Description: 

Poor sleep and insomnia can contribute to depression and anxiety and to chronic health conditions like diabetes, heart disease, and obesity—not to mention burnout among the very health care and behavioral health professionals that are poised to help with these conditions. Insomnia medications are often habit-forming, have troubling side effects, and merely mask the symptoms of sleeplessness rather than treat the underlying problems.  We all have had clients who have suffered from a poor night's sleep. What role do we play in helping to curb the effects of sleeplessness and insomnia? A variety of behavioral approaches have been proven effective in treating insomnia and difficulties with sleep. However, many clinicians lack the training and confidence to work effectively with these issues. This presentation will emphasize ways to work with your existing clients who struggle with sleep so you do not need to disrupt your care by referring them out.

Part 1 (Noon to 1 pm). CBT-i and Basic Behavioral Strategies

The lunchtime presentation (Part 1) will review the basic components of CBT for Insomnia (CBT-i): Sleep Hygiene, Stimulus Control, and Sleep Restriction. We will consider challenges like:

• Why distributing Sleep Hygiene handouts is worse than useless and what to do instead.

• How modern comforts are scrambling our experience of days and nights and making sleep worse.

• How to think clearly about Sleep Restriction Therapy and how your fear of it is robbing clients of a powerful tool to reverse bad sleep habits.

We will start to consider when less control-based strategies drawn from ACT and mindfulness-based therapies might be more effective—and more acceptable to your clients. We will go deeper into these issues in Part 2 (optional). 

Learning Objectives (Part 1, Noon to 1 pm)

After this presentation, participants will be able to:

1. Summarize each of the “three tiers” of CBT-i: sleep hygiene, stimulus control, and sleep restriction.

2. Describe discrete behavioral goals for improving sleep habits.

3. Explain and use the simple metric of “sleep efficiency” to assess sleep quality and track progress.

Part 2 (1-2 pm). ACT and Mindfulness-Based Strategies to Boost your Sleep Care

In Part 2 (optional but recommended), we will dive deeper into the challenges of helping our clients sleep better. Topics will include:  

• Dealing with anxiety and worry that interferes with sleep including the “Scheduled Worry” practice. 

• Understand the difference between CBT “de-catastrophizing” and ACT “defusion” for sleep-related stress thoughts. 

• How to use softer versions of Sleep Restriction that may be more acceptable to your clients. 

• How to wean your client off control-based strategies so they can move toward “normal” (uncontrolled) sleep.

• Q&A and discussion of participants’ experiences trying to help their clients with insomnia.

• Time-permitting, processing of a sample case. 

Learning Objectives (Part 2, 1-2 pm)

After this presentation, participants will be able to:

1. Explain how to use mindfulness and acceptance to  “soften” unwanted awakenings from sleep.

2. Explain the difference between CBT “de-catastrophizing” and ACT “defusion”—of stress thoughts related to sleeplessness.

3. Use “Scheduled Worry” with a client.