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Low-intensity sleep intervention in a youth mental health service: a case series analysis

Published online by Cambridge University Press:  26 August 2020

Rebecca Rollinson ,
Isabel Price ,
Brioney Gee ,
Jonathan Lyons ,
Ben Carroll ,
Jonathan Wilson  and
Tim Clarke
Rebecca Rollinson*
Affiliation:
Norfolk and Suffolk NHS Foundation Trust, Newmarket Hospital, Exning Road, NewmarketCB8 7JG, UK
Isabel Price
Affiliation:
Norfolk and Suffolk NHS Foundation Trust, UK
Brioney Gee
Affiliation:
Norfolk and Suffolk NHS Foundation Trust and Norwich Medical School, University of East Anglia, UK
Jonathan Lyons
Affiliation:
Norfolk and Suffolk NHS Foundation Trust, UK
Ben Carroll
Affiliation:
Norfolk and Suffolk NHS Foundation Trust, UK
Jonathan Wilson
Affiliation:
Norfolk and Suffolk NHS Foundation Trust and Norwich Medical School, University of East Anglia, UK
Tim Clarke
Affiliation:
Norfolk and Suffolk NHS Foundation Trust and Norwich Medical School, University of East Anglia, UK
*
*Corresponding author. Email: rebecca.rollinson@nsft.nhs.uk
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Abstract

Background:

There is increasing evidence of a strong association between sleep and mental health in both adolescents and adults. CBT for insomnia is being applied to good effect with adults with mental health difficulties but there are few studies examining its applicability to adolescents within mental health services.

Method:

We carried out a case series analysis (n = 15) looking at the feasibility, accessibility and impact of a low-intensity sleep intervention for young people (14–25 years) being seen by a secondary care Youth Mental Health team in the UK. The intervention was based on cognitive behavioural therapy for insomnia (CBTi) and acceptance and commitment therapy (ACT) approaches and involved six individual sessions delivered on a weekly basis by a graduate psychologist. Routine outcome measures were used to monitor insomnia, psychological distress and functioning with assessments at baseline, session 3, session 6 and at 4 weeks after end of intervention. All participants scored in the clinical range for insomnia at the start of the study.

Results:

High uptake, attendance and measure completion rates were observed. Large effect sizes were observed for insomnia, psychological distress and functioning. Twelve of the fifteen participants (80%) no longer scored above threshold for insomnia at follow-up. All seven under-18s no longer met threshold for clinical ‘caseness’ on the Revised Child Anxiety and Depression Scale (RCADS) at follow-up.

Discussion:

The findings suggest that the intervention was well accepted by young people and feasible to apply within a secondary care setting. Strong effect sizes are encouraging but are probably inflated by the small sample size, uncontrolled design and unblinded assessments.

Keywords

acceptance and commitment therapyadolescentscognitive behavioural therapyinsomniasleepyouthyouth mental health
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 1 , January 2021 , pp. 62 - 75
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

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