Dissemination of CBTI to the non-sleep specialist: Protocol development and training issues

Rachel Manber, Colleen Carney, Jack Edinger, Dana Epstein, Leah Friedman, Patricia L. Haynes, Bradley E. Karlin, Wilfred Pigeon, Allison T. Siebern, Mickey Trockel

    Research output: Contribution to journalReview article

    96 Citations (Scopus)

    Abstract

    Strong evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI). A significant barrier to wide dissemination of CBTI is the lack of qualified practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended) . Among these decisions is the question of how to balance the structure and flexibility of the treatment protocol. We developed a case conceptualizationdriven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These "real-life" constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.

    Original languageEnglish (US)
    Pages (from-to)209-218
    Number of pages10
    JournalJournal of Clinical Sleep Medicine
    Volume8
    Issue number2
    DOIs
    StatePublished - Apr 15 2012

    Fingerprint

    Sleep Initiation and Maintenance Disorders
    Cognitive Therapy
    Mental Health
    Veterans Health
    United States Department of Veterans Affairs
    Clinical Protocols
    Social Work
    Hypnotics and Sedatives
    Psychiatry
    Comorbidity
    Sleep
    Nursing
    Psychology
    Education
    Research

    Keywords

    • Cognitive behavioral therapy
    • Dissemination
    • Insomnia

    ASJC Scopus subject areas

    • Pulmonary and Respiratory Medicine
    • Neurology
    • Clinical Neurology

    Cite this

    Dissemination of CBTI to the non-sleep specialist : Protocol development and training issues. / Manber, Rachel; Carney, Colleen; Edinger, Jack; Epstein, Dana; Friedman, Leah; Haynes, Patricia L.; Karlin, Bradley E.; Pigeon, Wilfred; Siebern, Allison T.; Trockel, Mickey.

    In: Journal of Clinical Sleep Medicine, Vol. 8, No. 2, 15.04.2012, p. 209-218.

    Research output: Contribution to journalReview article

    Manber, R, Carney, C, Edinger, J, Epstein, D, Friedman, L, Haynes, PL, Karlin, BE, Pigeon, W, Siebern, AT & Trockel, M 2012, 'Dissemination of CBTI to the non-sleep specialist: Protocol development and training issues', Journal of Clinical Sleep Medicine, vol. 8, no. 2, pp. 209-218. https://doi.org/10.5664/jcsm.1786
    Manber, Rachel ; Carney, Colleen ; Edinger, Jack ; Epstein, Dana ; Friedman, Leah ; Haynes, Patricia L. ; Karlin, Bradley E. ; Pigeon, Wilfred ; Siebern, Allison T. ; Trockel, Mickey. / Dissemination of CBTI to the non-sleep specialist : Protocol development and training issues. In: Journal of Clinical Sleep Medicine. 2012 ; Vol. 8, No. 2. pp. 209-218.
    @article{f566c3c3a1ec4b9b92b31dff7aa27577,
    title = "Dissemination of CBTI to the non-sleep specialist: Protocol development and training issues",
    abstract = "Strong evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI). A significant barrier to wide dissemination of CBTI is the lack of qualified practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended) . Among these decisions is the question of how to balance the structure and flexibility of the treatment protocol. We developed a case conceptualizationdriven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These {"}real-life{"} constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.",
    keywords = "Cognitive behavioral therapy, Dissemination, Insomnia",
    author = "Rachel Manber and Colleen Carney and Jack Edinger and Dana Epstein and Leah Friedman and Haynes, {Patricia L.} and Karlin, {Bradley E.} and Wilfred Pigeon and Siebern, {Allison T.} and Mickey Trockel",
    year = "2012",
    month = "4",
    day = "15",
    doi = "10.5664/jcsm.1786",
    language = "English (US)",
    volume = "8",
    pages = "209--218",
    journal = "Journal of Clinical Sleep Medicine",
    issn = "1550-9389",
    publisher = "American Academy of Sleep Medicine",
    number = "2",

    }

    TY - JOUR

    T1 - Dissemination of CBTI to the non-sleep specialist

    T2 - Protocol development and training issues

    AU - Manber, Rachel

    AU - Carney, Colleen

    AU - Edinger, Jack

    AU - Epstein, Dana

    AU - Friedman, Leah

    AU - Haynes, Patricia L.

    AU - Karlin, Bradley E.

    AU - Pigeon, Wilfred

    AU - Siebern, Allison T.

    AU - Trockel, Mickey

    PY - 2012/4/15

    Y1 - 2012/4/15

    N2 - Strong evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI). A significant barrier to wide dissemination of CBTI is the lack of qualified practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended) . Among these decisions is the question of how to balance the structure and flexibility of the treatment protocol. We developed a case conceptualizationdriven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These "real-life" constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.

    AB - Strong evidence supports the efficacy of cognitive behavioral therapy for insomnia (CBTI). A significant barrier to wide dissemination of CBTI is the lack of qualified practitioners. We describe challenges and decisions made when developing a CBTI dissemination program in the Veterans Health Administration (VHA). The program targets mental health clinicians from different disciplines (psychiatry, psychology, social work, and nursing) with varying familiarity and experience with general principles of cognitive behavioral therapies (CBT). We explain the scope of training (how much to teach about the science of sleep, comorbid sleep disorders, other medical and mental health comorbidities, and hypnotic-dependent insomnia), discuss adaptation of CBTI to address the unique challenges posed by comorbid insomnia, and describe decisions made about the strategy of training (principles, structure and materials developed/recommended) . Among these decisions is the question of how to balance the structure and flexibility of the treatment protocol. We developed a case conceptualizationdriven approach and provide a general session-by-session outline. Training licensed therapists who already have many professional obligations required that the training be completed in a relatively short time with minimal disruptions to training participants' routine work responsibilities. These "real-life" constraints shaped the development of this competency-based, yet pragmatic training program. We conclude with a description of preliminary lessons learned from the initial wave of training and propose future directions for research and dissemination.

    KW - Cognitive behavioral therapy

    KW - Dissemination

    KW - Insomnia

    UR - http://www.scopus.com/inward/record.url?scp=84861130116&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84861130116&partnerID=8YFLogxK

    U2 - 10.5664/jcsm.1786

    DO - 10.5664/jcsm.1786

    M3 - Review article

    C2 - 22505869

    AN - SCOPUS:84861130116

    VL - 8

    SP - 209

    EP - 218

    JO - Journal of Clinical Sleep Medicine

    JF - Journal of Clinical Sleep Medicine

    SN - 1550-9389

    IS - 2

    ER -