affirm. ‘They expect immediate validation and psychoeducation – the TikTok model rather than the slower, often messier work of actually changing how they story their lives. But real therapeutic work often requires exactly the opposite – sitting with contradiction, tolerating not-knowing. When clients have been fed a steady diet of ambient therapy that promises clarity and resolution, the actual uncertainty of transformative work may feel like failure.’
It’s not just younger generations. Thanks to ‘the algorithm’, anyone with an online life is, intentionally or otherwise, shown a curated version of the news and social media that interests them and affirms their views. ‘I do think we are all curating our own echo chambers now, and that extends into therapy,’ says Louise Chunn, founder and CEO of the therapist-matching platform Welldoing. ‘Some people want a therapist who reflects their views and won’t challenge certain assumptions. The whole language of “safe spaces” can sometimes feed into that, if “safe” means “never disagrees with me”.’

Chris Hoff, therapist, academic and author
John Wilson, psychotherapist, trainer and Director of Onlinevents, agrees it is a challenge but also sees it as a time to rethink where we best add value. ‘The entrylevel kind of contact with clients – a little bit of reflection and a supportive space – the AI models are already very, very good at that. Millions of people are using AI for that every single day. That ship has sailed,’ he says. Rather than seeing this as a threat, Wilson frames it as ‘a call to excellence’. If AI can handle basic reflection and support, human therapists need to excel at what machines cannot do – the deeply embodied, human-to-human sensing of what’s happening in another person. ‘That’s the bit that AI can’t get into right now,’ he says.
That doesn’t mean, however, that we shouldn’t also adapt and offer clients what they are asking for – and for some that might mean working at a faster pace, says Wilson. Along with Prof Windy Dryden he has been involved in training counsellors to deliver 20-minute ‘micro-sessions’ for a new subscription app, brightloaf. For years Dryden has offered demonstration sessions at training workshops, often lasting just 20 to 25 minutes. ‘That taught me what is possible in a fairly short period of time,’ he says. For a monthly payment brightloaf members get unlimited access to self-directed anxiety support, with the option to book 20-minute video sessions with BACP registered counsellors for an extra payment. ‘People don’t always want solutions to specific problems – some just want to talk for 20 minutes, and that’s fine,’ says Dryden. ‘They might want some reassurance, they might want to know, “is this normal?”.’ Rather than replacing long-term therapy, Dryden sees microtherapy as adding to our repertoire.
Trained in the person-centred approach with its ‘eye on a very long-term kind of experience’, Wilson found himself struggling when clients didn’t engage with that openended time frame. ‘I would have people coming, getting a little bit of benefit and not coming back,’ he says. ‘So my practice started to shift into, well, what can we do today?’
This isn’t about abandoning depth for convenience, Wilson insists – it’s about recognising that we can offer something tangible in each session while remaining open to longer-term work. ‘Clients shouldn’t need to wait for us to warm up to them,’ he argues. ‘If there’s something that we can do right away to make a difference in someone’s life, and they can have that right now, why should they wait for us to settle into the relationship?’

