Category: Treatment - CBT

Symposium

Implementing Group CBT for Insomnia: Protocol and Data From a Sleep Medicine Clinic

Friday, November 17
10:15 AM - 11:45 AM
Location: Sapphire Ballroom K & L, Level 4, Sapphire Level

Keywords: Sleep | Group Therapy | Treatment Development
Presentation Type: Symposium

Insomnia is a serious and highly prevalent form of sleep disturbance. It can present either as a primary sleep disorder or as a disorder comorbid with another sleep, medical, or psychiatric disorder and causes significant distress and functional impairment. The most common treatment for insomnia is pharmacotherapy in the form of benzodiazepine receptor agonists or sedating antidepressants (NIHSS, 2005), though a high risk of side effects and/or long term dependence is associated with their use. Cognitive-behavioural therapy for insomnia (CBTi) is an established, non-pharmacological, gold standard intervention (Edinger et al., 2007). However, few studies have examined CBTi delivered in a group format (G-CBTi) and no formal protocols have been published to date. Providing CBTi individually is a time-consuming and cost-inefficient form of treatment delivery. Group therapy represents a cost-effective alternative and offers added therapeutic benefits such as fostering social support and interpersonal learning (Bieling, McCabe, & Antony, 2006) along with the potential to reach more patients, reducing the waitlist. Unique challenges exist for group treatment for insomnia, as weekly individual sleep diary analyses need to take place to allow for a clinician to provide necessary tailored directions for each individual in treatment (e.g., sleep restriction details, time in bed, wake time). We developed a 6 session G-CBTi protocol and are evaluating its efficacy as well as participants’ satisfaction/acceptability with this format of treatment delivery. Individuals with a diagnosis of chronic primary insomnia either with or without secondary comorbid medical or psychiatric difficulties are being recruited from the Sleep Medicine clinic, within the Firestone Institute for Respiratory Health, St. Joseph’s Healthcare. Patients who meet inclusion criteria participate in a comprehensive baseline assessment prior to starting the program and then re-assessed immediately following group and again, three months later. In a projected sample of 35 participants who have completed the G-CBTi program, we will examine the following outcome variables: overall sleep efficiency, the Insomnia Severity Index, the Dysfunctional Beliefs about Sleep Scale, mood, anxiety and treatment acceptibility and satisfaction. Implications and future directions will be discussed. 

Sheryl M. Green

McMaster University

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