In the United Kingdom, the National Health Service (NHS) has taken a very active role in improving access to care with on-line therapeutic technologies. The NHS has recently released a description of five on-line services that they have endorsed, which were also studied by the National Institute for Health and Care Excellence.

Two of the products endorsed by the NHS have already been listed on PsyberGuide since they can be used relatively independently. Beating the Blues is a cognitive behavioral therapy (CBT) program for people with depression, anxiety or stress, which earned 10 of 14 points on the PsyberGuide scoring system and 4 of 5 stars on the NHS site. Similarly, Fear Fighter is a self-directed CBT program that earned identical ratings on the PsyberGuide and NHS sites. Big White Wall, Leso Digital Health and Silver Cloud have not been listed on PsyberGuide as they require substantial interaction with live therapists or supporters. Big White Wall and Leso Digital Health earned excellent ratings on the NHS site. Interestingly, many of the programs endorsed on the NHS site are paid for by the NHS. This is a situation that we have not yet encountered in the U.S., where insurance reimbursement for self-directed therapies by computer is still in its infancy. If anyone has experience with these products please share your comments with us.