Sarah Rees, private practitioner and author
Mental health ecosystem
We may see the traditional, 50-minute, weekly therapy session as the gold standard treatment for mental wellbeing but increasingly clients are viewing it as just one option in the ‘mental health ecosystem’, says Terry Hanley, Professor of Counselling Psychology at the University of Manchester. ‘Clients pick and mix from all over the place. They come to therapy and say “I talked to ChatGPT about this yesterday”. They bring in their mood apps, their wearables monitoring different things. It presents a question for us as a profession – do we engage with this, and take some responsibility for what happens in between our sessions with clients, or not?’
Although there were other options for mental health support in the past, says Jodie Cariss, founder of the innovative London-based therapy service Self Space, what’s changed is the sheer access: ‘In the past we just had the agony aunt in the back of a magazine and a few self-help books in the library. Now we have this expansive wealth of options.’ A key driver for clients seeking wider options is cost. ‘Weekly private therapy from £50 to £100 or more per session, long term, is a serious financial commitment.’
Hanley sees an emerging role for therapists in supporting people to think critically about the quality of the tools they use, and also recommend safer options where appropriate, and integrate those experiences into therapy. ‘We could respond by thinking that’s happening outside the 50 minutes, nothing to do with me, I have no responsibility whatsoever,’ he says, ‘but we’d miss out on an opportunity to actually orchestrate some of that space a little more.’
If we think beyond the idea of one-toone work being the only ‘real’ therapy, new opportunities to use our skills open up, argues Cariss: ‘That might mean personal therapy where appropriate but also psychoeducational talks, walking groups, retreats, workplace workshops, thoughtfully designed digital resources – and allowing the client to curate their own therapeutic package. Our role is ensuring these elements work together to support real change rather than becoming a way to avoid it.’
Diversification
It may feel like a threat, but the growth of the mental health ecosystem could make a therapy career more sustainable, according to Sarah Rees, private practitioner, therapy business coach and author of A Therapist’s Guide to Private Practice (Routledge). ‘We love the work but it can be exhausting, especially after many years. There are so many other ways people could access our knowledge. I think we’re going to have to diversify, partly for our own wellbeing,’ she says. ‘It’s a very different “energy bucket” to create a course or a digital resource than to see clients back-toback. For clients, especially when there’s shame involved, the leap from feeling ashamed to walking into a therapist’s room is enormous. We can bridge that gap through guides, courses, workshops and so on – helping people move from wanting help to feeling ready to see a therapist.’
Rees ran a workshop for therapists on diversifying, tying it in with Black Friday, and was surprised at the demand. ‘I worried it would feel gimmicky or too salesy and that no one would come. The response was huge. There’s clearly a need – therapists want to use their knowledge differently, and clients want more flexible, hybrid ways of working. Clients are busy, and many want to explore other options before committing to regular sessions. That might be a 90-minute, one-off session where they can bring a problem, explore what therapy might look like and leave with recommendations and resources. The wider point is that clients want options. Courses, groups, stand-alone sessions, hybrid models – these aren’t us “selling things” so much as responding to a genuine need.’

John Wilson, psychotherapist and trainer
Know, like and trust
Some changes in the therapy landscape reflect broader cultural shifts, such as the so-called ‘trust recession’. It’s one reason why therapists need to understand the ‘know, like and trust’ factor, says therapist and host of the Good Enough Counsellors podcast Josephine Hughes, who runs Therapy Growth Group: ‘If people are finding you online they need several “touchpoints” with you before deciding to work with you. Some clients are looking because they want help immediately, but many others are thinking about it and are not quite sure yet. We can really help that latter group by having some kind of social media presence that allows them to get to know us a little.’
66% of people have experienced at least one mental health issue in the past five years*
Visibility is increasingly important for therapists, agrees Rees. ‘In marketing terms success used to be about who you knew, then it was what you knew and now it’s who knows you. Therapists often put long lists of qualifications on their websites to attract clients, but most potential clients have no idea what those letters mean. Now clients want to know who the therapist is.’
How we show up digitally is becoming a reflection of how we show up in the therapy room, and it’s ultimately empowering for the client, she believes: ‘We lock so much expertise behind the therapy door, but we’re asking people to trust us with their most private, sometimes darkest experiences. The research is very clear – outcomes are better when clients know, like and trust their therapist and feel confident that we’ll look after them. That therapeutic relationship far outweighs the modality we use or how long we’ve trained for. And that relationship can start before they ever walk into the room.’
A well-written directory profile or website may no longer be enough – many therapists report that directory listings that worked well for years can no longer be relied on to consistently bring enquiries. Changes in Google’s search results, the rise of AI summaries and the prominence of Google business listings all play a part. Although word of mouth, referrals and networking all still matter, social media meets an emerging client expectation to have ‘seen something of us’ before they book, says Rees. ‘Therapists hate doing video, but it’s a very effective way for people to get a sense of us,’ she says.
Chunn agrees: ‘Therapists now have the option to add short videos to most directory profiles, and they can be effective. A lot of therapists have been camera-shy, but many now have ring lights for video calls and a smartphone, so taking a decent video is not a stretch. At Welldoing we’re currently experimenting with posting short, psychoeducational reels on social media, with therapists answering the questions people rarely voice: “Will my therapist judge me?”, “Are they analysing me outside sessions?”, “Are they bored by my problems?”. It’s not designed to replace therapy – it’s designed to lower the threshold for making contact.’

Josephine Hughes, therapist and podcast host
Vulnerability economy
The challenge for therapists is that creating and managing an effective and appropriate social media profile can feel like another job in itself – and as Rees points out, ‘you’re essentially investing your time in someone else’s platform’ and contributing to the profits of corporations such as Meta in the process. She also has reservations about what ‘the algorithm’ favours, as in general, posts containing controversial content tend to perform best. For therapists, whose work relies on compassion, thoughtfulness and containment, the pull towards ‘shocking stats’ and emotionally charged snippets can be dangerous. ‘The platforms want people to stay, be shocked, be entertained. That’s the content they reward. You could easily end up chasing shock value. We need to think carefully about the culture we’re creating in private practice,’ she says.
Alongside the visibility issue sits something subtler but more unsettling – a cultural expectation of self-disclosure. Across many fields we’re seeing the ‘marketing of vulnerability’ – the entrepreneur who posts about their social anxiety, the celebrity who shares about their panic attacks, the wellness influencer whose business is built on their breakdown and recovery. Vulnerability has become a kind of social currency, signalling authenticity and relatability.
For therapists on social media the implicit message can be that if you want to attract clients you must reveal something of your own struggles. Chunn says therapist directory profiles have changed dramatically since Welldoing was first launched: ‘There’s much more about the practitioners personally – whether they have children, what they do in their spare time, life and career experience, even that they had a mental health issue or breakdown themselves. Directories are becoming more like dating apps – therapists are definitely more open with personal information.’
Whether such sharing is in the best interests of clients, therapists and the profession is a complex issue, but there is genuine value in challenging the fantasy of the ‘perfect therapist’, says Hughes: ‘When therapists share, carefully and thoughtfully, that they too have had therapy, have struggled, have learned to manage their own difficulties, it can normalise distress and reduce shame.’

Louise Chunn, founder of Welldoing
Lifestyle choice
Normalising and reducing shame are also key for Rima Mehta who, along with fellow director Jenny Collard, recently rebranded the service they founded and have run successfully for 14 years, from Rutland House Counselling and Psychotherapy to the Therapy Lounge Collective, largely in response to what they believe clients want. ‘I wanted the brand to feel warm, relational and welcoming – less “you can only come if you are really unwell” and more “this is a place where you can come to feel at home, to find some peace and calm, and to work through whatever is troubling you”,’ says Mehta. ‘We deal with very complex presentations and severe distress, but we want the experience of coming to us to feel human, accessible and inclusive. Many clients over the years have spoken about how intimidating it can feel to see GPs and psychiatrists in very medical, clinical environments.’
75% of people who have had therapy would recommend it*
When clients are assessed they’re assigned to one of several ‘lounges’ spread out over a four-floor building – a corporate lounge for workplace wellbeing, a trauma lounge for deep healing work (EMDR, DID treatment, trauma-informed therapies), a general therapy lounge for broad-range work and couples counselling, and a DBT lounge. Clients can move between lounges as their needs evolve – starting with EMDR to stabilise trauma before moving to DBT skills work, for instance. The model creates what Mehta calls ‘a lifestyle place, where you come, do some work, leave when you’re feeling ready and then come back when you want to’.
The challenge going forward is balancing human connection with contemporary expectations around speed and convenience. ‘Immediacy is part of everyday life now – whether you order on Uber, JustEat or Amazon, you expect and usually get a swift service. Our challenge is managing those expectations in therapy too,’ she says. One response is that the practice aims to see new clients within two weeks – consultation within the first week, matched with a therapist by the second. ‘It’s quick, they’re getting help when they need it.’
She admits that the rebrand has felt at times like a leap of faith – not least because they invested in the purchase of the building, bucking the trend for online therapy. ‘We’re testing what clients want. It’s trial and error to work out what they actually end up using versus what they say they want.’
Community is key so the team includes Matt, whose role is to ‘keep relationships going – between clients and us as a practice, between us as a practice and therapists who are associates, and relationships with organisations and businesses. There’s a lot of communication to think about,’ says Mehta.
Rees agrees that clients are drawn to a feeling of belonging to something. Since the pandemic she has used an email list, collected via her website and social media posts, to create a sense of community around her practice, sharing reflections on mental health in the news, practical tips, updates on her work and links to resources. It is not unusual for someone to have read her newsletters for years before reaching out. ‘In effect, the therapeutic relationship is starting before they ever walk through the door,’ she says.
Younger generations especially feel more comfortable approaching a known entity than an anonymous individual in private practice, says Cariss – one reason why Self Space’s marketing feels more like an upmarket health club than a therapy service. ‘We live in a brand culture,’ she says. ‘My long-term aim has always been that Self Space becomes a trusted mental health brand, not just a directory of therapists. We educate, offer community and then, when people are ready, offer therapy too.’

