Frequent Questions

How is Sleep Counseling different from Behavioral Sleep Medicine (BSM) or CBT-I?
Clinical Sleep Counseling embraces evidence-based sleep improvement interventions including CBT-I adapted to mental health clinical practice.  The holistic perspective of Sleep Counseling, however, goes beyond CBT-I to include psychosocial, environmental and cultural contributors to poor sleep.  Unlike the skilled practitioners of BSM who address the behavioral components of many medical sleep disorders, mental health and addiction professionals using Clinical Sleep Counseling target only clinical/subclinical behavioral insomnia.

Does treating insomnia work well when depression, anxiety and/or chronic pain symptoms are present?
According to Dr. Michael Perlis, Director of the Behavioral Sleep Medicine Program at UPenn Medical School, his research so far has shown CBT-I to work very well in treating patients with insomnia who have these co-morbid conditions.

Do clients have to be off sleep medications and benzodiazapines before we can start sleep improvement intervention?
In some cases, benzo detox is indicated, however, tapering protocols can usually be designed in collaboration with the client’s physician during the course of Sleep Counseling.

What if a client lacks one or more criteria for a diagnosis of insomnia?
Clinical Sleep Counseling targets both clinical and subclinical insomnia so that all clients in any need of sleep improvement can be helped.  This feature is important considering Dr. Allison Harvey’s research showing a 41.7% comorbidity rate between insomnia and other psychiatric disorders in a community population.  Dr. Harvey emphasizes “the rates are even higher when clinically significant insomnia that doesn’t quite fulfill all diagnostic criteria is recognized (Harvey, 2001).”

Are non-medical counselors and therapists able to treat behavioral insomnia?
Clinical Sleep Counseling targets only insomnia (clinical and subclinical) because at least six studies show CBT-I to be more effective than drugs while polysomnography (laboratory sleep study) is not indicated for insomnia diagnosis like it is for almost all other sleep disorders.  Non-medical mental health and addiction professionals are behavioral specialists well-suited to treat behavioral insomnia after receiving training and certification in Clinical Sleep Counseling.

If Sleep Counseling only addresses insomnia, why does the training examine common medically-related sleep disorders as well?
Insomnia can accompany other sleep disorders and women who have obstructive sleep apnea (OSA) often present with insomnia.  Familiarity with the symptoms of other sleep disorders, especially OSA because of the increased risk of stroke and heart disease, is important in making timely referrals to sleep medicine.  Sleep Counseling can also support the client through the referral process to sleep medicine, the sleep study and evaluation and, in the case of OSA, in adjusting and adhering to the use of a positive airway pressure (PAP) device.  The support provided by Sleep Counseling could vastly improve patient PAP adherence which is a serious problem at present.

Where is the training located and how practical /affordable is it to attend the training?
After clinicians read the manual and complete the self-study exam they are ready to join one of the TeleStudyGroups.  These small groups of professionals meet monthly on a conference call for mini-lecture (based on manual material and more), recent sleep/insomnia research findings, discussion of sleep-challenged clients and interventions, personal sleep issues, and promoting sleep improvement in the profession and community.  TeleStudyGroups provide training that is convenient and economical for busy professionals.