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Therapy for Individuals,Couples, & Families
Family Therapy Session

 

 

Learn the skills to manage your daily life.

Reduce or eliminate your anxiety and depression.

Improve your communication and relationships.

Live with less worry and concern.

Learn to get unstuck and move forward.

Be positive and enagaging with people and opportunities.

Creat healthy behaviors and improve your wellness.

Move beyond negative and traumatizing experiences.

Get a good night's sleep.

Go beyond surving to thriving.

Be calmer, more peaceful, and confident.

Be healthier, empowered, and positive.

Start on a positive path to growth and well-being.
 

Intro to Insomnia

Insomnia and Symptoms
Causes
Treatment
Helpful Tips

70% of depression cases include insomnia symptoms
34% of women and 22% of men cite stress as a factor in their insomnia
53% of night shift workers fall asleep at work on a weekly basis
22% of secondary insomnia results from pain or discomfort
17% of women and 5% of men blame their insomnia on their partner's snoring
20% of cases of insomnia are due to excessive light, noise or temperature‚Ä®

Everybody
with anxiety related disorders experiences insomnia symptoms‚Ä®

Primary Insomnia makes up 20% of insomnia cases and is unrelated to other medical conditions (i.e., there is no underlying cause detected, stress is a factor).

Secondary Insomnia makes up 80% of insomnia cases where underlying causes of sleep disturbances can be detected. Insomnia can be acute, intermittent, or chronic.

Sleep Complaints and Daytime Impairments

  • Difficulty falling asleep       
  • Difficulty staying awake       
  • Waking too early                    
  • Poor Quality                 
  • Interrupted sleep           
  • Non-restorative sleep             
  • Daytime sleepiness
  • Reduced Motivation/energy/initiative
  • Mood disturbance/ irritability
  • Social/vocational problems, poor school performance
  • Attention, concentration, or memory impairment
  • Proneness for errors/accidents at work or driving;
  • Tension, headaches, and/or GI symptoms

Physical causes of secondary insomnia include:

  • Sleep Apnea
  • Pain
  • Medication
  • Illness
  • Heartburn
  • Asthma
  • Prostate
  • Hot flashes
  • Restless Legs
  • Parasomnias
  • Arthritis
  • Headaches
  • Poor sleep habits
  • Exercise Schedules

Mental health issues:

  • Major life events like job loss or change, death, divorce, moving
  • Depression
  • Anxiety
  • Chronic stress
  • PTSD
  • Substance use

Goals of Treatment:

  • Improvements in sleep quality, sleep latency, total sleep, and sleep efficiency
  • Improvements in vitality and physical and mental health
  • Improvements in insomnia related daytime impairments

Assessment

  • Symptoms/course
  • Sleep environment
  • Sleep habits
  • Daytime function
  • Medication use
  • Medical & psychiatric history
  • Alcohol/drug use
  • Assessment of goals
  • Compensatory strategies

Treatment

  1. Introduction, education, sleep logs, sleep history, screen for psychiatric disorders (depression, anxiety, PTSD, Alcohol)
  2. Sleep Restriction Procedures (Optional) involves controlling time in bed (TIB) based upon the person's sleep efficiency.
  3. Stimulus Control Procedures aimed at associating the bed with sleeping and limit its association with stimulating behavior.
  4. Relaxation Training (e.g., meditation, PMR, imagery, entrainment, breathing)
  5. Cognitive Therapy focuses on education about sleep in order to target dysfunctional beliefs/attitudes about sleep (use DBAS), catastrophic thinking, consequences, worries, expectations, medication.
  6. Sleep Hygiene aimed at controlling the environment and behaviors that precede sleep.
  7. Review, Answer Questions, Resistance, Titration, Problem Solving
  8. Relapse Prevention

Helpful Tips to Overcome Insomnia

  • Start by going to bed and getting up at the same time each day
  • Go to bed only when tired
  • Restrict activities in bed to sleep and sex
  • Avoid stimulating activities like TV, computer games, action-packed books
  • Avoid being around bright lights before going bed
  • Get moderate exercise during the day but not before bedtime
  • Avoid taking naps during the day
  • Don’t eat a heavy meal late in the day
  • Sometimes a light bedtime snack, such as milk or peanut butter helps
  • If you don’t fall asleep within 10 minutes, get up and go to another room and do something calming until sleepy.
  • Avoid substances like caffeine, nicotine, alcohol, and other street drugs that can interfere with proper sleep, especially within 4–6 hours of going to bed.
  • If you tend to worry before bed,  try making a to-do list.
  • Keep the bedroom dark, quiet, and comfortably cool.
  • Engage in a relaxing routine before going to bed, such as reading, writing, listening to calming music, taking a bath, meditation, progressive muscle relaxation, or calming breath exercises.