Psychotherapy Regulations in Europe
Agnieszka Popiel
European Association for Behavioural and Cognitive Therapies (EABCT); SWPS Universityhttps://orcid.org/0000-0001-9990-4971
Helen MacDonald
European Association for Behavioural and Cognitive Therapies (EABCT); University of Sheffield; British Association for Behavioural and Cognitive PsychotherapiesBranka Bagaric
European Association for Behavioural and Cognitive Therapies (EABCT)https://orcid.org/0000-0002-1786-0993
Adela Sălceanu
European Association for Behavioural and Cognitive Therapies (EABCT)Tanja Anastasova
European Association for Behavioural and Cognitive Therapies (EABCT)Abstract
Aim: This paper explores the evolving regulatory landscape of psychotherapy across European countries to identify structural, legal, and ethical patterns that shape the profession. The primary objective is to assess whether psychotherapy should be defined and regulated as an independent profession or as a specialisation within established health disciplines such as psychology or psychiatry. A comparative analysis was conducted, based on case (country regulations’) studies and data from the ACSTEC/SWPS (2023) and EABCT (2025) projects, which document a significant diversity in qualification and training requirements.
Theses: The main theses are as follows: (1) regulatory systems based on the “lowest common denominator” and overly inclusive educational pathways pose a risk to patients because: (a) they carry a risk of consensus that undermines standards of evidence-based treatment, (b) they legitimize practices with undocumented efficacy and cost-effectiveness; (2) legal frameworks for psychotherapy in Europe are highly diverse in terms of access to qualifications, the role of university education, and oversight.
Conclusion: Europe requires a balanced model that protects patient safety, upholds evidence-based practice, and allows for the assimilation of knowledge stemming from the scientific development of psychotherapy. The article proposes a hybrid, competency-based regulatory model emphasizing transparent standards for evidence-based practice, clear educational pathways, and guarantees of access to effective care.
Keywords:
psychotherapy regulation, evidence-based practice, Europe, professional standards, legal frameworks, competency-based training, ethics, hybrid modelReferences
évi CLIV. törvény az egészségügyről (1997) (Hungary).https://net.jogtar.hu/jogszabaly?docid=99700154.TV Google Scholar
British Association for Behavioural and Cognitive Psychotherapies (BABCP). (2024). Professional standards. Retrieved on 30 April 2025 from: https://babcp.com/about/who-are-babcp/our-policies/standards-of-conduct-performance-ethics/ Google Scholar
Clark, D. M. (2018). Realizing the mass public benefit of evidence-based psychological therapies: The IAPT program. Annual Review of Clinical Psychology, 14, 159–183. https://doi.org/10.1146/annurev-clinpsy-050817-084833 Google Scholar
Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013 amending Directive 2005/36/EC on the recognition of professional qualifications and Regulation (EU) No 1024/2012 (2013) (European Union). https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:32013L0055 Google Scholar
Gecoördineerde wet betreffende de uitoefening van de gezondheidszorgberoepen, consolidated act No. 2015A24141 (2015) (Belgium). https://www.ejustice.just.fgov.be/cgi_loi/article.pl?language=nl&lg_txt=n&type=&sort=&numac_search=&cn_search=2015051006&caller=SUM&&view_numac=2015051006f Google Scholar
Gesetz über den Beruf der Psychotherapeutin und des Psychotherapeuten, Federal Act No. [number not specified] (2020) (Germany). https://www.gesetze-im-internet.de/psychthg_2020/ Google Scholar
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., Roiser, J. P., Bockting, C. L. H., O’Connor, R. C., Shafran, R., Moulds, M. L., & Craske, M. G. (2018). The Lancet Psychiatry Commission on psychological treatments research in tomorrow’s science. The Lancet. Psychiatry, 5(3), 237–286. https://doi.org/10.1016/S2215-0366(17)30513-8 Google Scholar
