Web-Based Provider Training for Cognitive Behavioral Therapy for Nightmares


Develop and evaluate an online training program for Cognitive Behavioral Therapy for Nightmares

An estimated 315,000 U.S. military service members experience chronic nightmares that only a handful of mental health providers know how to treat directly. People who suffer from nightmares report greater substance use, physical health problems, insomnia, and posttraumatic stress disorder (PTSD) symptoms, all of which can compromise military readiness and quality of life. They also are at increased risk for suicidal ideation, suicidal attempts, or suicide completion. If left untreated, nightmares can persist for decades.

While Cognitive Behavioral Therapy for Nightmares (CBT-N) is endorsed by the American Academy of Sleep Medicine as effective for treatment of nightmares related to trauma and PTSD, few providers know how to deliver these treatments, and training opportunities are rare. This is true for the Defense Health Agency, Veterans Health Administration, and in clinics that serve civilians.

CBT-N involves writing a different storyline for the nightmare and repeatedly imagining the new dream before sleep. This gives the mind a different path to follow during sleep. The therapy also can include education about sleep and trauma, identifying and modifying unhelpful sleep habits, relaxation training, and written exposure therapy to nightmare content (similar to treatments for PTSD).

Training via: CBTNightmaresweb.org

A team led by Kristi Pruiksma, PhD, of The University of Texas Health Science Center at San Antonio aims to fill that gap by developing an online training program for CBT-N. This training via a site called CBTNightmaresweb would require less time and cost less than live workshops, while ensuring that providers receive state-of-the-science CBT-N training.

The team will work with leaders in the field, agencies, decision-makers and providers to develop and refine the program. They will then test it with a group of 100 providers who will complete either the CBTNightmaresweb training or a live workshop. The team then will compare the two groups’ reactions to and satisfaction with the training they received and will assess their learning via simulated treatment sessions.

The overarching goal of developing CBTNightmaresweb is to facilitate the delivery of nightmare treatment to improve the sleep and quality of life of service members, veterans, and civilians suffering from nightmares related to trauma. The U.S. military would benefit from improvements in the operational readiness and physical and mental health of its personnel.

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