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Study Objectives: To investigate the efficacy of cognitive behavioral therapy for insomnia (CBTI) in adolescents. Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL),... more
Study Objectives: To investigate the efficacy of cognitive behavioral therapy for insomnia (CBTI) in adolescents.
Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL), with assessments at
baseline, directly after treatment (post-test), and at 2 months follow-up.
Setting: Diagnostic interviews were held at the laboratory of the Research Institute of Child Development and Education at the University of
Amsterdam. Treatment for GT occurred at the mental health care center UvAMinds in Amsterdam, the Netherlands.
Participants: O ne hundred sixteen adolescents (mean a ge = 15.6 y, S D = 1.6 y, 25% m ales) meeting D SM-IV criteria f or insomnia, w ere
randomized to IT, GT, or WL.
Interventions: CBTI of 6 weekly sessions, consisted of psychoeducation, sleep hygiene, restriction of time in bed, stimulus control, cognitive
therapy, and relaxation techniques. GT was conducted in groups of 6 to 8 adolescents, guided by 2 trained sleep therapists. IT was applied
through an online guided self-help website with programmed instructions and written feedback from a trained sleep therapist.
Measurements and Results: Sleep was measured with actigraphy and sleep logs for 7 consecutive days. Symptoms of insomnia and chronic
sleep reduction were measured with questionnaires. Results showed that adolescents in both IT and GT, compared to WL, improved significantly
on sleep efficiency, sleep onset latency, wake after sleep onset, and total sleep time at post-test, and improvements were maintained at follow-up.
Most of these improvements were found in both objective and subjective measures. Furthermore, insomnia complaints and symptoms of chronic
sleep reduction also decreased significantly in both treatment conditions compared to WL. Effect sizes for improvements ranged from medium to
large. A greater proportion of participants from the treatment conditions showed high end-state functioning and clinically significant improvement
after treatment and at follow-up compared to WL.
Conclusions: This study is the first randomized controlled trial that provides evidence that cognitive behavioral therapy for insomnia is effective
for the treatment of adolescents with insomnia, with medium to large effect sizes. There were small differences between internet and group
therapy, but both treatments reached comparable endpoints.
Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL), with assessments at
baseline, directly after treatment (post-test), and at 2 months follow-up.
Setting: Diagnostic interviews were held at the laboratory of the Research Institute of Child Development and Education at the University of
Amsterdam. Treatment for GT occurred at the mental health care center UvAMinds in Amsterdam, the Netherlands.
Participants: O ne hundred sixteen adolescents (mean a ge = 15.6 y, S D = 1.6 y, 25% m ales) meeting D SM-IV criteria f or insomnia, w ere
randomized to IT, GT, or WL.
Interventions: CBTI of 6 weekly sessions, consisted of psychoeducation, sleep hygiene, restriction of time in bed, stimulus control, cognitive
therapy, and relaxation techniques. GT was conducted in groups of 6 to 8 adolescents, guided by 2 trained sleep therapists. IT was applied
through an online guided self-help website with programmed instructions and written feedback from a trained sleep therapist.
Measurements and Results: Sleep was measured with actigraphy and sleep logs for 7 consecutive days. Symptoms of insomnia and chronic
sleep reduction were measured with questionnaires. Results showed that adolescents in both IT and GT, compared to WL, improved significantly
on sleep efficiency, sleep onset latency, wake after sleep onset, and total sleep time at post-test, and improvements were maintained at follow-up.
Most of these improvements were found in both objective and subjective measures. Furthermore, insomnia complaints and symptoms of chronic
sleep reduction also decreased significantly in both treatment conditions compared to WL. Effect sizes for improvements ranged from medium to
large. A greater proportion of participants from the treatment conditions showed high end-state functioning and clinically significant improvement
after treatment and at follow-up compared to WL.
Conclusions: This study is the first randomized controlled trial that provides evidence that cognitive behavioral therapy for insomnia is effective
for the treatment of adolescents with insomnia, with medium to large effect sizes. There were small differences between internet and group
therapy, but both treatments reached comparable endpoints.
Objective: This study investigated reliability, validity, and clinical relevance of the Adolescent Sleep Hygiene Scale (ASHS) in Dutch adolescents. Methods: The Dutch translation of the ASHS was administered to 186 normal-sleeping... more
Objective: This study investigated reliability, validity, and clinical relevance of the Adolescent Sleep
Hygiene Scale (ASHS) in Dutch adolescents.
Methods: The Dutch translation of the ASHS was administered to 186 normal-sleeping adolescents and
112 adolescents with insomnia. Their sleep variables were measured using sleep logs and questionnaires.
From the insomnia group, scores were also obtained after six weeks of cognitive behavioral therapy for
insomnia (n = 58) or waiting list (n = 22).
