IPT UK & NICE
IPT UK review of NICE guidelines for depression in children and young people (2019)
An updated IPT UK review regarding the NICE guideline for depression in children and young people can be downloaded by clicking here.
The NICE depression guidelines for children and young people can be accessed by clicking here.
An updated IPT UK review regarding the NICE guideline for depression in children and young people can be downloaded by clicking here.
The NICE depression guidelines for children and young people can be accessed by clicking here.
External Webinar Invitation about the Stakeholder Campaign against the NICE Guideline Update for Depression in Adults
Abstract:
Since July 2017, the SPR UK has been leading a major stakeholder campaign calling on the National Institute of Health and Care Excellence (NICE) to conduct a ‘full and proper revision’ of its 2009 guidelines on the Recognition and Management of Depression in Adults. Dozens of leading health organisations and individuals have now joined the stakeholder coalition and signed the position statement. They stress that if the identified serious methodological flaws are not adequately addressed, it would result in misleading treatment recommendations affecting the care of millions of people suffering from depression. It would furthermore effect existing treatment services, the psychotherapeutic workforce and future research practices.
Earlier this year, pressure from the coalition, supported by important UK MPs and peers, led to an unprecedented achievement: A third revision of the proposed guideline.
In this presentation, Dr Felicitas Rost, current president of the SPR UK Chapter, will provide an overview of the campaign she’s been spearheading, as well as outline the key methodological concerns raised in some detail. She will argue for a much needed paradigm shift in order to make treatment guidelines for mental health fit for purpose.
Abstract:
Since July 2017, the SPR UK has been leading a major stakeholder campaign calling on the National Institute of Health and Care Excellence (NICE) to conduct a ‘full and proper revision’ of its 2009 guidelines on the Recognition and Management of Depression in Adults. Dozens of leading health organisations and individuals have now joined the stakeholder coalition and signed the position statement. They stress that if the identified serious methodological flaws are not adequately addressed, it would result in misleading treatment recommendations affecting the care of millions of people suffering from depression. It would furthermore effect existing treatment services, the psychotherapeutic workforce and future research practices.
Earlier this year, pressure from the coalition, supported by important UK MPs and peers, led to an unprecedented achievement: A third revision of the proposed guideline.
In this presentation, Dr Felicitas Rost, current president of the SPR UK Chapter, will provide an overview of the campaign she’s been spearheading, as well as outline the key methodological concerns raised in some detail. She will argue for a much needed paradigm shift in order to make treatment guidelines for mental health fit for purpose.
Update re: NICE - Depression in adults: treatment and management guideline
An updated stakeholders position statement regarding the NICE guideline for Depression in Adults can be downloaded by clicking here.
An updated stakeholders position statement regarding the NICE guideline for Depression in Adults can be downloaded by clicking here.
Update from NICE - Depression in adults: treatment and management guideline
NICE have changed the publication date of the update to their 'Depression in adults' guideline to February 2020, and have added in an additional consultation period between 2nd October - 13th November 2019. For more updates, please click here.
You can download the Stakeholder Position Statement (March 2019) by clicking here.
NICE have changed the publication date of the update to their 'Depression in adults' guideline to February 2020, and have added in an additional consultation period between 2nd October - 13th November 2019. For more updates, please click here.
You can download the Stakeholder Position Statement (March 2019) by clicking here.
Update from NICE - Depression in adults: treatment and management guideline
Please see the update from NICE below. You can view the published responses by clicking here, and the final scope for the update by clicking here.
Please see the update from NICE below. You can view the published responses by clicking here, and the final scope for the update by clicking here.
Update from NICE - Depression in adults: treatment and management guideline
Please see the update from NICE below:
Please see the update from NICE below:
Update from NICE - Depression in adults: treatment and management - Second consultation
We have received the following update from NICE:
As your organisation is a registered stakeholder for NICE’s update of its depression in adults guideline, I am writing to advise that NICE has decided to run an exceptional second consultation on the guideline. This will start next Tuesday, 15th May. The deadline for comments will be 5pm on 12th June.
The consultation documents will include revised versions of the short and long versions of the guideline and a table of all comments received in the first consultation, together with NICE’s responses. NICE is running this exceptional second consultation so that, before final publication, stakeholders can see how their previous comments have been dealt with and to provide an additional opportunity to comment. Responses to second round consultation comments will be published with the final guideline.
