Quality statement 2: Psychological interventions
People with an anxiety disorder are offered evidence-based psychological interventions.
Evidence-based psychological interventions can be effective treatments for anxiety disorders. They are recommended first-line treatments in preference to pharmacological treatment. Healthcare professionals should usually offer or refer for the least intrusive, most effective intervention first, in line with the stepped-care approach set out in the NICE guidance.
Evidence of local arrangements to ensure that people with an anxiety disorder are offered evidence-based psychological interventions.
Data source: Local data collection.
Proportion of people with an anxiety disorder who receive evidence-based psychological interventions.
Numerator – the number of people in the denominator who receive evidence-based psychological interventions.
Denominator – the number of people with an anxiety disorder.
Data source: Local data collection. National data are collected in the NHS Digital Improving Access to Psychological Therapies (IAPT) Data Set and the Royal College of Psychiatrists National Audit of Psychological Therapies for Anxiety and Depression (standard 1b).
Service providers ensure that they are able to provide evidence-based psychological interventions to people who are referred to them with anxiety disorders.
Healthcare professionals ensure that they offer evidence-based psychological interventions to people with anxiety disorders.
Commissioners ensure that they commission services from providers who are able to deliver evidence-based psychological interventions to meet the needs of people with anxiety disorders.
People with an anxiety disorder are offered psychological treatments (sometimes called 'talking treatments') that have been shown by evidence to be helpful for their disorder.
Common mental health problems: identification and pathways to care. NICE guideline CG123 (2011), recommendation 18.104.22.168
Obsessive-compulsive disorder and body dysmorphic disorder: treatment. NICE guideline CG31 (2005), recommendations 22.214.171.124, 126.96.36.199 (key priority for implementation) and 188.8.131.52 (key priority for implementation)
Post-traumatic stress disorder. NICE guideline NG116 (2018), recommendations 1.6.6, 1.6.7 and 1.6.11
Social anxiety disorder: recognition, assessment and treatment. NICE guideline 159 (2013), recommendations 1.3.2 (key priority for implementation), 1.3.4 (key priority for implementation), 1.3.7, 1.3.12, 1.5.3 (key priority for implementation) and 1.5.6
Anxiety disorders are generalised anxiety disorder, social anxiety disorder, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder and body dysmorphic disorder.
Evidence-based psychological interventions include both low-intensity interventions incorporating self-help approaches and high-intensity psychological therapies.
For adults with generalised anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive-compulsive disorder or body dysmorphic disorder psychological interventions are offered based on the stepped-care approach. [NICE's guideline on common mental health problems, recommendation 184.108.40.206]
Cognitive behavioural therapy has been specifically developed to treat social anxiety disorder in adults, children and young people. [NICE's guideline on social anxiety disorder, recommendations 1.3.2 and 1.5.3]
Psychological therapies have been specifically developed to treat obsessive-compulsive disorder, body dysmorphic disorder and post-traumatic stress disorder in children and young people. [NICE's guideline on obsessive-compulsive disorder and body dysmorphic disorder, recommendations 220.127.116.11 and 18.104.22.168, and NICE's guideline on post-traumatic stress disorder, recommendation 1.6.11]
For people with generalised anxiety disorder who have a learning disability or cognitive impairment, methods of delivering treatment and treatment duration should be adjusted if necessary to take account of the disability or impairment, with consideration given to consulting a relevant specialist.
It is important that healthcare professionals familiarise themselves with the cultural background of the person with an anxiety disorder. They should pay particular attention to identifying people with post-traumatic stress disorder whose work or home culture is resistant to recognising the psychological consequences of trauma.