The management of insomnia by Australian psychologists: a qualitative study

ABSTRACT

Objective

Although clinical guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the first-line treatment for insomnia, many people with insomnia do not have access to CBTi and are prescribed sedative-hypnotic medicines by medical health professionals. Psychologists have training in CBT and may be well placed to deliver behavioural therapy for insomnia. However, the current treatment of insomnia, amount of sleep-specific training and knowledge of CBTi among Australian psychologists remains unknown.

Method

This qualitative study conducted semi-structured interviews with Australian psychologists. Interviews included case study scenarios to provide an in-depth exploration of psychologists’ knowledge and skills in the management of insomnia. Interview transcripts were analysed using thematic analysis to identify themes.

Results

Twenty-six psychologists participated in this study. Four themes were identified in the data: 1) Sleep is important but rarely a treatment priority; 2) Confusion about funding pathways discourages treatment of insomnia; 3) A variety of approaches are used in the management of insomnia; 4) Psychologists with experience in CBTi are rare.

Conclusions

Most Australian psychologists are not well equipped to manage insomnia effectively with CBTi. Along with other primary health care professionals, psychologists need training in the delivery of evidence-based insomnia treatment.

KEY POINTS

What is already known about this topic:

1. The recommended treatment for insomnia is Cognitive Behavioural Therapy for insomnia (CBTi) but most people with insomnia do not receive this treatment

2. The most common treatments for insomnia are sedative hypnotic medications and sleep hygiene education

3. Most people with insomnia are not referred to a psychologist.

What this topic adds:

1. Most psychologists and other primary care professionals lack specific knowledge and training in insomnia and CBTi

2. Insomnia is often regarded as a secondary problem and clients are not usually referred to psychologists for treatment of insomnia

3. Psychologists use a range of treatments for insomnia, most common are sleep hygiene and relaxation.

KEYWORDS:

• Insomnia
• sleep
• psychologists
• psychology
• cognitive behavioural therapy for insomnia
• CBTi

Acknowledgments

This work has been conducted by the National Centre for Sleep Health Services Research, a program funded by a National Health and Medical Research Council Centres of Research Excellence grant.

Disclosure statement

Applicable to all authors, this research has been supported by competitive research funding from the National Health and Medical Research Council of Australia.

EH– no competing interests but is employed in part by the National Centre of Sleep Health Services Research.

The authors declare that they have no other competing interests.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author, (JH). The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/00050067.2022.2089544.

Additional information

Funding

This work was supported by a National Health and Medical Research Council Centres of Research Excellence grant and research funds from the College of Medicine and Public Health, Flinders University.