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Abstract Introduction Many patients who enter treatment for mental health problems experience insomnia symptoms that may hinder their response to general mental health treatment. There is also a shortage of CBTi providers in the United States and worldwide. One method to address the paucity of CBTi providers is to integrate digital CBTi (dCBTi) into general psychotherapy, which, on its own, does not sufficiently address insomnia symptoms. This approach is likely to improve sleep and potentially also mental health outcomes. Integrated dCBTi provides the patient with support around adherence and engagement. This study aims to pilot test and refine a program for training licensed therapists to support their patients undergoing dCBTi. This integrated approach is novel and yet to be tested. Methods Licensed therapists participate in a 4-hour training. Therapists subsequently enroll 1-2 patients with insomnia symptoms and comorbid depression and/or anxiety to receive integrated dCBTi. Therapists complete measures evaluating the training. At each psychotherapy session, therapists complete a checklist documenting which elements of the integrated dCBTi support they provide and how much time they spend doing so. Patients complete the Insomnia Severity Index, the Diagnostic Interview for Anxiety, Mood, and OCD and Related Neuropsychiatric Disorders, and qualitative measures about their experience of integrated dCBTi after receiving integrated dCBTi. Results As of December 2023, 11 therapists are enrolled and patient enrollment is ongoing. After the training, therapists rated that they were “well-prepared” to integrate dCBTi into their routine practice, and 100% indicated that they would recommend this training. Regarding the content of dCBTi, therapists expressed understanding of the value of time in bed restriction and importance of monitoring the patient’s engagement and progress continuously. Therapists also noted an improved ability to present the rationale for CBTi components and to answer patient questions about dCBTi. Post training data, including patient data, will be available by June 2024. Conclusion The integration of dCBTi in general psychotherapy through brief training of licensed therapists may be a viable approach to improve access to CBTi for patients with comorbid depression and/or anxiety. Support (if any) Sleep Research Society Foundation Career Development Award 035-JP-22 and T32MH019938
Gumport et al. (Sat,) studied this question.