Layard, R., & Clark, D. M. (2014). Thrive: The power of psychological therapy. Penguin. Google Scholar
Legea nr. 213 din 27 mai 2004 privind exercitarea profesiei de psiholog cu drept de liberă practică, înființarea, organizarea și funcționarea Colegiului Psihologilor din România (2004) (Romania). http://86.105.216.122:83/MOfsWeb/2004/0492.pdf Google Scholar
Nowak-Far, A. (2025). Opinia w sprawie poselskiego projektu ustawy o zawodzie psychoterapeuty oraz samorządzie zawodowym zgłoszonego marszałkowi sejmu RP 11 lutego 2025 r. [Opinion on the deputies' draft act on the profession of psychotherapist and the professional self-government, submitted to the Marshal of the Sejm of the Republic of Poland on February 11, 2025]. https://www.pttpb.pl/get_media_preview/4f6db6be-96bd-473e-ab3b-9d72959a0e94 Google Scholar
Popiel, A., & Pragłowska, E. (2022). Psychoterapia poznawczo-behawioralna. Teoria i praktyka (wyd. 2 rozsz.). [Cognitive behavioral therapy: Theory and practice (2nd expanded ed.)].Wydawnictwo Naukowe PWN. Google Scholar
Popiel, A., & Zawadzki, B. (2023). Psychoterapia – quo vadis? [Psychotherapy – quo vadis?]. Nauka, 3, 61–85. https://doi.org/10.24425/nauka.2023.147311 Google Scholar
Professional Standards Authority for Health and Social Care. (n.d.). Retrieved from Professional Standards Authority for Health and Social Care, https://www.professionalstandards.org.uk/ Google Scholar
Regulation of the profession of the psychologist. Presidential acts, decrees and ordinances – ACT No. 56 18/2/1989 (1989) (Italy). https://www.psy.it/regulation-of-the-profession-of-the-psychologist-2 Google Scholar
Salkovskis, P. M., Sighvatsson, M. B., & Sigurdsson, J. F. (2023). How effective psychological treatments work: Mechanisms of change in cognitive behavioural therapy and beyond. Behavioural and Cognitive Psychotherapy, 51(6), 595–615. https://doi.org/10.1017/S1352465823000590 Google Scholar
Wet van 11 november 1993, houdende regelen inzake beroepen op het gebied van de individuele gezondheidszorg (Wet op de beroepen in de individuele gezondheidszorg) (2023) (The Netherlands). https://wetten.overheid.nl/BWBR0006251 Google Scholar
Wykowski, M. (2024a). Pierwszy wywiad z krajowym konsultantem psychoterapii: Co dalej w zakresie regulacji zawodu i jakości usług? [First interview with the National Consultant for Psychotherapy: What’s next for professional regulation and service quality?]. Rynek Zdrowia. Retrieved on 30 April 2025 from: https://www.rynekzdrowia.pl/Polityka-zdrowotna/Pierwszy-wywiad-z-konsultantem-w-dziedzinie-psychoterapii-Co-dalej-z-regulacja-zawodu-i-jakoscia-uslug,259633,14.html Google Scholar
Wykowski, M. (2024b). Prof. Popiel o podwójnych standardach dla psychoterapeutów: „To jak usuwanie ulotek z lekami”. [Prof. Popiel on double standards for psychotherapists: “It’s like removing leaflets from medication packs”]. Rynek Zdrowia. Retrieved on 30 April 2025 from: https://www.rynekzdrowia.pl/Polityka-zdrowotna/Prof-Popiel-o-podwojnych-standardach-psychoterapeutow-To-tak-jakby-usunac-ulotki-do-lekow,259902,14.html Google Scholar
Zakon o djelatnosti psihoterapije NN 18/22 na snazi od 17.02.2022 (2022) (Croatia). https://www.zakon.hr/z/1045/zakon-o-djelatnosti-psihoterapije Google Scholar
European Association for Behavioural and Cognitive Therapies (EABCT); SWPS University
https://orcid.org/0000-0001-9990-4971
European Association for Behavioural and Cognitive Therapies (EABCT); University of Sheffield; British Association for Behavioural and Cognitive Psychotherapies
European Association for Behavioural and Cognitive Therapies (EABCT)
https://orcid.org/0000-0002-1786-0993
European Association for Behavioural and Cognitive Therapies (EABCT)
European Association for Behavioural and Cognitive Therapies (EABCT)
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
