CBT FOR IN

SOMNIA

E M P I RI C

A L LY VA L I D

A T E D TX S

T R A T E G I ES

A P R I L C

FO R E M

A N , P H . D

. , L

. P.

P E E R TR A I N

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F C MH C

J UN E A

N D JU LY,

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WHY INSOMNIA SPECIFIC INTERVENTIONS?

WHY CBT?

Can we talk people into sleeping?

SO, GIVE US THE QUICKIE TIPS AND TRICKS!

TWO WAVE THEORY

Recommended Reading:Glovinsky, P. & Spielman, A. The

Insomnia Answer (2006). The BerkelyPublishing Company, NY, NY.

SLEEP IS A NATURAL PROCESS, SO…

When there is chronic sleep disruption, we

need to do detective work to figure out what is interfering with it.

3P MODEL OF SLEEP DISORDERS

PREDISPOSING CHARACTERISTICS

Inherited or acquired

PRECIPITATING EVENTS

Clients often call this “the cause”

PERPETUATING ATTITUDES AND PRACTICES

What is maintaining the sleep interference?

Best place to intervene and to use CBT skills.

STIMULUS CONTROL

• For conditioned insomnia• Use Motivational Interviewing skills• Use Acceptance and Commitment

Therapy (ACT)

SLEEP RESTRICTION

More sleep is not the same as better sleep.

Not recommended for Bipolar D/Os.Use Motivational Interviewing skills.

CALCULATE SLEEP EFFICIENCY

• Time_sleep/Time_bed• If <.90, use sleep

restriction• When >.90 increase

Time_bed

5 COGNITIVE DISTORTIONS OF POOR SLEEPERS

Use CBT, Motivational Interviewing, and ACT skills to

help clients change.

1) MY POOR SLEEP IS OUT OF MY CONTROL…

…And none of my choices or habits make a difference.

2) IF I DON’T SLEEP IT’S A DISASTER!!

3) ONLY “PERFECT” SLEEP IS GOOD SLEEP!

…And all other sleep is bad, no matter how rested I

actually feel.

4) “I CAN’T CONTROL MY SLEEP!!”

…So give me something that will!

5) I HAVE TO MAINTAIN BAD HABITS!!

…Because better habits will only make it worse!

• Dr. Colleen Erhnstrom

• practiceground.org

• actskillsgroup.com

• docforeman.com

WANT TO KNOW MORE?

It was my pleasure to share this with you. For more clinical resources and

discussions, visit my website, or follow me on Twitter as @DocForeman