CBT-I CBT-I Group Therapy & Digital Delivery 1 — Questions and Answers
Question 1: Group-delivered CBT-I has been shown to be:
- Significantly inferior to individual CBT-I
- Comparable in efficacy to individual CBT-I with greater cost-effectiveness (Correct answer)
- Effective only for mild insomnia
- Contraindicated for patients with comorbid anxiety
Correct answer: Comparable in efficacy to individual CBT-I with greater cost-effectiveness
Meta-analyses demonstrate that group CBT-I produces outcomes comparable to individual format, making it more scalable and cost-effective.
Question 2: The typical group size recommended for group CBT-I is:
- 2-3 patients
- 6-10 patients (Correct answer)
- 15-20 patients
- Any size up to 50
Correct answer: 6-10 patients
Groups of 6-10 allow sufficient individual attention, sharing of experiences, and group cohesion without overwhelming the clinician.
Question 3: A key therapeutic advantage of group CBT-I over individual therapy is:
- Faster treatment completion for every patient
- Normalization of insomnia experiences and peer support (Correct answer)
- Ability to fully customize each session to individual needs
- Avoidance of all homework assignments
Correct answer: Normalization of insomnia experiences and peer support
Hearing others' experiences with insomnia reduces shame and isolation, and peer accountability enhances adherence.
Question 4: Digital CBT-I (dCBT-I) programs most commonly deliver treatment through:
- DVD-based sessions
- Web-based or smartphone app platforms with interactive modules (Correct answer)
- Telephone-only check-ins
- Email correspondence with therapists
Correct answer: Web-based or smartphone app platforms with interactive modules
Digital CBT-I uses interactive web or app platforms that guide users through CBT-I components with automated feedback and tracking.
Question 5: Research on fully automated dCBT-I without therapist involvement shows:
- No clinical benefit compared to control conditions
- Significant improvements in insomnia severity, often comparable to therapist-guided CBT-I (Correct answer)
- Benefits limited to sleep hygiene only
- High risk of adverse events requiring medical monitoring
Correct answer: Significant improvements in insomnia severity, often comparable to therapist-guided CBT-I
Multiple RCTs demonstrate that fully automated dCBT-I programs produce clinically meaningful improvements in insomnia, though therapist-guided programs may enhance adherence.
Question 6: The stepped care model for insomnia treatment begins with:
- In-person individual CBT-I with a specialist
- The least intensive effective intervention and escalates as needed (Correct answer)
- Pharmacotherapy followed by CBT-I
- Group therapy before individual therapy
Correct answer: The least intensive effective intervention and escalates as needed
Stepped care matches treatment intensity to patient need, starting with lower-intensity options (e.g., self-help or dCBT-I) and stepping up if response is insufficient.
CBT-I CBT-I Group Therapy & Digital Delivery 1
Group-delivered CBT-I has been shown to be: