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The Impact of Comorbid Disorders on Sleep and Insomnia

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The Impact of Comorbid Disorders on Sleep and Insomnia ebook THE GUILFORD PRESS TREATMENT PLANS AND INTERVENtiONS FOR INSOMNIA TREATMENT PLANS AND INTERVENtiONS FOR EVIDENCE-BASED PSYCHOTHERAPY Robert L. Leahy, Series Editor www.guilford.com/TPI This series provides psychotherapy practitioners with a wealth of practical tools for treat- ing clients with a range of presenting problems. Each volume synthesizes current informa- tion on a particular disorder or clinical population; demonstrates how to develop specific, tailored treatment plans; and describes interventions proven to reduce distress and alle- viate symptoms. Step-by-step guidelines for planning and implementing treatment are illustrated with rich case examples. User-friendly features include reproducible self-report forms, handouts, and symptom checklists, all in a convenient large-size format. Specific strategies for handling treatment roadblocks are also detailed. Emphasizing a collabora- tive approach to treatment, books in this series enable therapists to offer their clients the very best in evidence-based practice. TREATMENT PLANS AND INteRVENtiONS FOR DepRessiON AND ANXietY DisORDERS, SECOND EDitiON Robert L. Leahy, Stephen J. F. Holland, and Lata K. McGinn TREATMENT PLANS AND INteRVENtiONS FOR BULIMIA AND BINGE-EAtiNG DisORDER Rene D. Zweig and Robert L. Leahy TREATMENT PLANS AND INteRVENtiONS FOR INSOMNIA: A CAse FORMULAtiON AppROACH Rachel Manber and Colleen E. Carney Treatment Plans and Interventions for Insomnia A Case Formulation Approach Rachel Manber Colleen E. Carney THE GUILFORD PRESS New York London © 2015 The Guilford Press A Division of Guilford Publications, Inc. 370 Seventh Avenue, Suite 1200, New York, NY 10001 www.guilford.com All rights reserved Except as indicated, no part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number: 9 8 7 6 5 4 3 2 1 LIMITED PHOTOCOPY LICENSE These materials are intended for use only by qualified professionals. The publisher grants to individual purchasers of this book nonassignable permission to reproduce all materials for which photocopying permission is specifically granted in a footnote. This license is limited to you, the individual purchaser, for personal use or use with individual clients. This license does not grant the right to reproduce these materials for resale, redistribution, electronic display, or any other purposes (including but not limited to books, pamphlets, articles, video- or audiotapes, blogs, file-sharing sites, Internet or intranet sites, and handouts or slides for lectures, workshops, or webinars, whether or not a fee is charged). Permission to reproduce these materials for these and any other purposes must be obtained in writing from the Permissions Department of Guilford Publications. The authors have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards of practice that are accepted at the time of publication. However, in view of the possibility of human error or changes in behavioral, mental health, or medical sciences, neither the authors, nor the editor and publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or the results obtained from the use of such information. Readers are encouraged to confirm the information contained in this book with other sources. Library of Congress Cataloging-in-Publication Data Manber, Rachel, author. Treatment plans and interventions for insomnia : a case formulation approach / Rachel Manber, Colleen E. Carney. p. ; cm. — (Treatment plans and interventions for evidence-based psychotherapy) Includes bibliographical references and index. ISBN 978-1-4625-2008-4 (pbk.) I. Carney, Colleen, author. II. Title. III. Series: Treatment plans and interventions for evidence-based psychotherapy. [DNLM: 1. Sleep Initiation and Maintenance Disorders—therapy. 2. Cognitive Therapy—methods. 