Understanding Complementary Therapy Regulation, Registers and Professional Associations – Why these organisations matter to therapists and the public

Principles & Practices of Complementary Therapy

The complementary therapy sector includes many different disciplines, organisations and membership bodies. It is therefore understandable that therapists, and sometimes members of the public, are unsure who regulates what, which organisations they should join and what professional membership actually means.

The simple answer is that there is no single organisation governing the whole sector. Different bodies perform different roles, and most complementary therapies are not regulated by law. This does not mean that professional standards are unimportant. In fact, where statutory regulation is absent, qualifications, voluntary registration, professional membership, insurance and continuing professional development become particularly important ways of demonstrating safe and responsible practice.

What do we mean by complementary and alternative therapies?

The terms complementary and alternative are often placed together under the abbreviation CAM, but they do not mean quite the same thing. A complementary therapy is used alongside conventional healthcare, whereas an alternative therapy is used instead of conventional medical treatment.

For most therapists working within our sector, complementary is the more appropriate term. A responsible complementary therapist does not diagnose illness, replace medical advice or encourage a client to stop conventional treatment. Instead, the therapist works within the boundaries of their training to support comfort, relaxation, wellbeing and quality of life.

At the heart of complementary therapy is a holistic approach. This means considering the person as a whole rather than focusing solely on one symptom or area of the body. It also recognises that physical, emotional, social and lifestyle factors may all influence how someone feels. The aim is not to promise a cure or claim to treat an underlying medical condition, but to provide appropriate, person-centred support.

How did the sector begin to gain wider recognition?

Many of the individual disciplines now described as complementary therapies have roots stretching back hundreds or even thousands of years. However, their relationship with conventional Western medicine has not always been an easy one. For much of the twentieth century, many approaches outside mainstream healthcare were viewed with considerable scepticism.

King Charles III, who was then HRH The Prince of Wales, played an instrumental and high-profile role in encouraging discussion about a more integrated approach to health. In 1982, during his presidency of the British Medical Association (BMA), he addressed its 150th anniversary dinner. He challenged the medical profession to be less hostile towards unorthodox approaches and warned against losing sight of the whole person while concentrating on individual parts of the body.

His views were not universally welcomed; he often spoke out about things he felt passionately about and sometimes was ridiculed; however, it helped bring the debate about complementary healthcare into public view.

In 1993, The Prince of Wales established the Foundation for Integrated Health. Although the organisation was controversial and is no longer operating, it contributed to discussions about education, professional standards and regulation within complementary healthcare. This work also formed part of the background to the eventual establishment of the Complementary and Natural Healthcare Council (CNHC).

The House of Lords report

Another significant turning point came in 2000, when the House of Lords Select Committee on Science and Technology published its Sixth Report following an inquiry into complementary and alternative medicine.

The report placed therapies into three broad groups:

Group 1: professionally organised alternative therapies. This included osteopathy and chiropractic, which were already subject to statutory regulation, as well as acupuncture, herbal medicine and homoeopathy.
Group 2: complementary therapies that were generally used alongside conventional medicine and did not claim to diagnose illness. Examples included massage, reflexology and aromatherapy.
Group 3: other alternative disciplines. This group included long-established traditional systems of healthcare, such as Traditional Chinese Medicine, alongside other approaches considered by the Committee to lack a credible evidence base.

The Committee made recommendations concerning regulation, training and research. It also acknowledged that some Group 2 therapies could provide help and comfort when used in a complementary way, including by supporting people experiencing stress, the side effects of cancer treatment, older age or palliative care.

The report is now more than two decades old and should be understood in its historical context. Nevertheless, it remains an important landmark in the development of the UK complementary therapy sector.

More recent developments

In 2021, the UK Government recognised hair, beauty and spa as part of a distinct Personal Care Sector rather than grouping it solely with retail and hospitality. A dedicated team was established within the then Department for Business, Energy and Industrial Strategy (BEIS). BEIS was replaced in 2023, with relevant business responsibilities transferring to the Department for Business and Trade and other newly formed departments.

