Quality statement 2: Psychological interventions

Quality statement

People with an anxiety disorder are offered evidence-based psychological interventions.

Rationale

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.

Quality measures

Structure

Evidence of local arrangements to ensure that people with an anxiety disorder are offered evidence-based psychological interventions.

Data source: Local data collection.

Process

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 Improving access to psychological therapies data set and National audit of psychological therapies for anxiety and depression (standard 1b).

What the quality statement means for service providers, healthcare professionals and commissioners

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.

What the quality statement means for service users and carers

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.

Source guidance

  • Common mental health disorders (NICE clinical guideline 123), recommendation 1.4.1.4.

  • Obsessive-compulsive disorder and body dysmorphic disorder (NICE clinical guideline 31), recommendations 1.5.1.8, 1.5.1.9 (key priority for implementation) and 1.5.1.10 (key priority for implementation).

  • Post-traumatic stress disorder: (NICE clinical guideline 26), recommendations 1.9.5.1 and 1.9.5.2 (key priorities for implementation).

  • Social anxiety disorder (NICE clinical guideline 159), 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.

Definitions of terms used in this quality statement

Anxiety disorders

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

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 clinical guideline 123, recommendation 1.4.1.4]

Cognitive behavioural therapy has been specifically developed to treat social anxiety disorder in adults, children and young people. [NICE clinical guideline 159, 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 clinical guideline 31, recommendations 1.5.1.9 and 1.5.1.10; NICE clinical guideline 26, recommendation 1.9.5]

Equality and diversity considerations

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.