CBT-I to Improve Functional Outcomes in Veterans With Psychosis (CBT-I Merit)
Insomnia, Psychosis
About this trial
This is an interventional treatment trial for Insomnia focused on measuring Mental Disorders, Insomnia Disorder, Psychosis
Eligibility Criteria
Inclusion Criteria:
meet criteria established by the VA Serious Mental Illness Treatment Research and Evaluation Center:
- schizophrenic disorders (295.0-295.9)
- affective psychoses (296.0-296.1, 296.4-296.8)
- or major depression with psychotic features (296.24, 296.34)
- be between the ages of 18 and 80
- be actively participating in outpatient mental health services at designated site
Exclusion Criteria:
- currently in CBT-I treatment
- planning to move out of the area during the study period
Sites / Locations
- Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MDRecruiting
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PARecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Cognitive Behavioral Therapy-Insomnia
Health and Wellness
CBT-I addresses cognitive, arousal and behavioral factors related to sleep difficulties. Sessions combine assessment, conceptualization, psychoeducation, behavioral strategies and cognitive therapy, using a consistent structure including review of participants' sleep log and adherence to behavioral guidelines, modification of time in bed, cognitive therapy, and relaxation techniques. CBT-I also incorporates psychoeducation about biological and psychological elements that regulate sleep. Other strategies include stimulus control (i.e., getting out of bed when not sleepy) to extinguish the conditioned arousal common in insomnia, and relaxation techniques to reduce arousal associated with the bed, bedroom, or bedtime.
Health and Wellness is a general self-management curriculum focused on providing education and support for managing physical and emotional well-being. Each session follows a basic structure including review of previous session material, new educational information and discussion on several topics over the course of single or multiple sessions. Each session will focus on the impact of the topic on overall health and wellness, identifying benefits and challenges to improving or maintaining health in that area, and strategies that clients may find helpful to address challenges in that area. Example topics include physical activity/exercise, nutrition/healthy eating, managing medications and side effects, and addictive behaviors (e.g., substance use, gambling, eating).