Tailoring cognitive behavioural therapy for insomnia across contexts, conditions, and individuals: What do we know, where do we go?

Abstract

SummaryCognitive behavioural therapy for insomnia (CBT‐I) is considered the front‐line treatment for insomnia. Despite the demonstrated effectiveness of CBT‐I, it is necessary to consider how CBT‐I may be tailored to different individuals. The purpose of the present review is to provide a summary of literature on tailoring CBT‐I to different individuals and provide directions for future research. This review focused on the following domains of adaptation: (i) tailoring CBT‐I components to individuals with comorbid mental or physical health conditions such as comorbid depression and pain; (ii) adapting CBT‐I delivery for different contexts in which individuals exist, such as inpatient, educational, and different social/cultural settings, (iii) adapting CBT‐I to specific individuals via case‐formulation in clinical settings. We highlight current gaps in the exploration of tailored CBT‐I, including a lack of research methodology to evaluate tailored interventions, a need for the integration of ongoing individualised assessment to inform treatment, and the necessary involvement of consumers and stakeholders throughout the research and treatment development process. Together, this review showed abundant adaptations in CBT‐I already exist in the literature. Future research is needed in understanding when and how to apply adaptations in CBT‐I and evaluate the benefits of these adaptations.

Improving adolescent sleep in long-term Juvenile correctional settings: case examples with clinical, research, and policy implications

“…sleep restriction or compression) which have been found to benefit adult PSTD symptoms [ 68 ]. However, little guidance exists around when and how to adapt CBT-I [ 69 ] for adolescents in correctional settings, as previously discussed in the context of Justin’s case. An additional consideration would be imagery rehearsal therapy, which has been found to reduce PTSD-related nightmares in adolescents [ 70 ], with one study examining this approach among adjudicated youth [ 71 ].…”