Feature Series: Overcoming Insomnia with CBT-I

It’s hard to encompass everything we are as helping professionals into a few-paragraph bio statement. If you’re hoping to learn more about the diverse group of people behind the Therapy Collective, you’ve come to the right place. This post is the third in a series of interviews with Therapy Collective clinicians and coaches about their backgrounds, passions, and clinical interests.

By Carley Foster, LCPC

This interview has been edited for length and clarity.

Christine Joy, LGPC, has been a Registered Polysomnographic Sleep Technologist (RPSGT) for over 25 years and has special training in a form of Cognitive Behavioral Therapy (CBT) specifically for treating insomnia. She is passionate about the role of sleep in mental health, and has telehealth availability for Maryland residents as of Fall 2023.

How would you describe CBT-I in your own words?

CBT-I is a brief therapy to treat Insomnia that is tailored to each individual and has a very high success rate. It is typically covered by insurance and is considered the gold standard of treatment for Insomnia.

The therapy is usually completed within 6-8 weeks, sometimes shorter, and occasionally longer.  Studies have shown that CBT-I is as effective as medication short term, and more effective than medication in the long term. Clients can use sleep medication while participating in CBT-I, and most clients continue to see their regular therapist while participating in CBT-I therapy.

What can people expect from CBT-I treatment with you?

CBT-I uses principles from CBT to focus on thoughts and behaviors about sleep that can contribute to Insomnia symptoms. I also incorporate Acceptance and Commitment Therapy (ACT), to incorporate mindfulness, values, cognitive defusion, commitment, and acceptance into the treatment. Treatment includes keeping a sleep diary, an extensive interview about the client’s sleep, education about Insomnia and various tools to utilize toward reduction, improvement, and/or elimination of Insomnia symptoms.

What do you enjoy about offering this treatment?

My favorite aspect of the therapy is that the client has the knowledge and learned tools for life, and is more prepared to navigate sleep issues on their own in the future. The psychoeducation aspect of CBT-I helps the client understand how Insomnia starts, and also educates them on why CBT-I treatment works. This knowledge allows the client to understand why the therapy includes certain behavior changes or recommendations. They are more likely to comply with therapy, which is more likely to lead to a successful outcome.

In your experience, who is a good fit for CBT-I? Who is not?

CBT-I is a good fit for anyone experiencing difficulty falling asleep, staying asleep, or waking up too early for three or more nights a week for at least three months. Certain conditions (for example, epilepsy) might be contraindicated due to sleep adjustments that might be made during therapy. CBT-I does take commitment to the therapy, which includes meeting weekly for up to an hour and keeping a daily sleep diary on an app. I have found that most clients are ready to commit to therapy and do a great job at keeping the diary, which is a tool we use to make decisions together about sleep each week.

What was the process for training in CBT-I?

I participated in a 12 hour training for CBT-I and a 6 hour training for CBT-I that includes Acceptance and Commitment Therapy (ACT) components to the therapy, including Mindfulness exercises. I also seek consultation as needed, participate in two peer groups related to CBT-I treatment, and am always seeking out more education opportunities related to Insomnia treatment.

Any special CBT-I success stories you would like to share?

 I have worked with clients in their 20’s through 80’s, and most clients have had great success with improvement or elimination of Insomnia symptoms in a short amount of time. Many clients also show marked improvement in assessments such as the Insomnia Severity Index, PHQ-9 (a depression assessment), and the GAD-7 (an anxiety assessment).

Is there any other information that would be helpful/important for readers to know?

I have availability for telehealth therapy in Maryland, and am happy to speak with anyone interested in learning more about CBT-I for Insomnia!

You can make an appointment with Christine through our appointment request form.

You can learn more about Christine by visiting her bio page.