The National Institute for Health and Clinical Excellence (NICE) has recommended two computerised packages for cognitive behaviour therapy for use by the NHS in England and Wales in guidance published last week.
The guidance updated previous recommendations from 2002, in which the use of this therapy was not recommended. The latest guidance recommends two computerised packages—Beating the Blues (Ultrasis, London) for the management of mild and moderate depression and FearFighter (ST Solutions, Stourbridge) for the management of panic and phobia, on the basis of new evidence of effectiveness.
Cognitive behaviour therapy is a psychotherapy based on the idea that people's beliefs about themselves and the world affect how they feel and their behaviour. It aims to use cognitive and behavioural methods to change the way people think, to change their behaviour and emotional reactions.
In comparison with other psychotherapies, cognitive behaviour therapy is brief, highly structured, problem oriented and prescriptive, and patients are active collaborators. Computerised cognitive behaviour therapy delivers the treatment via an interactive computer interface.
NICE's appraisal found evidence that some people prefer “talking therapies,” involving face to face contact with the therapist rather than drug treatment. But NICE found that access to counselling and psychotherapy services was restricted by the high level of demand and the limited availability of therapists, especially in some geographical areas.
NICE heard evidence from experts that computerised packages could be considered as safe as treatment delivered by other methods because the information and guidance delivered were similar. The appraisal committee noted, however, that computerised treatment would not necessarily be the best delivery method for all patients and was not appropriate for the management of severe depression.
After reviewing evidence on five packages, NICE recommended the use of two on the grounds of clinical and cost effectiveness.
Supplementary Material
Depression and Anxiety: Computerised Cognitive Behavioural Therapy (No 97) is available at www.nice.org.uk.
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