Rima Mehta, Director of Therapy Lounge Collective
Therapy on credit
As well as more choice in accessing support, clients are looking for more ways to pay for it. With weekly sessions of £60 and upwards beyond many people’s means, it’s becoming the norm for clients to opt for fortnightly or three-weekly sessions to make long-term work affordable. Many therapists also offer discounts for blockbooking sessions. Now younger clients are bringing another consumer trend into the therapy room – ‘pay in three’, an option normalised by the consumer credit company Klarna. ‘I’ve been asked about it by younger clients, and I know some therapists are open to it. I haven’t accepted payment by Klarna yet, but there is a credit option available for clients via the online payment provider I use, Stripe,’ says Rees. ‘It’s not something I advertise, but if people ask, we explore it. I think in some cases it’s less about not having the money and more about this being how people pay for everything now. A colleague in e-commerce says even low-cost items are often bought in three instalments. It’s coming into every area of life.’
The ethical issues are complex, and there are legitimate concerns about encouraging debt. But Rees is clear that financial flexibility is part of the broader consumerisation trend and that therapists cannot pretend it isn’t happening. ‘More clients are asking for packages where they never would have before,’ she says. ‘That might mean offering blocks of five or more sessions with a discount. Packages also help with motivation and commitment – if someone commits to a certain number of sessions they’re more likely to show up and do the work, which is better for outcomes.’
We’ve also seen the steady growth of the subscription model in recent years – we can now ‘subscribe and save’ to household items we need regularly such as pet food and toilet rolls. There are also a host of subscription-basis lifestyle apps marketed to support healthy eating, exercise, meditation and stress reduction. It was only a matter of time before a provider found a way of introducing it to the therapy market, and in 2022 BetterHelp, the controversial US venture capital-funded platform, launched in the UK and offered access to weekly online therapy for £65 per week by direct debit.
Subscription models are harder for lone practitioners or smaller services to operate – although as Rees points out, ‘personal trainers have worked on a subscription model for years’. Cariss says it comes down to price: ‘To make it viable you’d need to charge £300 a month, more than even the most expensive personal trainers or gyms.’
Self Space is instead about to launch community crowdfund where people can invest anywhere from £25 to £25,000, receiving shares plus perks like newsletters, tote bags or, at higher levels, retreats and therapy sessions. ‘I’m interested in what it will bring,’ says Cariss. ‘I wonder about people – even if they’re not able to use the service – thinking “I’m an investor in a mental health brand” and signposting others.’
There is much to be learned by thinking beyond our own profession and learning from other service industries, says Rees. ‘There is, understandably, a lot of emphasis on boundaries in our profession, but the more diverse our thinking and professional networks, the stronger and more supported we become. We gain access to more knowledge and skills, and that helps us create a clearer step-by-step pathway for clients rather than letting them fall between services. We can link with other professionals, access peer supervision from different places, upskill ourselves and improve access for clients. That’s all part of seeing ourselves as a collective.
‘We need to see ourselves as a community of like-minded practitioners supporting people’s mental wellbeing rather than a set of individuals. I think we really have to work together, especially as big organisations arrive wanting a slice of the “therapy pie”. If you come at it with a collaborative mindset, you naturally attract collaborators.’
Good therapy
There’s no denying that the professional landscape for therapists is turbulent – we’re being externally disrupted by tech, by economics and by culture, and we have to respond. The shift from clients to consumers is not merely semantic. It reconfigures expectations and creates a pressure for therapists to not only be clinically competent but also visible, branded and algorithm-friendly.
At the same time, the core of good therapy remains unchanged – people still need to be heard and understood, and they still need a place where their experience can be explored without judgment. The question for all of us is how we can respond to changing client expectations without losing sight of what makes the work meaningful – how do we become more visible in a way that feels comfortable and authentic, adopt useful innovations without losing the quality of the relationship, and respond to therapeutically informed clients without surrendering professional judgment? If we stay open to change while holding on to the therapeutic alliance, we stand the best chance of offering services that are in clients’ best interests – and our own.
- For more on how ‘therapy speak’ is changing both our profession and culture, see our 'Viewpoint' article, ‘What in the name of Narcissus is this?’ by Julia Bueno, on pages 70-72.

Jodie Cariss, founder of Self Space
References
1. Staton B. ‘Profession of the century’: why so many people are retraining as therapists. Financial Times; 27 August 2023.
2. BACP Mindometer Survey. bacp.co.uk/about-us/ about-bacp/bacp-mindometer-2025