In the UK, the National Institute for Health and Care Excellence (NICE) produces clinical guidelines that shape how the NHS assesses and treats health conditions. These guidelines determine everything from how a condition is identified at its earliest stages through to the more intensive support available when first-line interventions have not worked. While the evidence from yoga and anxiety research continues to mount, yoga remains a notable exclusion from NICE’s guidelines.
Because there are a number of distinct anxiety disorders, NICE has produced separate guidelines for different conditions. Generalised Anxiety Disorder (GAD) and Panic Disorder (PD) are addressed under one guideline, a reasonable grouping, given that whilst the two conditions have meaningful differences in both assessment and treatment, they share enough clinical overlap to sit under the same framework.
The core guidance on GAD and PD, NICE guideline CG113, has not been substantively revised since 2011, fifteen years ago. In 2019, a surveillance review noted:
“Evidence suggests yoga is effective for state anxiety (i.e. feelings of anxiety not caused by an anxiety disorder) but less effective in reducing symptoms in people with clinically diagnosed anxiety disorders.”
That is an acknowledgement of yoga’s value, not a recommendation. And it makes sense as far as it goes, state anxiety is not a clinical condition, so no treatment recommendation is required. But here’s the thing.
The Minded Institute shares occasional updates on yoga therapy, neuroscience, and professional training.
You can unsubscribe at any time.
What Yoga and Anxiety Research Now Shows
Across yoga research broadly, the most consistently replicated finding is yoga’s role in reducing stress and anxiety. And beyond that general body of work, there is now high-quality evidence specifically examining yoga as a treatment for clinically diagnosed GAD and comparing it directly to CBT, the most commonly available treatment for anxiety disorders on the NHS. Taken together, here at Minded, we believe that yoga should be recommended somewhere in this guidance.
Early Research on Yoga for GAD
The earliest study in this line of work is Kundalini Yoga for Generalized Anxiety Disorder: An Exploration of Treatment Efficacy and Possible Mechanisms, published in the International Journal of Yoga Therapy in 2018 by Gabriel, Curtiss, Hofmann and Khalsa. Forty-nine women with GAD received either an eight-week Kundalini Yoga intervention or a treatment-as-usual condition. The yoga group showed significantly lower levels of anxiety, with reductions in somatic symptoms identified as a key mechanism of change.
The JAMA Psychiatry Trial
That pilot informed the design of a far larger randomised controlled trial: Efficacy of Yoga vs Cognitive Behavioral Therapy vs Stress Education for the Treatment of Generalized Anxiety Disorder: A Randomized Clinical Trial, published in JAMA Psychiatry in 2021 by Simon, Hofmann, Rosenfield, Hoeppner, Hoge, Bui and Khalsa. Publication in JAMA Psychiatry, one of the most rigorous and widely read psychiatry journals in the world, is significant in itself. It means the methodology was scrutinised to an exceptionally high standard before the findings were accepted. The trial randomised 226 adults with a primary diagnosis of GAD to Kundalini Yoga, CBT, or a stress education control, each delivered over twelve two-hour group sessions. At twelve weeks, 54% of the yoga group and 71% of the CBT group had responded to treatment, compared to 33% in the control group, with both yoga and CBT significantly outperforming the control.
The publication of this study prompted The Times to raise the question of whether yoga should be available on the NHS. Here at Minded, this is a position we have long held.
Further Evidence Comparing Yoga and CBT
A third paper from the same trial, Comparing Kundalini Yoga, Cognitive Behavioral Therapy, and Stress Education for Generalized Anxiety Disorder: Anxiety and Depression Symptom Outcomes, published in Psychiatry Research in 2023 by Hoge, Simon, Szuhany, Feldman, Rosenfield, Hoeppner, Jennings, Khalsa and Hofmann, examined seven further anxiety and depression measures from the same trial. Across all of them, both yoga and CBT outperformed the control group, and on anxiety measures specifically, yoga and CBT did not differ significantly from each other.
Why NICE Anxiety Guidance Needs Updating
The case for revising NICE guideline CG113 is not made by Minded alone. It is, in fact, a substantive position held by much of the mental health sector, and the grounds go well beyond yoga.
On 17 March 2026, the UK Council for Psychotherapy (UKCP) led two letters to NICE calling for a comprehensive update to the guideline. The joint position statement was backed by over 45 organisations, academics and practitioners, including Mind and the Centre for Mental Health. The cross-party letter was signed by over 20 parliamentarians from all major parties, led by the Liberal Democrats’ mental health spokesperson, Dr Danny Chambers. The full campaign is on the UKCP campaign page. The call for revision reflects a wider recognition that anxiety treatment research has moved substantially since NICE guideline CG113 was last updated.
Fifteen years without a substantive revision means the guidance now conflicts with more recently updated NICE guidelines on related conditions. It uses outdated diagnostic frameworks. And critically, it recommends only two types of therapy for anxiety, CBT and applied relaxation, leaving clinicians with very limited options and patients with very limited choice. Fewer than half of those who access treatment through NHS Talking Therapies reliably recover from their presenting issue. The guidance, as it stands, is not serving people well enough.
What Yoga and Anxiety Research Means for NICE
This is the context in which yoga’s inclusion needs to be argued. A revision is underway. The sector is aligned with the need for change. And the evidence for yoga’s efficacy in GAD, across three studies culminating in a large randomised controlled trial published in JAMA Psychiatry, is now substantial enough to be part of that conversation.
We already have a foothold: yoga is acknowledged in the current surveillance notes. What is needed now is for that acknowledgement to be backed by the weight of the yoga and anxiety research that has accumulated since, and for the yoga world to be present and active in the process that determines whether it gets there.
What you can do next
There are several concrete ways to contribute, and they are not all equal in their likely impact.
If you represent a yoga or health organisation, you can join the UKCP coalition formally by contacting them at research@ukcp.org.uk to become a signatory to the joint position statement. You can also write to your MP, and the UKCP website has a standard letter you can use.
However, it is worth being direct about where real influence lies in this process. The formal stakeholder consultation that takes place once a guideline review is underway is important, but the decisions that shape a guideline are largely made earlier, by the guideline development committee, the evidence reviewers, and the technical advisers who are involved before general consultation opens. The people who can meaningfully shift what ends up in revised guidance are those with the clinical or research credentials to participate at that stage. If you are a researcher, clinician, or academic with relevant expertise, we would encourage you to explore how to get involved in the review process directly and early.
There is also real value in the yoga community speaking with a single, coordinated voice. A joint letter, evidenced and well-timed, carries considerably more weight than individual submissions. If you would like to be involved in crafting one, please let us know. We would welcome your participation.
For anyone who wants to go deeper into the research evidence, we are happy to share resources. Please reach out to us directly.
