Group cognitive behavioural therapy for insomnia: impact on psychiatric symptoms and insomnia severity in a psychiatric outpatient setting.
Insomnia, even when comorbid with other diagnoses is an independent health issue that warrants treatment. Cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment. Although the science is clear that CBT-I supports outcomes for those with mental ill health, the routi...
| Publicado en: | Clinical Psychologist Vol. 27; no. 2; pp. 160 - 171 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jul2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164370258&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 164370258 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13284207 V1U jtl: Clinical Psychologist issn: 13284207 maglogo: Y pubinfo: dt: Jul2023 vid: 27 iid: 2 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 164370258 162225741 164370258 164370258 10.1080/13284207.2022.2155034 164370258 ppf: 160 ppct: 11 formats: tig: atl: Group cognitive behavioural therapy for insomnia: impact on psychiatric symptoms and insomnia severity in a psychiatric outpatient setting. aug: au: Hardman, Jamie R. Rees, Clare S. Bonnar, Daniel Ree, Melissa J. affil: School of Psychology, Curtin University, Perth, Australia sug: subj: Insomnia Therapy Cognitive Therapy Group Processes Severity of Illness Patient-Reported Outcomes Program Evaluation Psychiatric Care Treatment Outcomes Implementation Science Human Middle Age Female Male Hospitals, Psychiatric Questionnaires Anxiety Quality of Life Regression Comorbidity Sleep Disorders Drug Therapy Middle Aged: 45-64 years Female Male ab: Insomnia, even when comorbid with other diagnoses is an independent health issue that warrants treatment. Cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment. Although the science is clear that CBT-I supports outcomes for those with mental ill health, the routine use of CBT-I in mental health contexts is rare. Implementation research on CBT-I in the psychiatric context is urgently needed. This study evaluated group CBT-I as routinely delivered in a psychiatric hospital service. Adult outpatients (N = 76; Mage = 50.20 years; female = 57; psychiatric comorbidity = 69.74%; using sleep medication = 76%) referred for insomnia treatment attended four sessions of group CBT-I. Standardised questionnaires were administered pre- and post-treatment. Intent-to-treat analysis revealed statistically significant and clinically meaningful improvements with large effect sizes in insomnia severity (d = 2.5, r = 0.8), depression (d = 1.4, r = 0.5), anxiety (d = 1.2, r = 0.5) and stress (d = 1.2, r = 0.5) symptoms, quality of life (d = 1.4, r = 0.6), and functional impairment (d = 2.2, r = 0.7). Regression analyses indicated pre-post changes in dysfunctional beliefs about sleep accounted for significant variance in post-treatment insomnia severity. Results supported feasibility of implementation and real-world effectiveness of CBT-I in a psychiatric setting. Cognitive models of insomnia, emphasising the role of unhelpful beliefs about sleep in insomnia treatment were supported. Future directions include the dissemination of CBT-Insomnia to improve its uptake in psychiatric care. What is already known about this topic: Insomnia is very common in mental health settings but it's assessment and treatment are frequently neglected Cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment and has been shown to improve mental health outcomes Implementation and effectiveness research is urgently needed in the psychiatric context to reduce the lag time between the scientific finding of effectiveness and delivery in clinical settings What this paper adds: This effectiveness study found that a four session, group CBT-I intervention was highly effective in a psychiatric setting with mixed mental health presentations and medication use. CBT-I lead to large improvements in insomnia, mood, anxiety, stress, quality of life and functional impairment. Treatment with CBT-I appears to optimise a broad range of outcomes in psychiatric care. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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