NICE recommends digital CBT for children with mild depression

Children and young people with mild depression should have access to digital cognitive behavioural therapy (CBT) as a first-line treatment, NICE has recommended in a draft update to guidance.

(Photo: iStock.com/SolStock)
(Photo: iStock.com/SolStock)

The guidance now says that digital CBT can be offered to children or young people aged between 5 and 18 with continuing symptoms of mild depression who do not have other significant health conditions or suicidal thoughts.

GPs can also consider referral to group CGT, group interpersonal psychotherapy and group mindfulness as first-line treatments and choice of treatment should be based on clinical need and patient and carer preference where possible, the guidelines say.

If the patient does not respond to therapy after two or three months they should be referred for review by a tier 2 or 3 child and adolescent mental health services (CAMHS) team.

Children and young people with moderate to severe depression should be reviewed by a CAMHS team and, following assessment, be offered individual CBT or family therapy for at least three months.

The draft updated guidance was fast-tracked to take account of a trial published in 2016. The guideline committee said that the evidence showed that digital CBT, group therapies, indvidual CBT and family therapy all reduced depression symtoms by the end of treatment compared with a waiting list control or no treatment.

The committee also recognised that digital CBT would be more readily available than individual CBT, which 'might have long waiting lists'. It added that some children and young people have difficulties accessing treatment because of lack of transport, chaotic family lives or being in a young offender’s institute or in care.

Mental health services

Access to CAMHS is an ongoing problem in many parts of England, with patients often having to wait for long periods to be assessed and then wait again to receive treatment. The RCGP has said that GPs need ‘far better access’ to to specialist services in order to support growing numbers of children and young people with mental health problems.

A report by the Nuffield Trust last year found that prevalence of mental illness in young people rose six fold in the past 20 years.

Paul Chrisp, director of the Centre for Guidelines at NICE, said: ‘In this update to our depression in children guideline, we reviewed evidence for the most effective psychological interventions for children and young people with depression. The guideline update emphasises the importance of a child or young person’s personal choice when receiving treatment for depression.

‘We want to ensure children are offered a range of therapies to suit their needs and individual preferences are placed at the heart of their care. The evidence showed digital CBT and group therapy were most effective at reducing depressive symptoms and we have recommend these as first-line options for children and young people with mild depression.’

The guidance is now out for consultation and the closing date for comments is 20 February.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Redacting information from medical records - advice for GPs

Redacting information from medical records - advice for GPs

MDU medico-legal adviser Dr Ellie Mein provides advice for GPs on reacting information...

Medicine shortages set to continue despite Brexit delay

Medicine shortages set to continue despite Brexit delay

Medicine shortages are unlikely to improve as a result of Brexit being delayed healthcare...

Doctors less likely to be investigated for 'one-off' mistakes under new GMC rules

Doctors less likely to be investigated for 'one-off' mistakes under new GMC rules

The GMC is introducing new measures to reduce the number of full investigations in...

RCGP revokes Sultan of Brunei's honorary title over anti-LGBTQ laws

RCGP revokes Sultan of Brunei's honorary title over anti-LGBTQ laws

The RCGP has revoked the honorary title it awarded the Sultan of Brunei following...

Financial considerations for primary care networks

Financial considerations for primary care networks

Specialist accountant Laurence Slavin highlights the financial issues that practices...

Number of CCGs could be cut by 75% by April 2020

Number of CCGs could be cut by 75% by April 2020

Measures to cut the number of CCGs in England by more than three quarters could be...