In March 2021, the then Prince of Wales returned to the subject of integrated healthcare in an article for the Future Healthcare Journal. He supported an open-minded discussion about evidence-informed conventional and complementary approaches and drew attention to the fact that some patients felt unable to discuss their use of complementary therapies with their doctors.

Today, access to complementary therapies through the NHS remains limited and varies considerably. Some services are available through hospitals, cancer centres, hospices, pain services and, less commonly, GP practices. Availability depends on the therapy, the evidence for its use in a particular context, local commissioning decisions and funding.

Cancer Research UK reports that researchers estimate around 30–40% of people with cancer use some form of complementary or alternative medicine. Complementary therapies may help some people feel better or cope with symptoms and treatment side effects, but some approaches may be unsuitable or interact with conventional treatment. Therapists should therefore work within their competence and encourage clients to discuss relevant complementary therapies with their medical team.

Is the complementary therapy sector regulated?

Frustratingly, the answer is Yes, through existing consumer protection legislation and No, not specifically for complementary therapies.

Osteopaths and chiropractors are regulated by law in the UK. They must be registered with their statutory regulator and comply with the standards required of their profession. Most other complementary therapy practitioners, including reflexologists, massage therapists and aromatherapists, are not subject to statutory professional regulation.

This means, for example, that the title reflexologist is not legally protected. Someone may describe themselves as a reflexologist without holding a recognised qualification. That is understandably concerning for both properly qualified therapists and members of the public who may not know what questions to ask.

However, an absence of statutory regulation does not mean an absence of responsibilities. Every therapist must comply with the laws that apply to their work. These may include health and safety, data protection, equality, consumer protection, advertising and local authority licensing requirements. The precise requirements can vary according to the therapy, the treatment environment and the local authority area.

Professional treatment and public liability insurance are strongly recommended and are normally required by professional associations, voluntary registers, training providers and premises owners. However, there is no single statutory insurance requirement applying to every complementary therapy practitioner in every setting.

Voluntary registers and the Professional Standards Authority

Practitioners in some unregulated health and care occupations can choose to join a voluntary register. Some register-holding organisations are accredited by the Professional Standards Authority for Health and Social Care (PSA).

It is important to understand what this means. The PSA accredits the organisation and its register; it does not accredit the therapy itself, and registration does not turn an unregulated occupation into a statutorily regulated profession. Accreditation does, however, show that the register has demonstrated that it meets the PSA’s standards for areas such as governance, education requirements, complaints and public protection.

The CNHC currently operates a PSA-accredited voluntary register covering a specified range of complementary healthcare disciplines. Other organisations operating PSA-accredited registers may also include practitioners working within parts of the complementary healthcare sector. Because accreditation and the disciplines covered can change, it is sensible to check the current PSA list rather than relying on an old list in a textbook or blog.

Other organisations, such as the General Regulatory Council for Complementary Therapies (GRCCT), also operate voluntary registers but are not necessarily part of the PSA Accredited Registers programme. Therapists should look carefully at what each register requires, what oversight it provides and whether it is relevant to their discipline and intended area of work.

What is the difference between a regulator, council and professional association?

The terms can become confusing because organisations sometimes perform more than one function. Broadly, however, they can be understood as follows:

Statutory regulators are created or recognised through legislation. They protect the public by setting standards, maintaining registers and taking action where regulated professionals fail to meet those standards.
Voluntary regulators or registers provide an optional route through which practitioners in unregulated occupations can demonstrate that they meet defined standards.
Sector councils represent, promote or help develop particular parts of an industry. Their work may include research, policy discussions, public education and engagement with government.
Professional associations primarily support practitioners within a particular profession or group of therapies. They may set entry requirements, publish a code of conduct, provide guidance, approve training or CPD, offer networking and represent members’ interests.

The CNHC is a voluntary regulator for a defined range of complementary healthcare practitioners. The British Beauty Council has a different role: it represents and champions the wider beauty and personal care industry. Their work may overlap in some areas, but they do not perform the same function or cover the entire complementary therapy sector.

