The article by Bower and Gilbody reviews the concept of stepped care in psychological therapies, aiming to examine its theoretical underpinnings and practical implementation. Stepped care is a healthcare delivery model that aims to provide the least restrictive treatment while ensuring significant health gains, with a self-correcting mechanism to monitor and adjust treatment intensity based on patient progress. The review highlights the potential benefits of stepped care in improving efficiency and access to psychological therapy services, which are currently limited by the availability of trained therapists. Key elements of stepped care include the use of minimal interventions, such as brief therapies, group treatments, and self-help approaches, and the decision-making process for advancing patients through different levels of treatment. The article discusses the clinical and economic evaluation of stepped care, emphasizing the need for rigorous research to support the assumptions of equivalence, efficiency, and acceptability. It concludes that while stepped care has the potential to improve efficiency, a significant research agenda is needed to fully understand its effectiveness and optimal implementation.The article by Bower and Gilbody reviews the concept of stepped care in psychological therapies, aiming to examine its theoretical underpinnings and practical implementation. Stepped care is a healthcare delivery model that aims to provide the least restrictive treatment while ensuring significant health gains, with a self-correcting mechanism to monitor and adjust treatment intensity based on patient progress. The review highlights the potential benefits of stepped care in improving efficiency and access to psychological therapy services, which are currently limited by the availability of trained therapists. Key elements of stepped care include the use of minimal interventions, such as brief therapies, group treatments, and self-help approaches, and the decision-making process for advancing patients through different levels of treatment. The article discusses the clinical and economic evaluation of stepped care, emphasizing the need for rigorous research to support the assumptions of equivalence, efficiency, and acceptability. It concludes that while stepped care has the potential to improve efficiency, a significant research agenda is needed to fully understand its effectiveness and optimal implementation.