Yours faithfully,
The National Institute for Health and Care Excellence
We have received the following update from NICE:
As your organisation is a registered stakeholder for NICE’s update of its depression in adults guideline, I am writing to advise that NICE has decided to run an exceptional second consultation on the guideline. This will start next Tuesday, 15th May. The deadline for comments will be 5pm on 12th June.
The consultation documents will include revised versions of the short and long versions of the guideline and a table of all comments received in the first consultation, together with NICE’s responses. NICE is running this exceptional second consultation so that, before final publication, stakeholders can see how their previous comments have been dealt with and to provide an additional opportunity to comment. Responses to second round consultation comments will be published with the final guideline.
Yours faithfully,
The National Institute for Health and Care Excellence
Update from NICE: Delay to the Depression in Adults Guideline
We have received the following from NICE regarding the upcoming update:
This is to advise you that NICE will not be publishing the depression in adults update on 21st March 2018 as planned. The publication date has been changed to ‘to be confirmed.’ As soon as a new publication date is available, you will be advised.
Yours faithfully,
Joshua South
Senior Guidelines Coordinator
The National Institute for Health and Care Excellence
We have received the following from NICE regarding the upcoming update:
This is to advise you that NICE will not be publishing the depression in adults update on 21st March 2018 as planned. The publication date has been changed to ‘to be confirmed.’ As soon as a new publication date is available, you will be advised.
Yours faithfully,
Joshua South
Senior Guidelines Coordinator
The National Institute for Health and Care Excellence
Update: NICE Eating Disorders Quality Standard Consultation
We have received the following from NICE regarding the upcoming consultation:
This is advance notice that the NICE eating disorders quality standard consultation will run from 12th March 2018 to 9th April 2018. We would very much welcome your comments on the draft quality standard.
Please note that this is the second consultation because of substantial changes after the post-consultation quality standard advisory committee. At the first consultation we asked whether access to services should be included as a key area for quality improvement. This received general stakeholder support and also coincided with the Parliamentary and Health Service Ombudsman report (December 2017) on ‘Ignoring the alarms: How NHS eating disorder services are failing patients’ which recommended NICE include coordination of care within the quality standard. As a result, two new quality statements have now been included on access to services and coordination of care.
Registered stakeholders will be notified on the day the consultation opens with instructions on how to submit comments.
For further information on the quality standard or the quality standards programme in general please see the links below:
Eating Disorders
Quality Standards Programme
Register as a Stakeholder
We encourage you to register as a stakeholder. Comments received from non-registered organisations and individuals are not summarised in the summary report presented to the committee but are included as an appendix. These comments are not made available on the NICE website. However, if they result in changes to the quality standard this is recorded in the committee meeting minutes.
Kind regards,
NICE Quality Standards Team
We have received the following from NICE regarding the upcoming consultation:
This is advance notice that the NICE eating disorders quality standard consultation will run from 12th March 2018 to 9th April 2018. We would very much welcome your comments on the draft quality standard.
Please note that this is the second consultation because of substantial changes after the post-consultation quality standard advisory committee. At the first consultation we asked whether access to services should be included as a key area for quality improvement. This received general stakeholder support and also coincided with the Parliamentary and Health Service Ombudsman report (December 2017) on ‘Ignoring the alarms: How NHS eating disorder services are failing patients’ which recommended NICE include coordination of care within the quality standard. As a result, two new quality statements have now been included on access to services and coordination of care.
Registered stakeholders will be notified on the day the consultation opens with instructions on how to submit comments.
For further information on the quality standard or the quality standards programme in general please see the links below:
Eating Disorders
Quality Standards Programme
Register as a Stakeholder
We encourage you to register as a stakeholder. Comments received from non-registered organisations and individuals are not summarised in the summary report presented to the committee but are included as an appendix. These comments are not made available on the NICE website. However, if they result in changes to the quality standard this is recorded in the committee meeting minutes.