3. Patient Care Planning. WM 188] RC548 616.8'4982—dc23 2014048114 In memory of Richard Bootzin, a mentor, friend, and founding father of behavioral interventions for insomnia About the Authors Rachel Manber, PhD, is Professor in the Department of Psychiatry and Behavioral Sciences and Director of the Insomnia and Behavioral Sleep Medicine Training Program at Stanford University. She is a clinical psychologist and has been certified by the American Board of Sleep Medicine in the practice of behavioral sleep medicine. Dr. Manber has trained many clinicians to deliver cognitive- behavioral therapy for insomnia (CBT-I) and has led the development and implementation of a nationwide CBT-I training initiative by the Department of Veterans Affairs. She has conducted sleep and depression research for 20 years and has published many articles in medical and psychiatric journals; numerous book chapters; and insomnia self-help books, includ- ing Quiet Your Mind and Get to Sleep: Solutions to Insomnia for Those with Depression, Anxiety, or Chronic Pain, coauthored with Colleen E. Carney. Colleen E. Carney, PhD, is Associate Professor in the Department of Psychology and Director of the Sleep and Depression Laboratory at Ryerson University in Toronto. She is certified as a cognitive- behavioral therapist by the Canadian Association for Cognitive and Behavioural Therapies, is President of the Behavioral Sleep Medicine Special Interest Group of the Asso- ciation for Behavioral and Cognitive Therapies, and is a Fellow of the Canadian Psychological Association. Dr. Carney’s areas of research include CBT-I; insomnia in the context of other health conditions, notably depression and chronic pain; evidence-based fatigue management strategies; rumination and sleep; fear of the dark in adults; and improving access to CBT. The author of over 100 publications, including seven books, Dr. Carney is a recipient of the Early Researcher Award from the Canadian Ministry of Research and Innovation and the Pickwick Fellowship from the National Sleep Foundation. vii Preface lmost everyone can relate to the experience of a fitful night and the unpleasant next- day consequences. Most people, however, experience sleepless nights as isolated or time- Alimited unpleasant occurrences during unsettling or distressing periods. They usually find it easy to understand why they lost sleep. For them, sleeping well after having lost sleep for a night or two feels refreshing and energizing, and represents a return to normality. People with insom- nia have trouble sleeping almost every night. They may experience occasional nights of good sleep, but they rarely understand why they slept well. As a result, an occasional good night is not a trusted sign of the resolution of insomnia. In other words, the experiences of a good sleeper who occasionally sleeps poorly and a person with chronically poor sleep who occasionally sleeps well are psychological mirror images, yet fundamentally different sets of experiences. It is gratifying to help people who experience poor sleep on most nights for months or years to sleep well. To do this, a therapist must understand the fundamental differences between these two types of experience, and must carefully listen with an open mind to the very personal ways each patient experiences insomnia. A therapist also needs to understand the physiological and psychological factors involved in the transition into and out of sleep. To help promote behaviors and thought habits that support good sleep, clinicians also need to be familiar with principles of behavioral change and cognitive therapy. Cognitive- behavioral therapy (CBT) is an effective and brief treatment for insomnia. It combines behavioral and cognitive interventions that target behaviors, thoughts, and emotions affecting sleep regulation. CBT protocols for treating insomnia that have been researched have consisted of two to eight sessions, with five- to six- session protocols being the most common. Although the majority of patients improve quickly, some may need more sessions. The use of these CBT protocols is empirically supported across myriad populations. Empirical evaluation began with the study of carefully selected samples of individuals who had no comorbidities, and later included samples with specific comorbidities as well as heterogeneous samples. The results across populations are consistent: These CBT approaches are effective. This book was shaped by our experience delivering and teaching others to deliver a form of CBT that targets insomnia, referred to as CBT-I. Our insights were gained from both successes and failures in our roles as teachers and therapists. We have translated these insights into a structured case formulation approach that guides the planning and treatment of insomnia. We have taught CBT-I to students and clinicians from multiple disciplines (psychologists, clinical ix x Preface social workers, mental health nurses, psychiatrists, counselors, nurses, pharmacists, and physi- cians). Mental health providers often begin CBT-I training with at least some knowledge and experience of helping patients change their behaviors, but little knowledge about sleep science. Medical practitioners often begin CBT-I
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