Treating Sleep Problems with Cognitive Behavioral Therapy Aarhus

Teacher

Steven J. Linton is professor of clinical psychology and the director of the Center for Health and Medical Psychology, Örebro University. He is active clinically as well as in conducting research about sleep and its treatment. Based on these activi-ties he has authored numerous scientific publications and two books about sleep. The research focuses in part on the psychological mechanisms that drive the development of sleep problems and in part on the treatment of sleep difficulties when it is the primary problem or when it is a co-occurring problem. Recent work has included a large study of adolescents and their sleep.

Course aim

This course aims to provide an overview of the area as well as step by step training in specific skills applicable to the treatment of various sleep difficulties.

In order to understand better sleep and sleep disorders, the course will begin by examining its biological and psychological basis.

We will examine how sleep works throughout the night and day with a perspective on targets for treatment.

The fascinating role of how psychological factors impact on the development of sleep patterns, dreams, nightmares shows why sleep disorders occur and become problematic. Moreover, this knowledge forms the basis of a psychological approach to treatment.

Since insomnia is the most commonly reported sleep disorder, and because cognitive behavioral therapy is the treatment-of-choice, a psychological approach to its assessment and treatment will be in focus.

We will systematically explore the basic elements of a CBT-insomnia treatment. Particular emphasis is on delivering treatment in various settings as well as when in-somnia is co-occurring with other problems such as depression or anxiety.

Since advancements in treatment are continually being made, new methods for treatment will also be addressed. For example, the use of behavioral experiments and mindfulness training can be helpful adjuncts. 

After competencies have been gained for insomnia, this knowledge will be generalized to provide methods for addressing the so-called “modern” sleep problems such as sleep deficit and “social jetlag” (the shifting of sleep times between weekdays and weekends). These problems are escalating and often associated with other symptoms like work stress. 

Finally, we will explore the latest approach, emotion-focused treatment method, which is currently under development. 

Learning Objectives

The workshop will develop the participants’ skills to:

• Conduct an evaluation of patients with sleep complaints
• Conduct a cognitive-behavioral treatment including the compo-nents of psychoeducation, cognitive framing, relaxation, stimulus control, and sleep restriction
• Evaluate the outcome of the sleep intervention
• At an introductory level conduct behavioral experiments for in-somnia

Participants (Target group) 

The course targets psychologits who meet patients with sleep difficulties or are interested in the area. 

Forms of teaching

To achieve the goals of this course, the workshop will feature active learn-ing and case studies. Knowledge will be gained through short presenta-tions, demonstrations, video clips, and a focus on case studies. Skills will be enhanced by discussion, step by step instruction, case studies and the lib-eral use of demonstrations and role play. Participants will have ample op-portunities to discuss pertinent issues, ask questions, as well as to actually train skills by applying knowledge to cases and testing techniques in role play.

Course themes

• Sleep is governed by biological and psychological processes
• Insomnia develops over time and is driven by psychological factors
• Several additional sleep problems e.g. deficit and social jet lag are also driven by psychological factors
• Psychological methods (CBT-I) are the treatment of choice for in-somnia
• Variations of CBT-I may be applied to several other types of sleep disorders and to sleep problems co-occurring with other problems e.g. depression, pain, or anxiety.
• Exciting new methods are being developed that may be used to complement CBT-insomnia.
• Dreams and nightmares are common and have a range of emo-tional intensity. Problematic nightmares may be treated with psy-chological methods.

Preparation / be-tween course days

Please read these two articles as preparation for the workshop.

1. Harvey, A.G. (2006). What about patients who can’t sleep? Case formulation for insomnia. In: Tarrier, N. (ed.), Case formulation in cognitive behavioral therapy. New York: Routledge. Pp 293-311.
2. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., . . . Gonçalves, M. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700. 

After the course

Application after the course is recommended as a way to maintain and en-hance the knowledge and skills gained. Discussion and questions will be facilitated on the webpage.

Literature

Additional readings you may wish to consult are listed below. Books and manuals that are designed to help clinicians understand and administer treatment are marked and with an asterisk*.

Edinger, J. D., & Carney, C. (2008). Overcoming insomnia: A cognitive-behavioral approach, Therapist guide. Oxford: Oxford University Press.

Harvey, A., & Buysse, D. J. (2018). Treating Sleep Problems-A Transdiagnostic Approach Treating Sleep Problems-A Transdiagnostic Approach. Harvey Allison G. Buysse Daniel J. New …. New York: Guilford Press.

Linton , S. J., & Flink, I. (2018). Sömn, dröm mardröm: kunskap och verktyg för god sömn. Stockholm: Natur och Kultur.

Manber, R., & Carney, C. (2015). Treatment plans and interventions for insomnia. Even in Swedish: KBT vid sömnproblem: Terapeutmanual för individanpassad behandling: Guildford press/Natur och Kultur.

Espie, C. A. (2009). “Stepped care”: a health technology solution for delivering cognitive behavioral therapy as a first line insomnia treatment. Sleep, 32(12), 1549. 

Harvey, A. G., Bélanger, L., Talbot, L., Eidelman, P., Beaulieu-Bonneau, S., Fortier-Brochu, É., . . . Soehner, A. M. (2014). Comparative efficacy of behavior therapy, cognitive therapy, and cognitive behavior therapy for chronic insomnia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(4), 670. 

Harvey, A. G., Murray, G., Chandler, R. A., & Soehner, A. (2010). Sleep disturbance as transdiagnostic: consideration of neurobiological mechanisms. Clinical Psychology Review, 31, 225-235. 

Jansson-Fröjmark, M., Norell-Clarke, A., & Linton, S. J. (2016). The role of emotion dysregulation in insomnia: Longitudinal findings from a large community sample. British Journal of Health Psychology, 21(1), 93-113. 

Mazzer, K., Bauducco, S., Linton, S. J., & Boersma, K. (2018). Longitudinal associations between time spent using technology and sleep duration among adolescents. Journal of adolescence, 66, 112-119. 

Norell-Clarke, A., Jansson-Fröjmark, M., Tillfors, M., Holländare, F., & Engström, I. (2015). Group cognitive behavioural therapy for insomnia: Effects on sleep and depressive symptomatology in a sample with comorbidity. Behaviour Research and Therapy, 74, 80-93. 

Van Straten, A. et al (2018). Cognitive behavioral therapies in the treat-ment of insomnia: A meta-analysis. Sleep Medicine Reviews, 38, 3-16.

Evaluation

The course will be evaluated with a questionnaire.

Godkendt til 

Kurset er godkendt til alle specialistuddannelser på det tværgående modul med 12 timer.