Kind regards,
NICE Quality Standards Team
Update - NICE Consultation on the Draft Guidelines for Depression (adults)
We offer our sincere thanks to the following individuals who put in a great deal of hard work by registering as stakeholders in the consultation:
Kate Halliday – Wiltshire IAPT
Annie Waring - Camden and Islington NHS Foundation Trust
Julia Fox-Clinch - 2gether NHS Foundation Trust
Philip McGarry - The Belfast Trust
Marie Wardle - IPT West Midlands
Julia Weatherley - Norfolk and Suffolk NHS Trust
Sam Heywood – North Staffordshire Combined Healthcare NHS Trust
Hazel Broom
Naomi Friel and Christine Lydoncarlile – South Tyneside Lifecycle Service
Cathy Cox and Nick Grey - Sussex Partnership NHS Foundation Trust
Joe Hickey – Islington CAMHS
Ed Moody – Turning Point
Ian Rigley - Let’s Talk Well-being, Nottinghamshire Healthcare Trust
We offer our sincere thanks to the following individuals who put in a great deal of hard work by registering as stakeholders in the consultation:
Kate Halliday – Wiltshire IAPT
Annie Waring - Camden and Islington NHS Foundation Trust
Julia Fox-Clinch - 2gether NHS Foundation Trust
Philip McGarry - The Belfast Trust
Marie Wardle - IPT West Midlands
Julia Weatherley - Norfolk and Suffolk NHS Trust
Sam Heywood – North Staffordshire Combined Healthcare NHS Trust
Hazel Broom
Naomi Friel and Christine Lydoncarlile – South Tyneside Lifecycle Service
Cathy Cox and Nick Grey - Sussex Partnership NHS Foundation Trust
Joe Hickey – Islington CAMHS
Ed Moody – Turning Point
Ian Rigley - Let’s Talk Well-being, Nottinghamshire Healthcare Trust
Update from NICE regarding the Guideline for CG28 Depression in children and young people: identification and management
Please see the email below from NICE, received on 24th August 2017:
Please see the email below from NICE, received on 24th August 2017:
IPTUK Update on NICE Guidelines on 'Depression in adults: Treatment and management'
Dear colleagues,
As many of you will already know, the NICE guidelines on ‘Depression in adults: Treatment and management’, is under review. The consultation period, during which stakeholders are invited to comment on the draft guidelines, opened on 18th July 2017 and will remain open until 5th September 2017.
The draft guideline has significant implications for the future availability of IPT, with the strength and breadth of the recommendation for IPT being downgraded in the current draft. It is imperative that therapists, service providers and education institutions register as stakeholder and participate in the consultation on the proposed guidelines. IPT UK will prepare and submit a response to the draft as part of the consultation, but IPT UK members should NOT assume that this is sufficient or will have the power to change the guideline. This will rely on the accurate presentation of evidence and strength of the response from practitioners and service providers. We hold a collective responsibility to respond to this draft and shape the next guideline.
Full details of the draft guideline can be found here:
https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/draft-guideline
https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/short-version-of-draft-guideline
Full details on how to register as a stakeholder, and therefore guaranteeing a written response by the guideline committee, can be found here:
https://www.nice.org.uk/guidance/indevelopment/gid-cgwave0725/consultation/html-content
Summary of the 2017 draft guideline, as it relates to IPT:
1. Less severe depression – IPT has been relegated to a second line recommendation
First line treatment for less severe depression:
Offer group-based cognitive behavioural therapy (CBT) specific to depression as the initial treatment for people with less severe depression [new 2017] (1.5.1)
Offer individual self-help with support for people with less severe depression who do not want group CBT [new 2017] (1.5.3)
Consider a physical activity programme specifically designed for people with depression who do not want group CBT or self-help with support [new 2017] (1.5.5)
Consider a selective serotonin reuptake inhibitor (SSRI) or mirtazapine for people with less severe depression who choose not to have psychological interventions, or based on previous treatment history for confirmed depression had a positive response to SSRIs or mirtazapine or had a poor response to psychological interventions.
Consider interpersonal therapy (IPT) if a person with less severe depression would like help for interpersonal difficulties that focus on role transitions or disputes or grief and:
When giving individual CBT, BA or IPT, also consider providing:
2. Person with depression and no response or limited response to initial treatment – IPT is considered only after another treatment has failed.
If a person with depression has had no response or a limited response to initial treatment (within 3–4 weeks for antidepressant medication or 4–6 weeks for psychological therapy or combined medication and psychological therapy), assess:· whether there are any personal or social factors that might explain why the treatment isn’t working· whether the person has not been adhering to the treatment plan, including any adverse effects of medication.
Work with the person to try and address any problems raised.
