Insomnia Treatment: Evidence-Based Strategies to Enrich Sleep & Boost Clinical Outcomes in Clients with PTSD, Anxiety, Chronic Pain & Depression

CPD

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Speaker

Colleen Carney, PhD Related seminars and products

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Colleen E. Carney, PhD, is on faculty in the department of psychology at Toronto Metropolitan University, where they are the director of the sleep and depression laboratory. They are a leading expert in psychological treatments for insomnia, particularly in the context of co-occurring mental health issues. Their work has been featured in The New York Times and they have over 100 publications on insomnia.

Dr. Carney frequently trains students and mental health providers in CBT for Insomnia at invited workshops throughout North America and at international conferneces. Dr. Carney is a passionate advocate for improving the availability of treatment for those with insomnia and other health problems. For more information, please visit www.drcolleen carney.com

Speaker Disclosures:
Financial: Dr. Colleen Carney has employment relationships with Toronto Metropolitan University and Duke University. They receive a grant from Canadian Institutes of Health Research and Sleep Research Consortium. Dr. Carney receives royalties as a published author. They receive a speaking honorarium and recording royalties from PESI, Inc. Dr. Carney has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Colleen Carney is a member of the Canadian Association of Cognitive and Behavioural Therapies, the Canadian Psychological Association, the Association for Behavioural and Cognitive Therapies (ABCT), the Canadian Sleep and Circadian Network, the Canadian Sleep Society, the Sleep Research Society, and the Canadian Association for Cognitive Behaviour Therapy.

Objectives

1. Select assessment tools that screen for other sleep disorders and identify insomnia treatment targets as it relates to case conceptualization.
2. Teach clients about the science of sleep, causes of chronic insomnia and the impact on overall mental health.
3. Explore three models of insomnia treatment and implementation issues for different practice settings.
4. Modify insomnia treatment interventions for use with clients who have co-occurring issues such as chronic pain, depression, anxiety or PTSD.
5. Setup treatment strategies that clients can easily implement to manage fatigue.
6. Collaboratively design a sleep schedule with clients using a sleep diary to improve sleep efficiency and daytime functioning.

Outline

Assessment

• Sleep regulation
• The elements of insomnia
• Goals of assessment
• Diagnostic criteria
• Comorbid conditions
• Other sleep disorders
• When to make a referral to a sleep clinic
• Take-home assessment tools
• Limitations of the research & potential risks
• Case Study: Sleep phase delay vs. insomnia

Stimulus Control (SC): Address Conditioned Arousal to Reduce Wakefulness

• Psychoeducation for your client
• Rules for reassociating the bed with sleep
• Fatigue management strategies to eliminate napping
• Ideas for late-night activities
• Case Study: Is the client a candidate for stimulus control?

Sleep Restriction Therapy (SRT): Restore the Sleep Drive to Improve Sleep Quality

• How to present rationale to your client
• Calculate time-in-bed prescription
• Placing the time-in-bed window
• Identify & overcome obstacles to adherence
• Sleep extension
• How to combine SC & SRT effectively
• Sleep hygiene
• Case Study: Would you increase time in bed?

Counterarousal Strategies: Five MustKnow Strategies to Quiet an Active Mind

• Establish a buffer zone
• Scheduled thinking time
• Combat excessive rumination
• Mindfulness strategies
• Relaxation therapies

Cognitive Therapy: Identify and Change Distorted Thoughts about Sleep

• Thought records
• Behavioral experiments
• Socratic questioning
• Case Study: Interpreting thought records

Modify Insomnia Treatment for Clients with Comorbid Disorders

PTSD

• Fear of silence
• Fear of loss of vigilance
• Delayed bedtime
• Sleep avoidance
• Prolonged nightmare awakenings
• Is hypnotic discontinuation necessary?

Anxiety

• When stimulus control rules can’t be tolerated
• Combat hastiness to get out of bed
• Sleep compression: An alternative to SRT
• Identify sleep anxiety vs. high arousal in bed
• Considerations for panic disorder

Depression

• Sleep’s impact on mood
• Distorted time-in-bed to time sleeping ratio
• Use of coping cards
• Troubleshoot adherence problems
• Worsening moods
• Case Study: Struggling to get out of bed

Chronic Pain

• Pain meds & sleep
• Considerations for use of stimulus control
• Break the association of bed & pain
• When it’s physically difficult to get out of bed

Target Audience

• Counselors
• Social Workers
• Psychologists
• Psychotherapists Therapists
• Addiction Counselors
• Marriage and Family Therapists
• Case Managers
• Nurses
• Other Mental Health Professionals

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