The NICE guideline on the treatment of child and adolescent depression : a meta-review of the evidence for individual CBT

Abstract

The National Institute for Clinical Excellence in the UK published its guideline on the treatment of children and adolescents who have been diagnosed with depression in 2005. Although the guideline has not been updated since, it is widely used in Child and Adolescent Mental Health Services in England and Wales to advocate that all children and young people who have been diagnosed with depression should have access to individual cognitive-behavioural therapy (CBT) through the Children and Adolescent Improving Access to Psychological Therapies (CYP-IAPT) project. This article critically reviews the guideline in terms of the evidence that NICE cites for the efficacy of individual CBT. In particular, it provides a meta-review of four randomised control trials where the effectiveness of individual CBT was compared to another psychological therapy intervention, a non-specific control intervention, and/or a wait-list. Each trial is considered separately, before looking at the overall evidence that they provide when the findings are considered as a whole. A trial comparing individual CBT to a non-psychological intervention (medication) is discussed separately. This review found that on present evidence, individual CBT cannot be viewed as an evidence-based psychological therapy for children and young people who have been diagnosed with depression.