If a person has had no response or a limited response to initial treatment after assessing the issues in recommendation 1.9.1, provide more support by increasing the number and length of appointments. Also consider:
· changing to a combination of psychological therapy and medication if the person is on medication only, or
· changing to psychological therapy alone, if the person is on medication only and does not want to continue with medication or
· changing to a combination of 2 different classes of medication, in specialist settings or after consulting a specialist, if the person is on medication only or a combination of medication and psychological therapy and does not want to continue with psychological therapy.
When changing treatment for a person with depression who has had no response or a limited response to initial medication, consider:
· combining the medication with a psychological therapy (CBT, BA, or IPT), or
· switching to a psychological therapy alone (CBT, BA, or IPT) if the person wants to stop taking medication.
3. More severe depression – IPT had been removed as a recommended treatment for high moderate to severe depression
First line treatment for more severe depression
Offer individual CBT in combination with an SSRI or mirtazapine as the initial treatment for more severe depression. [new 2017] (1.6.1)
If a person with more severe depression does not want to take medication, offer:
· group CBT, or
· individual CBT or BA if the person does not want group therapy. [new 2017] (1.6.2)
If a person with more severe depression does not want psychological therapy, offer an SSRI or mirtazapine. [new 2017] (1.6.3)
Consider short-term psychodynamic psychotherapy, alone or in combination with an SSRI or mirtazapine, for a person with more severe depression who would like help for emotional and developmental difficulties in relationships and:
· has had individual CBT in combination with an SSRI, group CBT, or individual CBT or BA for a previous episode of depression, but this did not work well for them, or
· does not want individual CBT in combination with an SSRI, group CBT, or individual CBT or BA. [new 2017] (1.6.4)
Behavioural couples therapy
Consider behavioural couples therapy for a person with depression who has problems in the relationship with their partner if:
· the relationship problem(s) could be contributing to their depression or
· involving their partner may help in the treatment of their depression. [new 2017] (1.7.1)
Ensure behavioural couples therapy for people with depression:
· follows the behavioural principles for couples therapy
· provides 15–20 sessions over 5–6 months. [2017] (1.7.2)
These details provide a summary of the proposed revision to the guideline. Please take time to read through the full guideline and rationale for making these changes.
IPT UK will publish an up to date record of all stakeholders within our membership. Please confirm that you have signed up to be a stakeholder with contact@iptuk.net to be added to the list.
Please consider attending and contributing to a one day conference, which will focus on the guideline and will bring together national experts representing key approaches to depression, each of whom will have an opportunity to comment on the new guidance and identify strengths as well as problematic areas. Details are available here:
http://www.annafreud.org/training-research/training-and-conferences-overview/conferences-and-seminars/new-nice-guidance-for-the-treatment-of-depression-implications-and-evaluation/
Dear colleagues,
As many of you will already know, the NICE guidelines on ‘Depression in adults: Treatment and management’, is under review. The consultation period, during which stakeholders are invited to comment on the draft guidelines, opened on 18th July 2017 and will remain open until 5th September 2017.
The draft guideline has significant implications for the future availability of IPT, with the strength and breadth of the recommendation for IPT being downgraded in the current draft. It is imperative that therapists, service providers and education institutions register as stakeholder and participate in the consultation on the proposed guidelines. IPT UK will prepare and submit a response to the draft as part of the consultation, but IPT UK members should NOT assume that this is sufficient or will have the power to change the guideline. This will rely on the accurate presentation of evidence and strength of the response from practitioners and service providers. We hold a collective responsibility to respond to this draft and shape the next guideline.
Full details of the draft guideline can be found here:
https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/draft-guideline
https://www.nice.org.uk/guidance/GID-CGWAVE0725/documents/short-version-of-draft-guideline
Full details on how to register as a stakeholder, and therefore guaranteeing a written response by the guideline committee, can be found here:
https://www.nice.org.uk/guidance/indevelopment/gid-cgwave0725/consultation/html-content
Summary of the 2017 draft guideline, as it relates to IPT:
1. Less severe depression – IPT has been relegated to a second line recommendation
First line treatment for less severe depression:
Offer group-based cognitive behavioural therapy (CBT) specific to depression as the initial treatment for people with less severe depression [new 2017] (1.5.1)
Offer individual self-help with support for people with less severe depression who do not want group CBT [new 2017] (1.5.3)
Consider a physical activity programme specifically designed for people with depression who do not want group CBT or self-help with support [new 2017] (1.5.5)
Consider a selective serotonin reuptake inhibitor (SSRI) or mirtazapine for people with less severe depression who choose not to have psychological interventions, or based on previous treatment history for confirmed depression had a positive response to SSRIs or mirtazapine or had a poor response to psychological interventions.
