Guided self-help digital cognitive behavioural therapy for children and young people with mild to moderate symptoms of anxiety or low mood: early value assessment

Guided self-help digital cognitive behavioural therapy (CBT) provides self-help materials based on the principles of face-to-face CBT in a digital format with regular support and guidance from a healthcare professional. Five guided self-help digital CBT technologies were assessed as an initial treatment option for children and young people with mild to moderate symptoms of anxiety or low mood, while evidence is generated. The technologies are:

• Lumi Nova (BfB labs) is for children aged 7 to 12 with symptoms of anxiety. It combines evidence-based therapeutic and psychoeducational content within an intergalactic role-playing game.

• Online Social anxiety Cognitive therapy for Adolescents (OSCA) is for young people aged 14 to 18 with social anxiety. All users receive a core set of modules to work through at the beginning of the programme, which are then individualised for each user.

• Online Support and Intervention for child anxiety (OSI) is for children aged 5 to 12 with symptoms of anxiety. It is an internet based, parent-led intervention that has 3 components: a parent's website, a clinical case management website and an optional game app for children.

• Space from anxiety for teens, space from low mood for teens, space from low mood and anxiety for teens (Silvercloud) is for young people aged 15 to 18 with symptoms of anxiety, low mood or both. It is internet based and has 7 core modules structured around the principles of CBT.

• ThinkNinja CBT Bytesize (Healios) is for children and young people aged 11 and older with anxiety or low mood, and related problems. It is an app that contains psychoeducational and CBT-based content. The coaches and CBT therapists who provide support to users are employed by Healios. This technology is awaiting CE mark approval so cannot be used yet.
  
  Children and young people who use these technologies may have further treatment such as face-to-face CBT.

Symptoms of anxiety or low mood may be identified by the child or young person themselves, their parents or carers, GPs, community care staff, social workers or school staff. Children and young people can be assessed and treated in a range of settings, including school mental health support teams, single point of access (SPA) teams, voluntary sector teams and children and young people's mental health services (CYPMHS). Some children and young people with mild to moderate symptoms of anxiety or low mood may be seen by CYPMHS, especially if they have other conditions. If they are not seen by CYPMHS they will be supported by mental health support teams or other services, including those provided by the voluntary, community and small enterprise sector. Across these settings the professionals will have varying levels of specialist mental health training and expertise to provide targeted outcome focused help. These professionals might include nurses, therapists, psychologists, psychiatrists, support workers, social workers, health visitors, school nurses and education mental health practitioners.

The comparator is standard care which may include education, advice, support and signposting without access to healthcare professionals.