Supporting an urgent review of NICE guidance on anxiety
The Society supports the sector-wide campaign, led by the UK Council for Psychotherapy, calling for an urgent and comprehensive update to the National Institute for Health and Care Excellence (NICE) guideline on generalised anxiety disorder and panic disorder in adults.
We have been signatories to this campaign from the outset and have also submitted our own evidence directly to NICE in support of a full review.
The current guideline, first published in 2011, has not kept pace with developments in clinical practice, service delivery, or the growing body of evidence around what helps people experiencing anxiety. In practice, this has narrowed the support available to people seeking help and reinforced a one-size-fits-all approach that does not reflect the diversity of need.
Despite anxiety being one of the most common reasons people seek counselling, the existing guidance effectively limits NHS provision to cognitive behavioural therapy (CBT) and applied relaxation. This restricts both access and choice, and sidelines approaches that work relationally, do not require diagnosis, and are often better suited to people with complex, contextual, or long-standing difficulties.
How does the campaign fit into the Society's broader work?
This campaign closely aligns with the Society’s Direct Access to Counselling campaign, which calls for people to be able to access counselling & psychotherapy without unnecessary clinical gatekeeping or diagnostic thresholds.
Our Direct Access work has consistently highlighted that:
- counselling does not require a diagnosis to be effective
- early, relational support can prevent difficulties from escalating
- restricting provision to a narrow set of modalities increases waiting times and disengagement
- client choice improves outcomes, engagement, and trust
Outdated NICE guidance plays a significant role in shaping commissioning decisions and service design. When that guidance recognises only a limited range of therapies, it becomes harder for systems to make proportionate use of the existing counselling workforce, including practitioners registered on Accredited Registers.
“We’re really grateful to the UKCP for driving this campaign forward. The need to update the NICE anxiety guideline is something we’ve felt strongly about for a long time, and it’s encouraging to see such broad support across the mental health sector.
Guidance like this shapes how services are designed, what gets commissioned, and ultimately whether people can access the kind of support that works for them. In this situation, it is unintentionally, but unfortunately, narrowing options and reinforcing unnecessary barriers.
We’re hopeful this review will lead to a change that brings the NICE guidance more in line with current evidence and lived experience. The reality is that therapy works best when people have choice, can access support early, and don’t need a diagnosis just to be heard, and more than anything I would love to see that reflected in our public sector services.”
Meg Moss, Head of Public Affairs & Advocacy
What is the campaign calling for?
It's calling on NICE to update the guideline so that it aligns with other revised NICE guidance and reflects current diagnostic frameworks; addresses barriers to access for marginalised and underserved communities; expands the range of recognised talking therapies for anxiety, enabling meaningful client choice, and considers a broader evidence base, including long-term outcomes, follow-up studies, and service user experience.
More than 30 organisations across the mental health sector have signed a joint position statement calling for the guideline to be reviewed.
From the Society’s perspective, this is about ensuring guidance reflects how counselling & psychotherapy actually work in practice: relationally, flexibly, and in ways that support autonomy rather than medicalisation.
What happens next?
Campaign partners are continuing to gather organisational signatories and are now building cross-party parliamentary support. A joint letter from organisations and a separate cross-party letter from policymakers will be submitted to NICE in the spring.
Members can also write to their MP about this, using the template letter provided by UKCP. You can find the link to do so here: UKCP NICE Anxiety Guideline Campaign