Professional associations include organisations such as the Federation of Holistic Therapists (FHT), the Association of Reflexologists (AoR) and many therapy-specific bodies. Membership is voluntary, and entry requirements vary. Some accept a range of recognised qualifications, while others have more specific requirements concerning the qualification, learning hours, supervised practical training or case studies.

Because requirements change, therapists should always check the association’s current membership criteria directly before beginning a qualification or submitting an application. A course stating that it is ‘accredited’ does not automatically mean it will be accepted by every association, insurer or voluntary register.

The role of collaborative organisations

Some organisations bring together professional associations and other stakeholders to work on shared priorities. One example is the Integrated Healthcare Collaborative (IHC), which was created following recommendations made by the All-Party Parliamentary Group for Integrated Healthcare.

Its members work together on areas of common interest, including access to complementary, traditional and natural healthcare, greater communication with conventional healthcare and improved outcomes for the public. Collaborative organisations can give a fragmented sector a stronger collective voice, particularly when communicating with government and policymakers.

Codes of conduct and ethics

As most complementary therapy professions are not regulated by statute, there is no single statutory code of conduct covering the whole sector. Professional associations and voluntary registers therefore publish their own codes, which members or registrants must follow if they wish to retain that membership or registration.

Although the wording varies, these codes commonly require therapists to:

act in the best interests of clients and treat them with dignity and respect;
maintain appropriate confidentiality and protect personal information;
take responsibility for their decisions and actions;
practise only within the limits of their training and competence;
maintain and develop their knowledge through continuing professional development;
communicate honestly about their qualifications and what the therapy may achieve;
maintain appropriate professional boundaries;
work respectfully with other practitioners and healthcare professionals; and
practise safely and within the law.

Why does a code matter?

A code of conduct is not simply a list of rules tucked away on an association’s website. It provides a practical framework for making professional decisions and helps protect the client, the therapist and the reputation of the wider profession.

For example, a code can help a therapist understand why it is important to:

avoid exaggerating their skills or making unsupported claims about what a therapy can treat or achieve;
recognise when a client’s needs fall outside their competence and referral or medical advice may be appropriate;
collect, use and store client information in accordance with the UK GDPR and the Data Protection Act 2018, recognising that health information receives additional protection;
maintain appropriate standards of hygiene, infection prevention, risk assessment and general safety;
obtain informed consent and maintain clear professional boundaries; and
provide an inclusive service and comply with the Equality Act 2010.

Therapists must also comply with consumer protection and advertising law. Claims about health, treatment outcomes or professional status must be accurate and capable of being substantiated. Good intentions are important, but they do not provide a small legal force field around an inaccurate claim.

What does professional membership demonstrate?

Joining an appropriate professional association or voluntary register cannot guarantee that every practitioner will always provide excellent care. It does, however, give the public additional reassurance that the therapist has met stated entry requirements, agreed to follow professional standards and can be held accountable through a complaints process.

For the therapist, membership can provide guidance, continuing professional development, professional updates, networking and a clearer framework for practice. It also demonstrates a willingness to be accountable rather than simply placing a certificate on the wall and hoping professionalism happens by osmosis.

Ultimately, professionalism is not created by membership alone. It is demonstrated in the way a therapist trains, communicates, keeps records, maintains boundaries, develops their knowledge and responds when something falls outside their competence.

Where does this leave the therapist?

The absence of statutory regulation across much of the complementary therapy sector places a greater responsibility on each of us to understand what good professional practice looks like. This includes choosing robust training, obtaining appropriate insurance, joining a relevant professional body or register, undertaking meaningful CPD and remaining within the boundaries of our competence.

A qualification is an essential starting point, but it is not the finishing line. Professional practice is something we continue to build through experience, reflection, education and accountability.

If we want complementary therapists to be taken seriously, we must be willing to show what safe, ethical and credible practice looks like. That responsibility belongs to the organisations that set standards, but it also belongs to every individual therapist. We cannot control every part of an unregulated sector, but we can control the standards we set for ourselves, and together, those individual choices help strengthen the reputation of the profession as a whole.

References and further reading