Background Within clinical psychology, there is a broad training and range of practice. However, most clinical psychologists practice psychotherapy and this study explored what relates to confidence in therapeutic practice. Method An online survey was distributed to Irish psychologists. Three‐quarters of the survey participants constituted 46% of the total population of Irish health service psychologists, the remainder working in various non‐health service settings. Clinical psychologists practising psychotherapy were the focus of this study (N = 170). Results Psychotherapy practice was a dominant activity for nearly all clinical psychologists but only 13% believed that their psychology training fully equipped them to practice psychotherapy and nearly one‐half felt limited confidence for therapeutic work. More confident clinical psychologists were more satisfied with the psychotherapy knowledge and skills gained during clinical psychology training, more satisfied with their supervisory support, had spent longer in personal therapy, and had more years of experience. Conclusions Perceived quality of psychotherapy training during clinical psychology training provides an essential foundation for therapeutic confidence. Ongoing access to satisfying supervision in post‐qualification practice also supports confident therapeutic work. In addition, the significance of substantial experience of personal therapy for confidence points to its inclusion as a valuable part of clinical psychology training.