Consider interpersonal therapy (IPT) if a person with less severe depression would like help for interpersonal difficulties that focus on role transitions or disputes or grief and:
- has had group CBT, exercise or facilitated self-help, antidepressant medication, individual CBT or BA for a previous episode of depression, but this did not work well for them, or
- does not want group CBT, exercise or facilitated self-help, antidepressant medication, individual CBT or BA [new 2017] (1.5.9)
When giving individual CBT, BA or IPT, also consider providing:
- 2 sessions per week for the first 2–3 weeks of treatment for people with less severe depression
- 3–4 follow-up and maintenance sessions over 3–6 months after finishing the course for all people who have had individual CBT, BA or IPT [new 2017] (1.5.11)
2. Person with depression and no response or limited response to initial treatment – IPT is considered only after another treatment has failed.
If a person with depression has had no response or a limited response to initial treatment (within 3–4 weeks for antidepressant medication or 4–6 weeks for psychological therapy or combined medication and psychological therapy), assess:· whether there are any personal or social factors that might explain why the treatment isn’t working· whether the person has not been adhering to the treatment plan, including any adverse effects of medication.
Work with the person to try and address any problems raised.
If a person has had no response or a limited response to initial treatment after assessing the issues in recommendation 1.9.1, provide more support by increasing the number and length of appointments. Also consider:
· changing to a combination of psychological therapy and medication if the person is on medication only, or
· changing to psychological therapy alone, if the person is on medication only and does not want to continue with medication or
· changing to a combination of 2 different classes of medication, in specialist settings or after consulting a specialist, if the person is on medication only or a combination of medication and psychological therapy and does not want to continue with psychological therapy.
When changing treatment for a person with depression who has had no response or a limited response to initial medication, consider:
· combining the medication with a psychological therapy (CBT, BA, or IPT), or
· switching to a psychological therapy alone (CBT, BA, or IPT) if the person wants to stop taking medication.
3. More severe depression – IPT had been removed as a recommended treatment for high moderate to severe depression
First line treatment for more severe depression
Offer individual CBT in combination with an SSRI or mirtazapine as the initial treatment for more severe depression. [new 2017] (1.6.1)
If a person with more severe depression does not want to take medication, offer:
· group CBT, or
· individual CBT or BA if the person does not want group therapy. [new 2017] (1.6.2)
If a person with more severe depression does not want psychological therapy, offer an SSRI or mirtazapine. [new 2017] (1.6.3)
Consider short-term psychodynamic psychotherapy, alone or in combination with an SSRI or mirtazapine, for a person with more severe depression who would like help for emotional and developmental difficulties in relationships and:
· has had individual CBT in combination with an SSRI, group CBT, or individual CBT or BA for a previous episode of depression, but this did not work well for them, or
· does not want individual CBT in combination with an SSRI, group CBT, or individual CBT or BA. [new 2017] (1.6.4)
Behavioural couples therapy
Consider behavioural couples therapy for a person with depression who has problems in the relationship with their partner if:
· the relationship problem(s) could be contributing to their depression or
· involving their partner may help in the treatment of their depression. [new 2017] (1.7.1)
Ensure behavioural couples therapy for people with depression:
· follows the behavioural principles for couples therapy
· provides 15–20 sessions over 5–6 months. [2017] (1.7.2)
These details provide a summary of the proposed revision to the guideline. Please take time to read through the full guideline and rationale for making these changes.
IPT UK will publish an up to date record of all stakeholders within our membership. Please confirm that you have signed up to be a stakeholder with contact@iptuk.net to be added to the list.
Please consider attending and contributing to a one day conference, which will focus on the guideline and will bring together national experts representing key approaches to depression, each of whom will have an opportunity to comment on the new guidance and identify strengths as well as problematic areas. Details are available here:
http://www.annafreud.org/training-research/training-and-conferences-overview/conferences-and-seminars/new-nice-guidance-for-the-treatment-of-depression-implications-and-evaluation/
