ORCID

https://orcid.org/0000-0003-1077-0298

Date of Award

Fall 2025

Language

English

Embargo Period

10-20-2025

Document Type

Master's Thesis

Degree Name

Master of Arts (MA)

College/School/Department

Department of Psychology

Program

Psychology (Master's)

First Advisor

James Boswell

Committee Members

Drew Anderson

Keywords

empirically supported treatment (EST); evidence-based treatment; insomnia; cognitive-behavioral therapy (CBT)

Subject Categories

Clinical Psychology

Abstract

Controlled research shows that cognitive-behavioral therapy (CBT) is an effective treatment for insomnia, yet clinician experiences with applying CBT in routine settings has received limited attention. This study replicated and extended upon the Two-Way Bridge initiative (Goldfried et al., 2014), which aimed to establish a dialogue between researchers and clinicians on the identification of variables that promote and interfere with the effectiveness of evidence-based therapies. This survey study asked clinicians to identify variables they have encountered that make it challenging to implement CBT and related interventions for insomnia. N = 182 clinicians completed an online survey on typical assessment practices, treatment techniques, and perceived barriers and their impact on treatment implementation and efficacy. A subsample (N = 87) repeated the survey approximately two weeks later to evaluate test-retest reliability. Frequently used interventions for treating insomnia included behavioral strategies, cognitive restructuring, and psychoeducation, with over half incorporating integrative adaptations into treatment. Factors perceived as highly limiting to effective treatment delivery included patient adherence difficulties, comorbidity, unhelpful beliefs about sleep and medication, stressful household environments, and challenges in applying behavioral protocols. Problems with training in CBT for insomnia were also reported. These findings provide researchers with practice-informed directions for future empirical investigation into improving the efficacy of CBT and offer clinicians insight into common challenges encountered in treating insomnia routine practice.

License

This work is licensed under the University at Albany Standard Author Agreement.

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