2017 Principles and Practice of CBT-I by Donn Posner , Michael Perlis & Jason Ellis
Cognitive Behavioral Therapy for Insomnia (CBT-I) is now recommended as the first line treatment for chronic insomnia. This recommendation was, interestingly enough, made by the second largest medical organization in the United States (The ACP) and was published in the Annals of Internal Medicine (2016;165(2):125-133).
The recommendation is, in part, based on the following findings.
- CBT-I is as efficacious and effective as pharmacotherapy in the short run, and is more durable in the long run
- CBT-I has a more benign side effect profile than pharmacotherapy
- CBT-I yields substantial improvement in sleep continuity, and does so largely irrespective of medical or psychiatric comorbidity.
- CBT-I directly targets the factors that are thought to perpetuate insomnia (i.e., the mismatch between sleep opportunity and sleep ability).
- CBT-I has been shown to work well even with patients with a long history of using hypnotics
The Penn Basic CBT-I Course is a two day intensive review of the principles and practice of this intervention. The 16 hour training, along with the conduct of practicum cases with supervision (peer consultation from credentialed BSM individuals [or established experts]) and targeted readings (Tx manuals and practice papers) should position established clinicians to 1) reliably and effectively deliver CBT-I and 2) be eligible for the credentialing exam that is in development by the SBSM and related agencies. For more information on the credentialing process, keep your eye on this space: http://www.behavioralsleep.org/.
- Welcome announcements and orientation
- Basics of sleep and behavioral model of insomnia
- Pharmacological and behavioral treatment options for insomnia
- Assessment of insomnia Part I-Definition, differential diagnosis, indications for treatment.
- Session 1– Assessment Part 2-CBT-I forms, devices, setting up sleep diaries
- Session 2- Treatment planning, setting up sleep restriction and stimulus control
- Session 3– Adherence issues, problem solving and sleep hygiene.
- Session 4- Cognitive Therapy- General and targeted therapies
- Session 5, 6, & 7– Titration of sleep window, treatment delivery, therapist factors, and charting.
- Session 8– Relapse prevention
- Concluding Remarks
More information about Medical:
Medicine is the science and practice of establishing the diagnosis, prognosis, treatment, and prevention of disease.
Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness.
Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease,
typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.
Medicine has been around for thousands of years, during most of which it was an art (an area of skill and knowledge) frequently having connections to the religious and
philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism.
In recent centuries, since the advent of modern science, most medicine has become a combination of art and science (both basic and applied, under the umbrella of medical science).
While stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.