Skip to main content Accessibility help

The Development and Evaluation of a Large-Scale Self-Referral CBT-I Intervention for Men Who Have Insomnia: An Exploratory Study

  • Marc Archer (a1), June S. L. Brown (a1), Helen Idusohan (a2), Shirley Coventry (a2), Andiappan Manoharan (a1) and Colin A. Espie (a3)...


Background: Whilst effective psychological treatments such as CBT-I have been developed for insomnia, few services provide CBT-I and awareness of CBT-I is low among referrers. In addition, men tend to seek help less frequently for their insomnia than women. This paper describes the development and evaluation of psycho-educational CBT-I workshops, each for up to 25 people, and designed to be acceptable to men. Method: The CBT-I programme was based on Morin and Espie (2003), and adapted into a self-referral one-day workshop format designed specifically to improve access. Workshops were held on Saturdays in leisure centres. A one group pretest-posttest design was used and assessments were collected before and 6 weeks after each workshop. Over a 6-month period, 74 men self-referred, and attended the Introductory Talks preceding the workshops. Of these, 49.3% had never sought help from their GP, 66.2% suffered from clinical insomnia (ISI) and 61.6% were experiencing elevated depression symptoms (BDI over 10). Results: At follow-up, the workshops were found to be effective in reducing insomnia and depression. Satisfaction ratings with the workshops were very high. Conclusions: Given these promising results, further work is now proposed for a larger controlled study with a longer-term follow-up.


Corresponding author

Reprint requests to June Brown, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. E-mail:


Hide All
Andreason, A. R. (1994). Social marketing: definition and domain. Journal of Marketing and Public Policy, Spring, 108–114.
Bastien, C., Vallieres, A. and Morin, C. M. (2001). Validation of the Insomnia Severity Index as a clinical outcome measure for insomnia research. Sleep Medicine, 2, 297307.
Bastien, C. H., Morin, C. M., Ouellet, M., Blais, F. C. and Bouchard, S. (2004). Cognitive-behavioural therapy for insomnia: comparison of individual therapy, group therapy, and telephone consultations. Journal of Clinical and Counselling Psychology, 72, 653659.
Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979). Cognitive Therapy of Depression. London: Wiley.
Beck, A. T., Steer, R. A. and Carbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clinical Psychology Review, 8, 77100.
Beck, A. T., Ward, C. H., Mendleson, M., Mock, J. and Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.
Breslau, N., Roth, T., Rosenthal, L. and Adreski, P. (1996). Sleep disturbance and psychiatric disorders: a longitudinal epidemiology study of young adults. Biological Psychiatry, 39, 411418.
Brown, J. S. L., Cochrane, R. and Cardone, D. (1999). Running large-scale stress workshops for the general public: promotion methods, programme content, clients' satisfaction and drop-out rates. Journal of Mental Health, 8, 391402.
Brown, J. S. L., Cochrane, R. and Hancox, T. (2000). Large-scale health promotion stress workshops: a controlled evaluation. Behavioural and Cognitive Psychotherapy, 28, 139151.
Brown, J. S. L., Elliott, S. A., Boardman, J., Ferns, J. and Morrison, J. (2004). Meeting the unmet need for depression services with psycho-educational self-confidence workshops: a preliminary report. British Journal of Psychiatry, 185, 511515.
Buysse, D. J., Reynold, C. F., Kupfer, D. J., Thorpy, M. J., Bixler, E., Manfredi, R., Kales, A., Vgontzas, A., Stepanski, E., Roth, T., Hauri, P. and Mesiano, D. (1994). Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders (ICSD), DSM-IV and ICD-10 categories: a report from the APA/NIMH DSM-IV field sleep trial. Sleep, 17, 630637.
Espie, C., Inglis, S., Tessier, S. and Harvey, L. (2001). The clinical effectiveness of cognitive behaviour therapy for chronic insomnia: implementation and evaluation of a sleep clinic in general medical practice. Behaviour Research and Therapy, 39, 4560.
Ford, D. E. and Kamerow, D. B. (1989). Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention? Journal of the American Medical Association, 262, 14791485.
Gallup (1991). Sleep in America. Princeton, NJ: Gallup Organization.
Hayward, P. and Bright, J. A. (1997). Stigma and mental illness: a review and critique. Journal of Mental Health, 6, 345354.
Hohagen, F., Rink, K., Käppler, C., Schramm, E., Riemann, D., Weyerer, S. and Berger, M. (1993). Prevalence and treatment of insomnia in general practice: a longitudinal study. European Archives of Psychiatry and Clinical Neuroscience, 242, 329336.
McKnight, P. E., McKnight, K. M., Sidani, S. and Figueredo, A. J. (2007). Missing Data: a gentle introduction (Methodology in the Social Sciences). New York: Guilford Press.
Mimeault, V. and Morin, C. M. (1999). Self-help treatment for insomnia: bibliotherapy with and without professional guidance. Journal of Clinical and Consulting Psychology, 67, 511519.
Morawetz, D. (2003). Insomnia and depression: which comes first? Sleep Research Online, 5, 7781.
Morin, C. M. (1994). Dysfunctional beliefs and attitudes about sleep: preliminary scale development and description. The Behavior Therapist, 17, 163164.
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A. and Lichstein, K. L. (2006). Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep, 29, 13981414.
Morin, C. M. and Espie, C. A. (2003). Insomia: a clinical guide to assessment and treatment. New York: Klewer Academic/Plenum.
Morin, C. M., Gaulier, B., Barry, T. and Kowatch, R. A. (1992). Patients' acceptance of psychological and pharmacological therapies for insomnia. Sleep, 15, 302305.
Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J. and Bootzin, R. R. (1999). Nonpharmacologic treatment of chronic insomnia: an American Academy of Sleep Medicine review. Sleep, 22, 123
Morin, C. M., LeBlanc, M., Daley, M., Gregoire, J. P. and Merette, C. (2006). Epidemiology of insomnia: prevalence, self-help treatments, consultations, and determinants of help-seeking behaviours. Sleep Medicine, 7, 123130.
Morin, C. M., Vallieres, A. and Ivers, H. (2007). Dysfunctional Beliefs and Attitudes about Sleep (DBAS): validation of a brief version (DBAS-16). Sleep, 30, 15471554.
Morlock, R. J., Tan, M. and Mitchell, D. Y. (2006). Patient characteristics and patterns of drug use for sleep complaints in the United States: analysis of National Ambulatory Medical Survey Data, 1997–2002. Clinical Therapeutics, 28, 10441053.
Ohayon, M. M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6, 97111.
Ohayon, M. M., Caulet, M. and Lemoine, P. (1998). Comorbidity of mental and insomnia disorders in the general population. Comprehensive Psychiatry, 39, 185–107.
Oosterhuis, A. and Klip, E. C. (1997). The treatment of insomnia through mass media: the results of a televised behavioural training programme. Social Sciences Medicine, 45, 12231229.
Rochlen, A. B. and Hoyer, W. D. (2005). Marketing mental health to men: theoretical and practical considerations. Journal of Clinical Psychology, 61, 675684.
Smith, M. T. and Wegener, S. T. (2003). Measures of sleep: the Insomnia Severity Index, Medical Outcomes Study MOS) Sleep Scale, Pittsburgh Sleep Diary (PSD), and Pittsburgh Sleep Quality Index (PSQI). Arthritis and Rheumatism (Arthritis Care and Research), 49 (5S), S184-S196.
Vincent, N. and Lionberg, C. (2001). Treatment preference and patient satisfaction in chronic insomnia. Sleep, 11, 488496.
Watkins, E., Elliott, S., Stanhope, N., Button, J., Williams, R. and Brown, J. S. L. (2000). Meeting the needs for psychological treatment of people with common mental disorders: an exploratory study. Journal of Mental Health, 9, 445456.


Related content

Powered by UNSILO

The Development and Evaluation of a Large-Scale Self-Referral CBT-I Intervention for Men Who Have Insomnia: An Exploratory Study

  • Marc Archer (a1), June S. L. Brown (a1), Helen Idusohan (a2), Shirley Coventry (a2), Andiappan Manoharan (a1) and Colin A. Espie (a3)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

The Development and Evaluation of a Large-Scale Self-Referral CBT-I Intervention for Men Who Have Insomnia: An Exploratory Study

  • Marc Archer (a1), June S. L. Brown (a1), Helen Idusohan (a2), Shirley Coventry (a2), Andiappan Manoharan (a1) and Colin A. Espie (a3)...
Submit a response


No Comments have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *