Insomnia Treatment: Evidence-Based Strategies to Enrich Sleep and Boost Clinical Outcomes in Clients with PTSD, Anxiety, Chronic Pain and Depression – Colleen E. Carney

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We all know the necessity of sleep –yet we often overlook addressing it in therapy. Your clients with PTSD, anxiety, depression and chronic pain are struggling with symptoms of those disorders, and everything is made worse when they aren’t able to sleep.

If your clients aren’t sleeping, do you know what to do about it?

In this recording, I’ll show you successful, proven techniques I’ve developed over the last decade on how to optimize your clients’ sleep – without medication! You don’t need to be a sleep specialist to implement these strategies in your office.

Discover evidence-based strategies to help your clients increase energy during the day, sleep more deeply and re-initiate sleep after it’s been disrupted. In addition, you’ll learn how to easily integrate these strategies into existing treatment for trauma, anxiety, depression and chronic pain.

Watch and discover:

• New tools to assess for sleep quality & sleep disorders other than insomnia
• Strategies to address conditioned wakefulness and restore your clients’ sleep drives
• Sleep logs, worksheets and other tools to use in your clinical practice
• Specific interventions for clients with comorbid PTSD, anxiety, depression or chronic pain

Add insomnia treatment to your therapeutic toolbox! 

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.

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