Supervised Cognitive-Behavior Therapy for Insomnia in General Medical Practice—Preliminary Results from the West of Scotland Program

There can be practical and clinically efficacious ways of implementing psychological treatment for chronic insomnia in general medical practice settings, according to the potential of the sleep clinic model developed during this study as an effective and efficient one.

Abstract

This chapter provides an overview of survey conducted over the insomnia patients of West of Scotland. The patients treated in the west of Scotland program had severe and chronic insomnia, and represented a relatively unselected clinical population presenting as a consecutive series. The validity of the results is a particular strength in terms of generalizability to general medical practice. The psychological treatment was associated with significant improvement in self-report of sleep pattern for the group as a whole. Combining sleep latency and wake time after sleep-onset for the average night, the mean reduction in sleep disruption was around 70 minutes per person. The therapists in this study were neither sleep experts nor psychologists. They were experienced health professionals who were able to assimilate skills from training. This suggests that the source of the treatment effect may lie in the impact of treatment itself, rather than in therapist or nonspecific factors. The training of nonexpert staffs available to see patients at the primary care point of contact, and the use of group intervention, confirm the potential of the sleep clinic model developed during this study as an effective and efficient one. Thus, there can be practical and clinically efficacious ways of implementing psychological treatment for chronic insomnia in general medical practice settings.