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Title: Self-guided online cognitive behavioural therapy for insomnia: A naturalistic evaluation in patients with potential psychiatric comorbidities
Contributor(s): Grierson, A B (author); Hobbs, M J  (author)orcid ; Mason, E C (author)
Publication Date: 2020-04-01
Early Online Version: 2020-01-28
DOI: 10.1016/j.jad.2020.01.143
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Abstract: Background: Insomnia is the most prevalent sleep disorder worldwide, and regularly co-occurs with anxiety and depression. Cognitive behavioural therapy is the gold standard treatment for insomnia (CBT-I), however demand for treatment providers drastically exceeds supply. Internet-delivered programs for insomnia (iCBT-I) improve treatment access. However the effects of unguided iCBT-I for individuals with comorbidities within a naturalistic setting remains unexplored. We developed a novel unguided iCBT-I program and evaluated its impact on insomnia, psychological distress, and wellbeing when accessed by the public. Methods: 317 participants experiencing insomnia for over 3 months enrolled in the program. The program consisted of 4 lessons delivered online with automated web support. Insomnia symptoms, psychological distress, and general wellbeing were assessed at lesson 1 and 4. Intention-to-treat linear mixed models were used to examine effects on insomnia, distress, and wellbeing. Results: Participants experienced large (g = 1.11) and significant reductions in insomnia, moderate (g = 0.55) and significant reductions in distress, and small (g = 0.37) but significant improvements in wellbeing. 65% of participants who reported pre-treatment insomnia severity at clinical levels remitted following treatment. Limitations: To examine the program in a naturalistic setting, we did not employ a control group or follow participants beyond the completion of treatment. Conclusions: Unguided iCBT-I is effective for individuals in the community who experience insomnia and are likely experiencing comorbid mental health problems. These effects in the absence of guided contact strengthen the utility of unguided iCBT-I as a scalable and cost-effective method of disseminating treatments for this disorder.
Publication Type: Journal Article
Source of Publication: Journal of Affective Disorders, v.266, p. 305-310
Publisher: Elsevier BV
Place of Publication: The Netherlands
ISSN: 1573-2517
Field of Research (FoR) 2008: 110319 Psychiatry (incl. Psychotherapy)
111714 Mental Health
170106 Health, Clinical and Counselling Psychology
Field of Research (FoR) 2020: 320221 Psychiatry (incl. psychotherapy)
520302 Clinical psychology
520303 Counselling psychology
520304 Health psychology
Socio-Economic Objective (SEO) 2008: 920410 Mental Health
920209 Mental Health Services
920204 Evaluation of Health Outcomes
Socio-Economic Objective (SEO) 2020: 200409 Mental health
200305 Mental health services
200202 Evaluation of health outcomes
Peer Reviewed: Yes
HERDC Category Description: C1 Refereed Article in a Scholarly Journal
Appears in Collections:Journal Article

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