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Digital therapy recommended as first-line treatment for children and young people with mild depression

National Institute for Health and Care Excellence draft guidance says wider adoption would give faster access to psychological help and avoid long waiting lists

National Institute for Health and Care Excellence draft guidance says wider adoption of digital cognitive behavioural therapy would speed up access to psychological help


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Digital cognitive behavioural therapy (CBT) has been recommended as a first-line treatment for children and young people experiencing mild depression.

According to the National Institute for Health and Care Excellence (NICE) draft guidance consultation, CBT is delivered on mobile phones, tablets or computers and can be made readily available. This gives children and young people faster access to psychological help and avoids long waiting lists.

Continuing symptoms

NICE’s draft consultation, which closed on 20 February, suggests that digital CBT can be offered to children or young people who are aged 5-18 years who are experiencing continuing symptoms of mild depression and do not have other significant health conditions or suicidal thoughts.

Responding to the NICE consultation, RCN professional lead for children and young people Fiona Smith said: ‘Tackling depression and mental health at the earliest possible stage is vitally important.

‘We know that technology can play a vital role in engaging with young people and the recommendations are a welcome step.’

But she added: ‘Such technology should not be seen as a way of filling in for the damaging cuts to the part of the nursing workforce that works directly with children and their families, including mental health nurses and those who work with children and young people to improve their health.

Personal contact through digital platforms

‘School and mental health nurses working with children and young people have the personal contact that digital platforms cannot provide. It is important the findings from this consultation are properly analysed to ensure those working with children and young people can provide the best possible targeted care.’

Group CBT, group interpersonal psychotherapy and group mindfulness are also recommended as first-line treatments. The NICE committee highlights the choice of treatment should be based on clinical need and patient and carer preferences wherever possible.

The child or young person’s history and circumstances should be considered, for example, their family context and how they may function at school. It is also important to consider the level of development and maturity of the child or young person receiving treatment, NICE states.

Effective treatment

Digital CBT is already recommended for adults with mild to moderate depression.

NHS England national mental health director Claire Murdoch said: ‘Digital and online interventions can play an effective and important role in treatment, particularly when backed up by face-to-face support.

‘The NHS Long Term Plan makes clear that the health service will continue to look to harness the benefits these advancements can bring.’

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