NICE early-value digital therapies for children and young people

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

What it is

This is not one therapy. It is a NICE decision that four guided self-help digital CBT technologies can be used as an initial treatment option for 5 to 18 year olds with mild to moderate anxiety or low mood while more evidence is collected. The four are: Lumi Nova (BfB Labs), a therapeutic game for…

Format

• Active guided self-help. The young person or parent works through the content, and the practitioner checks in weekly. Typical formats: OSI: 8 weekly modules of about 30 minutes, each followed by a phone call of about 20 minutes.
• OSCA: 8 core modules in the first 2 weeks, then optional modules, over 14 weeks, with weekly 20-minute calls.

Evidence status, as the guide reports it

• Version followed: NICE early value assessment "Guided self-help digital cognitive behavioural therapy for children and young people with mild to moderate symptoms of anxiety or low mood", published 8 February 2023 as HTE3 and now listed on the NICE site as HealthTech guidance HTG660 (last updated 5…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• No data collected. Contract lengths that run past the review date. Products used outside their age band.
• Duplicate or conflicting homework. Unclear clinical responsibility between school, voluntary sector and CYPMHS teams.
• Plans that rely only on the app. A parent who isn't told when the young person agreed they should be. Plans that are out of date.
• Abrupt drop-off without an ending. Families who feel they "failed" the app; reframe this as useful information for choosing next care.
• Conflict over devices. Late-night use. Engagement that is all in-game with no real-world steps. Disengagement after the novelty wears off, usually in week 2 or 3.

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.