ABSTRACT
INTRODUCTION The efficacy of cognitive behavioral treatments of insomnia has been well-documented in adults of all ages (1). A major challenge facing behavioral sleep medicine experts is how to best disseminate cognitive behavioral treatments to patients in primary care settings. A major barrier to the routine provision of such interventions in primary care settings is the length of the time required for treatment. Cognitive behavioral interventions have traditionally been administered over the course of 6 to 10 sessions lasting 50 to 90 minutes each (1). Another barrier is the common approach of providing treatment on a one-to-one basis. It is not difficult to see how lengthy intervention periods and individually administered treatment combine to consume a great deal of clinician time-–a valuable and often limited resource in primary care settings. As a result, access to cognitive behavioral treatments for insomnia is frequently limited outside of a few select academic medical settings and specialized sleep treatment centers. Both of the intervention approaches presented in this chapter represent methods of treatment administration that offer potential solutions to these barriers. For example, shortened protocols and group treatment (treating more than one patient at a time) can make the best use of available healthcare provider resources by reducing demands on clinician time. Importantly, evidence suggests that these alternative approaches to administering cognitive behavioral treatment of insomnia can be adopted without compromising treatment quality. As will be presented in this chapter, research indicates that both brief and group approaches can be as efficacious in the treatment of insomnia as traditional cognitive behavioral protocols. Additionally, although the majority of research on these approaches has examined their efficacy, a smaller body of evidence provides promising preliminary support for their effectiveness as well. The first half of this chapter provides an overview of brief interventions, while the second half focuses on group therapy.
