Friday, January 31, 2020

Self-Guided Online CBT May Benefit Patients With Insomnia

People with insomnia may find significant relief of their symptoms through self-guided, internet-based cognitive-behavioral therapy (iCBT), a study in the Journal of Affective Disorders suggests. This could help address a need in communities where mental health professionals are in short supply, the researchers wrote.

Ashlee B. Grierson of St. Vincent’s Hospital in Sydney, Australia, and colleagues measured the effectiveness of an iCBT program consisting of four online lessons. The lessons were presented as an illustrated story about a male character with insomnia who learns about the condition and ways to manage his symptoms. After each lesson, participants were asked to download a summary of key concepts introduced in the lesson and practice activities. Of the 317 people who enrolled in the program, 118 completed all four lessons.

Participants completed the Insomnia Severity Index (ISI) and the Kessler 10-item Psychological Distress Scale online before each lesson. They also took the World Health Organization 5-item Well-Being Index assessment before the first lesson, and those who completed the program took it again before the fourth lesson.

Overall, the participants reported large improvements in their insomnia symptoms, moderate improvements in their psychological distress, and small improvements in their general well-being. Among the participants who started the study with ISI scores 15 or above (considered the cutoff for clinical insomnia), 65% remitted (ISI below 15) following iCBT treatment.

The authors noted that their findings suggest that iCBT is a scalable and cost-effective way to disseminate the psychotherapy considered to be the gold standard for insomnia. “Unguided iCBT-I offers the benefits of being accessible at times convenient to the user (for example, outside of business hours), at a low cost, and in a confidential and private environment. Additionally, treating as many patients as possible with the least intensive but still clinically effective care allows for more substantial resources (for example, face-to-face and guided online programs) to be allocated to those who require additional care.”

For related information, see the American Journal of Psychiatry article “Proof of Concept for an Adaptive Treatment Strategy to Prevent Failures in Internet-Delivered CBT: A Single-Blind Randomized Clinical Trial With Insomnia Patients.”

(Image: iStock/monkeybusinessimages)

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