An Educational Intervention to Increase Provider Utilization of Cognitive Behavioral Therapy for Insomnia in a Psychiatric Practice

Abstract

Problem Statement: Chronic insomnia is a highly prevalent condition associated with manynegative physical and mental health outcomes. Despite a large body of evidence supporting the use of cognitive behavioral therapy for insomnia (CBT-I) as a first-line treatment for insomnia, this treatment continues to be underutilized in psychiatric practice. Research indicates that clinician factors, including inadequate knowledge and treatment biases, represent a significant treatment barrier. Purpose: To improve the use of CBT-I skills and resources in the treatment of insomnia in apsychiatric setting through the delivery of an educational intervention addressing clinician knowledge, attitudes, and intention to use CBT-I. Methods: This was a quality improvement project that utilized descriptive quantitative pre- andpost-survey design with a brief educational intervention in the form of a voice-over PowerPoint presentation. All providers at a small psychiatric private practice in Pima County, AZ, were surveyed before and after an educational intervention to assess changes in knowledge, attitude, and intention to use CBT-I in practice. Participants were recruited through informal conversation and email, and all educational materials were delivered to participants through professional email. Data were collected anonymously through Google Forms, a web-based survey platform. Results: All recruited psychiatric providers completed the surveys in their entirety. Prior to the educational intervention providers endorsed varying degrees of knowledge about CBT-I and most characterized their current utilization as neutral to poor. After the educational intervention, all providers endorsed a strong agreement on the perceived benefit of CBT-I and their intention to use this treatment in practice. When asked to identify personal utilization barriers, providers cited time management and perceived resistance from patients. Conclusion: Targeted educational interventions can improve psychiatric provider knowledge,attitude, and intention to use CBT-I in the treatment of insomnia. Despite the positive intention to use CBT-I, providers continue to face systemic barriers to implementation, and more research is needed to understand the unique challenges involved in improving CBT-I treatment uptake in psychiatric settings.