FOUNDATIONS FOR THE TREATMENT PROGRAM
This treatment program is based on both the program developed by the Harvard Medical Center and that developed by the Stanford University Sleep Center. (The latter model is that being used by the Veterans' Administration.) The program I'm using also draws on clinical works and treatment guides published by the American Psychological Association and the American Association of Sleep Medicine.
Most programs range from 4-8 weeks. I have gone for the most common length, 6 sessions, because I believe a shorter length risks not enough time for individualized needs to be addressed, and a longer time is too difficult for most people to schedule easily..
Most of the models are based on individual sessions. However, the research indicates no difference in treatment success between individual treatment and treatment in group sessions. Given the huge cost savings to a client in doing this in a group, I offer that as the primary choice. INDIVIDUAL SESSIONS ARE AN OPTION if you would prefer that.
Links to research studies on the effectiveness of the treatment are provided at the bottom of this page.
THIS TREATMENT IS NOT TALK THERAPY
This treatment is based on Cognitive-Behavioral Therapy (CBT) and specifically on CBT-I (CBT-Insomnia). Talk therapy is called Cognitive Therapy. This can be confusing, as many therapists who say they provide CBT actually are doing Cognitive Therapy instead. CBT recognizes that while thinking things through - cognition - is important, action -- behavioral changes -- are equally important, and A SEPARATE THING from our conscious thinking.
As an example: deciding that I need to lose weight is a result of cognitive thinking. Making a diet work even when I am not thinking about it, that is about my behavioral thinking.
COULDN'T I DO THIS ON MY OWN?
Yes , that is possible -- but there are good reasons why this tretament option may be a much better choice for you.
First, It is true that many elements of the program have been described (in more-or-less the same ways) in the following self-help style books:
Say Goodnight to Insomnia
There is some discrepancy regarding napping -- some say never, others say its OK under specific guidelines, Some books focus too much attention on sleep disorders other than insomnia. Some books make charting your progress overly complicated, in my opinion. Some are better at exploring why sleep problems occur and what we don't know about them, while others offer a pretty much cookie-cutter approach, a list of do's and don't's. All are helpful.
There are also on-line resources which provide much the same information as in the self-help books, many of which were created by the book authors, Some of these are:
WHY DO I THINK WORKING ON TREATING INSOMNIA IN A CLINICAL TREATMENT PROGRAM IS THE BETTER CHOICE FOR MOST PEOPLE?
Foremost is the fact that research says that doing it this way has shown a consistent csuccess rate of at least 70-80%. There is no research on the success rate for doing it through a self-help approach, but plenty of reason to believe that the success rate would not be as good.
At a treatment cost of $350 (with insurance possibly covering much of that) versus a self help cost of $60 or so, I think it makes sense to go with the more proven option.
Secondly, if you've been struggling with insomnia for any length of time you've probably already tried many of the things the self-help books talk about. I found some of the same information in free pamphlets at Walgreens, and have seen it repeated multiple times in magazine and newspaper articles as well as on most health websites. Its unlikely that knowing some of what to do is really helping -- either because it's too hard to make knowledge become action, the techniques don't work well for you (or in Alaska), or what you need is something more than just
some logistical changes.
And that goes to the third point: doing this as part of a clinical program and in a group setting significantly helps things like motivation and follow-through. It increases your ability to make the changes needed consistently for the length of time needed for those changes to really produce the results you want. We do much better at making effective changes if we have coaching, guidance, support, and a structure that encourages us.
Fourth, while the strictly BEHAVIORAL aspects of treatment (such as sleep hygiene practices) are relatively simple fixes for most people, the COGNITIVE aspects of this Cognitive-Behavioral Therapy are likely to be more difficult challenges for someone without clinical training and experience. Doing this under the guidance of atrained clinician means that your iondividual difficulties, situations, and experiences can be dealt with: the treatment can be adjusted
to work for you, not the generic every=person in the books.
Finally, my belief is that. like learning to be skilled in a sport or playing a musical instrument, access to a coach and having a set structure for skill development and practice is of significant help in succeeding in learning the new skills.
If you can do this on your own using the self-help resources above or others you find, that's wonderful. Please feel free to use any resources on this website to help you do that. The goal is that you get better.
If you think that doing this in a clinical treatment program makes better sense for you, then welcome. Either way, my goal is that you get a better night's sleep.
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