Child and Adolescent Psychotherapy in NICE and SCIE Guidelines
Depression in Children and Young People
NICE recommends psychodynamic psychotherapy in its guidance on management of depression in children and young people*:
- For 5 – 11 year olds psychodynamic psychotherapy is recommended (1.6.4) as one of the options for first line treatment for those with severe to moderate depression.
- For 12 – 18 year olds it recommends psychodynamic psychotherapy as an option to consider (1.6.6) if individual CBT would not meet the clinical needs of those with moderate to severe depression or is unsuitable for their circumstances.
- In addition the guidance recommends psychodynamic psychotherapy (approximately 30 weekly sessions) for depression unresponsive to combined treatment (1.6.13).
CYP with moderate to severe depression, and co-morbid depression and anxiety, are likely to make up a significant proportion of the additional 345,000 to be seen under the LTP and therefore psychodynamic psychotherapy should be made available in all CAMHS and considered as an option for all 5 to 18 years olds with moderate to severe depression.
CAPTs undertook the work in the trials that have led to the inclusion of psychodynamic psychotherapy in the NICE guideline and are best placed to offer treatment for these groups of patients. This work is included as a core competency in their training.
Abuse and Neglect
NICE/SCIE guidelines** on therapeutic interventions after abuse and neglect recommend individual psychoanalytic psychotherapy as an intervention after sexual abuse for girls aged 6-14.
It also recommends providing separate sessions for non-abusing parents or carers to help them support their child’s attendance and address issues in the family. Concurrent work with parents is a key aspect of the CAPT approach.
Looked-after children and young people
The 2021 update of the Guideline*** for looked-after children and young people states that local services should:
Offer a range of dedicated CAMHS that are tailored to the needs of looked-after children and young people – for example, making them longer term, more trauma informed and relationship based. (Section 1.5.18)
The majority of children who remain in care are there because they have suffered abuse or neglect and the prevalence of mental illness is significantly higher in looked after children than equivalent populations. Child and Adolescent Psychotherapists are ideally placed to respond to the guideline by offering services that are tailored to the needs of looked-after children and young people.
* NICE (2019) NICE guideline [NG134] Depression in children and young people: identification and management, available at: https://www.nice.org.uk/guidance/ng134/chapter/Recommendations
** NICE/SCIE (2018) Therapeutic Interventions After Abuse and Neglect, accessed at: https://www.nice.org.uk/about/nice-communities/social-care/quick-guides…
*** NICE (2021). Looked-after children and young people guideline Available at: https://www.nice.org.uk/guidance/ng205