with Jason DiViva, PhD & Claudia Zayfert, PhD
Difficulty falling and staying asleep is one of the most common clinical complaints after trauma. Insomnia is associated with impaired concentration and memory, elevated levels of anxiety and depression, decreased pain threshold, and worsening of overall health functioning, all of which are also effects of trauma. In this institute, clinicians will learn how they can improve trauma survivors’ sleep and mitigate the negative effects of sleep disturbances on mental and physical health and functioning. Participants will learn strategies to address various factors that precipitate and maintain sleep problems following traumatic experiences. We will describe the interactions between disturbed sleep and other symptoms and associated features of PTSD. We will present a model for understanding the initiation and maintenance of sleep problems, integrating predisposing, precipitating, and perpetuating factors that contribute to trauma-related insomnia. Participants will then learn to address the factors contributing to trauma-related insomnia using evidence-based cognitive-behavioral methods.
We will cover strategies that treat precipitating factors (e.g., nightmares and vigilance) as well as perpetuating patterns of behavior and cognition (e.g., maladaptive sleep-related behavior). This will include detailing basic components of cognitive behavioral treatment for insomnia, including assessment of sleep using a sleep diary and other measures, assessment of maladaptive beliefs about sleep, fear of sleep, and other relevant constructs, psychoeducation about sleep, stimulus control, sleep restriction, sleep hygiene, cognitive restructuring, and relaxation strategies. We will discuss the research supporting use of these components for treatment of insomnia in general and with trauma populations. In addition, we will use extensive case material to demonstrate how to tailor application of these components to address specific manifestations of insomnia among survivors of trauma. Participants will learn how to determine when evidence-based treatments for insomnia are indicated, when they may be contraindicated, and how sequence them with evidence-based treatments for PTSD. Particular attention will be paid to the role of fear of sleep in perpetuating sleep problems. Factors affecting sleep of returning military personnel will also be specifically addressed.
Participant Alert: This Institute involves frank discussion of specifics of traumatic events in patients' lives, including graphic descriptions to illustrate therapy procedures.