Results: The full scale of the ASHS had acceptable internal consistency. The results showed moderate to
strong correlations of the ASHS (domains) with sleep quality, sleep duration and chronic sleep reduction.
Furthermore, the Dutch ASHS was able to discriminate between normal sleepers and adolescents with
insomnia, and scores of adolescents with insomnia improved after treatment.
Conclusions: These findings confirm the importance of sleep hygiene in adolescent sleep, and contribute
to the validity of the ASHS and its applicability in research and clinical practice.
Hygiene Scale (ASHS) in Dutch adolescents.
Methods: The Dutch translation of the ASHS was administered to 186 normal-sleeping adolescents and
112 adolescents with insomnia. Their sleep variables were measured using sleep logs and questionnaires.
From the insomnia group, scores were also obtained after six weeks of cognitive behavioral therapy for
insomnia (n = 58) or waiting list (n = 22).
Results: The full scale of the ASHS had acceptable internal consistency. The results showed moderate to
strong correlations of the ASHS (domains) with sleep quality, sleep duration and chronic sleep reduction.
Furthermore, the Dutch ASHS was able to discriminate between normal sleepers and adolescents with
insomnia, and scores of adolescents with insomnia improved after treatment.
Conclusions: These findings confirm the importance of sleep hygiene in adolescent sleep, and contribute
to the validity of the ASHS and its applicability in research and clinical practice.
Suicidal individuals are among the most reluctant help-seekers, which limits opportunities for treating and preventing unnecessary suffering and self-inflicted deaths. This study aimed to assist outreach, prevention, and treatment efforts... more
Suicidal individuals are among the most reluctant help-seekers, which limits opportunities for treating and preventing unnecessary suffering and self-inflicted deaths. This study aimed to assist outreach, prevention, and treatment efforts by elucidating relationships between suicidality and both online and offline help seeking. An anonymous online survey provided data on 713 participants, aged 18-71 years. Measures included an expanded General Help-Seeking Questionnaire and the Suicidal Affect-Behavior-Cognition Scale. General linear modeling results showed that, as predicted, face-to-face help-seeking willingness decreased as risk level increased. However, for emerging adults help-seeking likelihood increased with informal online sources as risk increased, while other online help-seeking attitudes differed little by risk level. Linear regression modeling determined that, for suicidal individuals, willingness to seek help from online mental health professionals and online profession...
Research indicates that adolescents are at risk for insomnia, but are reluctant to seek help. Treatment of insomnia has been extensively examined in adults, but studies with adolescents are sparse. The purpose of this pilot study was to... more
Research indicates that adolescents are at risk for insomnia, but are reluctant to seek help. Treatment
of insomnia has been extensively examined in adults, but studies with adolescents are sparse.
The purpose of this pilot study was to assess feasibility and efficacy of cognitive behavioral
therapy for insomnia (CBT–i) for adolescents in both group and Internet settings. Twenty-six
adolescents received 6 weekly sessions of CBT–i in a group .N D 13/ or individual Internet
setting .N D 13/. Their sleep was measured with actigraphy, sleep logs, and questionnaires at
baseline, posttreatment, and a 2-month follow up. For both treatments, results show a significant
improvement, with medium to large effect sizes (ESs) of sleep onset latency, wake after sleep
onset, and sleep efficiency. There was also a small ES increase of total sleep time in sleep log
measures, but not in actigraphy measures. On questionnaires measuring symptoms of insomnia
and chronic sleep reduction, significant improvements occurred either at posttreatment or at follow
up. No differences were found between the groups. This study indicates CBT–i, either in group
or in Internet formats, is an effective treatment for insomnia in adolescents. Further studies in a
randomized controlled design are warranted.
of insomnia has been extensively examined in adults, but studies with adolescents are sparse.
The purpose of this pilot study was to assess feasibility and efficacy of cognitive behavioral
therapy for insomnia (CBT–i) for adolescents in both group and Internet settings. Twenty-six
adolescents received 6 weekly sessions of CBT–i in a group .N D 13/ or individual Internet
setting .N D 13/. Their sleep was measured with actigraphy, sleep logs, and questionnaires at
baseline, posttreatment, and a 2-month follow up. For both treatments, results show a significant
improvement, with medium to large effect sizes (ESs) of sleep onset latency, wake after sleep
onset, and sleep efficiency. There was also a small ES increase of total sleep time in sleep log
measures, but not in actigraphy measures. On questionnaires measuring symptoms of insomnia
and chronic sleep reduction, significant improvements occurred either at posttreatment or at follow
up. No differences were found between the groups. This study indicates CBT–i, either in group
or in Internet formats, is an effective treatment for insomnia in adolescents. Further studies in a
randomized controlled design are warranted.
