BAMT joins coalition calling for urgent review of NICE anxiety guideline

BAMT has joined over 70 organisations and policymakers calling on NICE to undertake the urgent review of their anxiety guidelines. 

While there have been a small number of surveillance and evidence reviews leading to minor changes, these have not resulted in any substantial revision. Without a full update, anxiety treatment guidance risks remaining out of step with other NICE mental health guidelines, grounded in outdated evidence, older diagnostic criteria, and an older understanding of what constitutes effective care.

At the same time, the number of adults living with common mental health conditions such as anxiety has been steadily rising. In 2024–25, NHS Talking Therapies received almost half a million referrals for anxiety or stress-related disorders, yet fewer than half of those who access treatment “reliably recover”- meaning they are no longer considered a clinical case and show a significant improvement in their condition (NHS Digital, 2025).

Crucially, the guideline currently recommends only two therapies for anxiety: cognitive behavioural therapy (CBT) and applied relaxation. This narrow focus can restrict access to other effective forms of support and evidence-based interventions, such as Music Therapy. It also excludes approaches that explore underlying causes and wider contributing factors.

This matters because people seeking help for anxiety through the NHS should have access to a broader range of evidence-based treatments, so support can be tailored and work effectively for everyone, regardless of background or circumstances.

In summary, our shared concerns are that:

• The guideline has not been meaningfully updated since 2012, resulting in incongruity with the recently updated NICE guideline for depression in adults.
  This guideline demonstrates its age through references to out-of-date diagnostic manuals, a contradiction between the guidelines in how to treat comorbid depression and anxiety, and little to no discussion of a collaborative approach to treatment with patients.
• The current guideline does not reference barriers to access for marginalised and hard-to-reach populations or any methods to promote access and uptake.
• Evidence for recommended interventions is treated inconsistently, resulting in a bias in favour of existing recommendations which prevents updating of the guideline.
• Evidence from randomised controlled trials (RCTs) is weighted heavily, whilst evidence from Service User experience, long-term or follow-up studies is neglected.
• Only two therapies are recommended, despite well-established evidence that other talking therapies are effective in treating anxiety. There is high quality evidence that many other talking and creative therapies can be used to treat anxiety.
• The guideline poses a serious threat to patient choice and will result treatments being offered which may not have the best chance of addressing the root cause of anxiety (which in turn will contribute to poor cost effectiveness in the long term). 
  
  Our ask 
  
  We have called on NICE to conduct an urgent and comprehensive update to the NICE anxiety guideline so that it:
  
  
• is compatible with other revised guidelines and uses the most up to date diagnostic criteria such as the DSM-5 and ICD-10
• includes guidance for addressing barriers to accessing treatment for marginalised and hard-to-reach populations
• increases the number of therapies approved to treat anxiety so that patients have a choice in their care
• considers a broader range of high-quality evidence available on treating anxiety (for example, Service User experience, long term and follow-up studies).

Chief Executive at BAMT Andrew Langford said:

"BAMT is proud to be a partner in the campaign calling for an urgent review of NICE’s anxiety guideline. With anxiety referrals on the rise, it’s vital that clinicians are working with guidance that is as current and comprehensive as possible.

Out-of-date frameworks and limited therapeutic options risk far-reaching harm for patients, services, and the mental health workforce. Music Therapy is an evidence-based intervention for anxiety, and everyone deserves genuine choice so care can be tailored to what works best for each individual.”

See the full list of partner organisations and find out more here.