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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Digitally enabled therapies for adults with anxiety disorders: early value assessment

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    1 Recommendations

    1.1 Six digitally enabled therapies can be used as treatment options for adults with anxiety disorders while further evidence is generated. These technologies can be used once they have Digital Technology Assessment Criteria (DTAC) approval and NHS Talking Therapies digitally enabled therapies assessment from NHS England. The technologies are:

    • Perspectives (Koa Health) for body dysmorphic disorder (BDD)

    • Beating the Blues (365 Health Solutions) for generalised anxiety symptoms or unspecified anxiety disorder

    • Space from Anxiety (SilverCloud) for generalised anxiety symptoms or unspecified anxiety disorder

    • iCT-PTSD (OxCADAT) for post-traumatic stress disorder (PTSD)

    • Spring for PTSD

    • iCT-SAD (OxCADAT) for social anxiety disorder.

    Low intensity interventions should be supported by a psychological wellbeing practitioner and high intensity interventions by a high intensity therapist in NHS Talking Therapies services.

    1.2 Further evidence should be generated on:

    • rates of recovery

    • rates of reliable recovery

    • rates of reliable improvement

    • rates and reasons for stopping treatment

    • rates of relapse

    • adverse effects and stepping up of care

    • patient experience

    • health-related quality of life

    • resource use during and after treatment, including level of guidance provided (defined by healthcare professional grade and time)

    • baseline data including the demographics of the people using the technology and their risk classification.

    Find out more in the evidence generation section in this guidance.

    1.3 The following technologies should only be used in research for treating anxiety disorders in adults:

    • Cerina (NoSuffering), Iona Mind (Iona Mind), Minddistrict (Minddistrict), Resony (RCube Health) and Wysa (Wysa) for generalised anxiety disorder (GAD) or generalised anxiety symptoms

    • Minddistrict and SilverCloud programmes for health anxiety, obsessive compulsive disorder (OCD), panic disorder with or without agoraphobia, social anxiety disorder, and phobias.

    Potential benefits of early access

    • Access: Digitally enabled therapies offer another treatment option for adults with anxiety disorders. They will particularly benefit anyone who needs more flexible access to treatment or who prefers digitally enabled therapy to face-to-face therapy.

    • Clinical benefit: The clinical evidence suggests that digitally enabled therapies may reduce symptoms of anxiety in the anxiety disorders they were designed to treat. They may help people to better manage their anxiety and treatment choices, which could increase autonomy and empowerment.

    • Resources: Digitally enabled therapies may need less practitioner or therapist time for delivery than other psychological interventions in NHS Talking Therapies services. This could reduce demand on some mental health services by freeing up resources that could be allocated elsewhere in the service. There is preliminary evidence that digitally enabled therapies may be cost effective compared with standard care.

    Managing the risk of early access

    • Clinical assessment: In NHS Talking Therapies services, digitally enabled therapies would be offered after assessing and identifying the appropriate problem descriptor in line with ICD-10. Mental health professionals would also access patient safety and suitability to use these interventions.

    • Clinical support: Digitally enabled therapies in NHS Talking Therapies services must be delivered with practitioner or therapist support including monitoring and managing patient safety and progress. This means that if the treatment is not working and symptoms worsen, it can be identified quickly.

    • Individual choice: Digitally enabled therapies can be offered as a treatment option for adults with anxiety disorders. Some people may choose not to use digitally enabled therapies and may prefer another treatment option such as face-to-face therapy. Everyone has the right to make informed decisions about their care. People should be offered another treatment option if they do not want to or cannot use digitally enabled therapies.

    • Equality: Digitally enabled therapies may not beaccessible to everyone. Adults with limited access to equipment, internet connection or low digital literacy skills are less likely to benefit and may prefer another treatment option.

    • Costs: Results from the early economic analysis suggest that the technologies could be cost effective based on current prices and evidence. This guidance will be reviewed within 4 years and the recommendations may change. Take this into account when negotiating the length of contracts and licence costs.

    • Care pathway: This guidance focuses on using digitally enabled therapies for treating anxiety disorders in adults who have been referred to NHS Talking Therapies. Digital therapies may be used elsewhere in the NHS care pathway, but this is outside the scope of this assessment.