Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health

Laurin J Mack, Bruce D RybarczykClinical Psychology Program, Department of Psychology, Virginia Commonwealth University, Richmond, VA, USAAbstract: Chronic insomnia is a highly prevalent condition that has psychological and medical consequences for those who suffer from it and financial consequences...

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Autores principales:	Mack L, Rybarczyk B
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/2bdc30a8478641279bb82893fbbdfc0b
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spelling	oai:doaj.org-article:2bdc30a8478641279bb82893fbbdfc0b2021-12-02T00:43:49ZBehavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health1179-1608https://doaj.org/article/2bdc30a8478641279bb82893fbbdfc0b2011-07-01T00:00:00Zhttp://www.dovepress.com/behavioral-treatment-of-insomnia-a-proposal-for-a-stepped-care-approac-a7945https://doaj.org/toc/1179-1608Laurin J Mack, Bruce D RybarczykClinical Psychology Program, Department of Psychology, Virginia Commonwealth University, Richmond, VA, USAAbstract: Chronic insomnia is a highly prevalent condition that has psychological and medical consequences for those who suffer from it and financial consequences for both the individual and society. In spite of the fact that nonpharmacologic treatment methods have been developed and shown to be as or more effective than medication for chronic insomnia, these methods remain greatly underutilized due to an absence of properly trained therapists and a general failure in dissemination. A stepped-care model implemented in a primary-care setting offers a public health solution to the problem of treatment accessibility and delivery of behavioral treatments for insomnia. Such a model would provide graduated levels of cognitive behavioral intervention, with corresponding increases in intensity and cost, including self-help, manualized group treatment, brief individual treatment, and finally, individualized behavioral treatment provided by a specialist. To provide such a systematic approach, future research would need to confirm several aspects of the model, and a cadre of professionals would need to be trained to administer manualized care in both group and individualized formats.Keywords: cognitive behavioral therapy, chronic insomnia, stepped care, primary careMack LRybarczyk BDove Medical PressarticlePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol 2011, Iss default, Pp 87-99 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Mack L Rybarczyk B Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
description	Laurin J Mack, Bruce D RybarczykClinical Psychology Program, Department of Psychology, Virginia Commonwealth University, Richmond, VA, USAAbstract: Chronic insomnia is a highly prevalent condition that has psychological and medical consequences for those who suffer from it and financial consequences for both the individual and society. In spite of the fact that nonpharmacologic treatment methods have been developed and shown to be as or more effective than medication for chronic insomnia, these methods remain greatly underutilized due to an absence of properly trained therapists and a general failure in dissemination. A stepped-care model implemented in a primary-care setting offers a public health solution to the problem of treatment accessibility and delivery of behavioral treatments for insomnia. Such a model would provide graduated levels of cognitive behavioral intervention, with corresponding increases in intensity and cost, including self-help, manualized group treatment, brief individual treatment, and finally, individualized behavioral treatment provided by a specialist. To provide such a systematic approach, future research would need to confirm several aspects of the model, and a cadre of professionals would need to be trained to administer manualized care in both group and individualized formats.Keywords: cognitive behavioral therapy, chronic insomnia, stepped care, primary care
format	article
author	Mack L Rybarczyk B
author_facet	Mack L Rybarczyk B
author_sort	Mack L
title	Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
title_short	Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
title_full	Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
title_fullStr	Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
title_full_unstemmed	Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
title_sort	behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/2bdc30a8478641279bb82893fbbdfc0b
work_keys_str_mv	AT mackl behavioraltreatmentofinsomniaaproposalforasteppedcareapproachtopromotepublichealth AT rybarczykb behavioraltreatmentofinsomniaaproposalforasteppedcareapproachtopromotepublichealth
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Behavioral treatment of insomnia: a proposal for a stepped-care approach to promote public health

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