Cognitive Behavioral Therapy for Treatment of Insomnia in Primary Care for Resident Physicians

Abstract

Introduction Insomnia is a common complaint among primary care patients that can have significant consequences for physiological and mental health. Although psychopharmacological interventions have traditionally been taught as first-line treatment in medical education, cognitive behavioral therapy (CBT) for insomnia has emerged as the recommended treatment to address the multimodal precipitants and reinforcing factors of insomnia symptoms. Methods We developed a 90-minute workshop that included a didactic component to deliver content, role-playing to practice skills, and discussion to reflect and solidify learning. Two facilitators, a general internist and a clinical psychologist with content expertise in CBT, delivered the workshop to 16 internal medicine residents. This pairing provided complementary perspectives to allow for learner engagement. To evaluate the workshop, we used a pre/post survey that was administered at the beginning of the workshop and at its end. Participants were asked how often they incorporated (presurvey) and intended to incorporate (postsurvey) CBT as part of treatment of insomnia in their clinical practices. Results Sixteen internal medicine residents participated in the workshop and completed the pre/post survey. Our results showed immediate positive outcomes as a result of participating in the workshop. Discussion Our results showed that participants increased their intent to incorporate CBT in their primary care practice and increased their comfort with the various components of CBT. Our future directions include examining how long-term behavior changes as a result of this training.

Keywords

• Insomnia
• Cognitive Behavioral Therapy
• Internal Medicine
• Primary Care
• CBT-i
• Nonpharmacologic Treatment