UK national guidelines emphasize CBT for children and adolescents

A recent article in Current Opinion in Psychiatry summarized the UK National Institute for Health and Clinical Excellence (NICE) clinical guidelines and reviews of cognitive behavioral therapy (CBT) for children and adolescents with mental health problems.

NICE is the UK’s independent organization responsible for providing national guidance on the “promotion of good health and the prevention and treatment of ill health.”

For the treatment of depression in children and young people, NICE guidelines recommended “that pharmacological approaches should not be the first-line approach to the treatment of depression in this age group.” It recommended instead “the initial use of psychosocial interventions, including CBT, for all severities of depression.”

Meta-analyses of randomized controlled trials suggested the importance of CBT for children and adolescents with generalized anxiety disorder, depression, obsessive compulsive disorder, and posttraumatic stress disorder. More limited evidence suggested CBT’s benefit in attention deficit hyperactivity disorder and others conditions.

The authors noted that CBT for these populations “should be extended by further primary and secondary research.”

Review authors: A. Munoz-Solomando, T. Kendall, C. J. Whittington

CT Worldwide: The UK, ahead of the game

globe.pngWe’ve been closely watching the UK, which has recently begun trying to make evidence-based mental health treatment more readily available to its citizens. The UK is far ahead of the U.S. in trying to implement an evidence-based agenda for mental health care, and ahead of many other countries as well. Back in 2004, the UK’s Lord Layard recommended increased use of Cognitive Behavior Therapy (CBT) to respond to the UK’s mental health needs. Providing evidence-based care is an effective and economical way to ensure that citizens receive a form of treatment that is clinically demonstrated to actually help. Layard points out that improving citizens’ access to evidence-based mental health treatment will help alleviate their mental health problems, and will also help many who are receiving “incapacity benefits” (disability benefits) due to mental health problems get back to work. Everyone wins in this situation — those with mental health problems get better care, and the UK’s costs in paying out incapacity benefits will go down as more citizens return to work.

Now, in 2006, the UK is beginning to move towards its goals by initiating a pilot program to improve citizens’ access to evidence-based treatment, including CBT.