NICE-recommended digital therapies in NHS Talking Therapies

Domain IX · Biomedical, neuro & digital · 2023 · England

What it is

This entry is not a single therapy. It is a service model: NICE-assessed, CBT-based online programmes that a client works through on a computer or phone, offered inside NHS Talking Therapies (England) after an assessment, and always with support from a trained psychological wellbeing practitioner…

Format

• Talking Therapies routine outcome monitoring is session by session, so client and clinician have up-to-date information on progress. Some programmes administer outcome measures themselves (iCT-PTSD and iCT-SAD administer the Talking Therapies measures and export them to local IT systems).

Who practises it, and how they are trained or regulated

• iCT-SAD is built on Clark and Wells' cognitive model of social anxiety: psychoeducation, monitoring, video feedback, attention training, behavioural experiments and memory-focused work.

Evidence status, as the guide reports it

• Whether each conditionally recommended product currently holds its DTAC, DET and (for Spring and Perspectives) UKCA/CE approvals, and which services commission it, is not shown on the NICE pages; check with your service's digital lead before offering. NICE states the guidance will be reviewed if…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Unrecorded supporter time; missing ending reasons.
• Ending without final measures; residual symptoms that need a further step.
• Passive reading without homework; rising PHQ-9 scores or self-harm thoughts.
• Clients who never log in after onboarding; an early non-use flag should trigger contact (B8).
• Clients asking whether to stop medication now they are "doing therapy"; route to the prescriber.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.