The double mediation of art and technology. The example of a virtual group with drama-therapy techniques The term of mediation is chosen in the purpose of this research, as it refers in three different theoretical aspects. The first is... more
The double mediation of art and technology. The example of a virtual group with drama-therapy techniques The term of mediation is chosen in the purpose of this research, as it refers in three different theoretical aspects. The first is the one of the psychoanalytic literature the second refers in media studies and the third is the one of the artistic mediation during the therapeutic process. It's exactly in this crossroad of these three aspects the experimental method we plan to present in this paper. In psychoanalysis, Freud (1920) described the game of his grandson with the bobbin on a string. The little boy for facing his stress by the going-and-coming of his mother, he represented the situation by leaving and retrieving the bobbin by saying " Fort-da " (far/there). This game as a cultural achievement and as transformation of passivity to activity (Fuery, 1995) had prepared the theoretical environment for the scientific interest on mediation functions of the game. In 1953, Winnicott names " transitional experience " the middle ground between the objective reality and subjective omnipotence. The " transitional object " , in his theory, is a meditative object between the mother and the child invested by the fantasy of the child. This transitional experience is for Winnicott the phase where the infant can develop his/her creative self still feeling protected. In France, Kaës (1976) and Anzieu (1984) used the term of mediation to describe the therapeutic function of the group therapy experience. The group, in this point of view, is a meditative experience that represents the familial bonds of the members and acts in a therapeutic way on them. Arts therapies introduced another aspect in the term of mediation in therapy. In this point of view, arts are the medium for having access to different aspects of the self. However, the term of mediation in arts therapies, is mostly used in francophone therapists, like Chouvier et al.(2002) and refers in the psychodynamic frame.
Objective: To examine the effects of online Cognitive Behavior Therapy for Insomnia (CBTI) on adolescents’ sleep and cognitive functioning. Methods: 32 adolescents (13–19 years, M = 15.9, SD = 1.6) with DSM-5 insomnia disorder, were... more
Objective: To examine the effects of online Cognitive Behavior Therapy for Insomnia (CBTI) on adolescents’
sleep and cognitive functioning.
Methods: 32 adolescents (13–19 years, M = 15.9, SD = 1.6) with DSM-5 insomnia disorder, were randomly
assigned to a treatment group (n = 18) or a waiting list (n = 14). Treatment consisted of six guided
self-help online CBTI sessions. Both groups were assessed at baseline and post-treatment. Sleep was measured
with actigraphy, sleep logs, and questionnaires. Cognitive functioning was assessed with a battery
of standard cognitive tests.
Results: After CBTI the treatment group showed significant improvements compared to the waiting list
group in sleep efficiency from actigraphy and sleep logs. This finding was confirmed by improvements
in other sleep variables from sleep logs, and in symptoms of chronic sleep reduction and insomnia. Most
participants from the treatment group improved to sub clinical levels of insomnia. Cognitive functioning
of the treatment group showed more improvement compared to the waiting list in visuospatial
processing, selective attention and phonological working memory, and a trend of improvement in response
inhibition and set shifting, letter fluency and sustained attention, but not in declarative memory,
visuospatial working memory, category fluency, and general cognitive speed. Changes in sleep appeared
to be related to changes in cognitive functioning.
Conclusions: These results indicate that CBTI can have positive effects on cognitive functions in adolescents,
with notable improvements in visuospatial processing and phonological working memory but not
in visuospatial working memory.
sleep and cognitive functioning.
Methods: 32 adolescents (13–19 years, M = 15.9, SD = 1.6) with DSM-5 insomnia disorder, were randomly
assigned to a treatment group (n = 18) or a waiting list (n = 14). Treatment consisted of six guided
self-help online CBTI sessions. Both groups were assessed at baseline and post-treatment. Sleep was measured
with actigraphy, sleep logs, and questionnaires. Cognitive functioning was assessed with a battery
of standard cognitive tests.
Results: After CBTI the treatment group showed significant improvements compared to the waiting list
group in sleep efficiency from actigraphy and sleep logs. This finding was confirmed by improvements
in other sleep variables from sleep logs, and in symptoms of chronic sleep reduction and insomnia. Most
participants from the treatment group improved to sub clinical levels of insomnia. Cognitive functioning
of the treatment group showed more improvement compared to the waiting list in visuospatial
processing, selective attention and phonological working memory, and a trend of improvement in response
inhibition and set shifting, letter fluency and sustained attention, but not in declarative memory,
visuospatial working memory, category fluency, and general cognitive speed. Changes in sleep appeared
to be related to changes in cognitive functioning.
Conclusions: These results indicate that CBTI can have positive effects on cognitive functions in adolescents,
with notable improvements in visuospatial processing and phonological working memory but not
in visuospatial working memory.
- by Susan Bögels and +1
- •
- Internet Therapy
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