CBT-I Group Therapy & Digital Delivery Flashcards

Which component of CBT-I is most challenging to implement in a group format?

Answer: Individually tailored sleep restriction with different prescribed windows for each patient

Sleep restriction requires individually calculated sleep windows based on each patient's sleep diary data, making it more complex to manage simultaneously across 6-10 patients.

In group CBT-I, the facilitator should address individual sleep diaries by:

Answer: Using aggregate patterns to illustrate concepts while providing brief individual feedback

Efficient group CBT-I reviews common patterns from diaries to illustrate treatment principles while offering brief individual feedback on prescribed sleep windows.

The integration of wearables (e.g., smartwatches) into CBT-I delivery is viewed with caution because:

Answer: Orthosomnia — excessive preoccupation with device-measured sleep data — can worsen insomnia

Orthosomnia refers to the paradoxical worsening of insomnia driven by obsessive monitoring of objective sleep metrics from wearable devices.

The primary ethical concern specific to dCBT-I programs involves:

Answer: Data privacy and security of sensitive health and sleep information

Digital platforms collect sensitive personal health data, raising concerns about data security, ownership, and potential sharing with third parties.

For patients who do not respond to dCBT-I, the stepped care model recommends:

Answer: Stepping up to therapist-guided or individual in-person CBT-I

Non-response to lower-intensity digital interventions triggers an escalation to more intensive therapist-guided or in-person CBT-I.

Therapist-guided internet CBT-I differs from fully automated dCBT-I in that it includes:

Answer: Asynchronous or synchronous contact with a clinician

Therapist-guided internet CBT-I adds clinical oversight and personalized feedback to the digital platform, potentially improving adherence and individualization.