Introduction
Although group Cognitive Behavioral Therapy for Insomnia (CBT-I) is an efficacious treatment, relatively less is known about its clinical effectiveness in real-world settings. For example, to our knowledge, it is unknown how many patients referred to CBT-I initiate treatment, and prior research has suggested that drop out may be high in treatment settings vs. clinical trials. The
... [Show full abstract] current study therefore investigated the rates and predictors of initiating and attending CBT-I group within an outpatient psychiatry clinic.
Methods
Participants were 75 consecutive outpatients presenting for treatment at a specialty sleep and anxiety clinic who completed an evaluation and were referred to CBT-I group. The majority were women (77.3%), and white (62.7%), with an average age of 52.63 (SD = 16.39). Participants completed self-report measures (i.e., Pittsburgh Sleep Quality Index; State Trait Anxiety Index, and Patient Health Questionnaire-9), and their attendance throughout treatment was tracked.
Results
The majority of referred patients (79.7%) attended ≥1 session, with a mean of 2.5/5 sessions completed (SD = 1.80). Sex, age, and race did not predict initiation of CBT-I or number of sessions attended (ps > .109). Those with poorer global sleep quality and longer sleep onset latency were less likely to attend group (r=-.37, p=.026 and r=-.34, p=.036, respectively) and attended fewer sessions (r=-.48, p=.002; r=-.37, p=.021). In terms of comorbid symptoms, those with higher anxiety and depression were less likely to initiate attendance (r=-.39, p=.018 and r=-.44, p=.007, respectively), and attended fewer sessions (r=-.47, p=.004; r=-.34, p=.042).
Conclusion
Encouragingly, the majority of patients referred to CBT-I initiated it and attended at least half of the sessions. Further, demographics do not seem to impact these rates. Unfortunately, those with the most severe symptoms, and thus in most need for treatment, are least likely to initiate and attend. This may be due to comorbid anxiety or depression symptoms. Future research should replicate these findings, as well as explore how to encourage those most in need of treatment to initiate and attend CBT-I.
Support (If Any)
N/A
