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MIRECC Matters - Spring 2022 | Volume 23, Issue 1

A publication of the VISN 5 MIRECC - MIRECC Matters - Putting Recovery into Practice

CBT-I to Improve Functional Outcomes in Veterans with Psychosis

Insomnia affects an alarming number of Veterans with psychotic disorders. Poor sleep is a major contributor to poor functioning, high distress, and unrealized rehabilitation and recovery. Veterans with psychosis face many special challenges to getting good sleep. Some of these include frightening hallucinations that make it hard to sleep, taking antipsychotics with side effects that keep them awake or asleep at the wrong times, and low motivation to stick with good sleep habits. I have developed guidelines to assist providers in tailoring the gold standard intervention for insomnia–Cognitive Behavioral Therapy for Insomnia (CBT-I)–so that it meets the needs of Veterans living with psychosis.

In 2021, I was granted a VA Merit Award by the VA Rehabilitation Research and Development (RR&D) Service to test whether CBT-I delivered using these guidelines improves both sleep and functioning in Veterans living with psychosis and insomnia. This project, titled, CBT-I to Improve Functional Outcomes in Veterans with Psychosis, will also examine the extent to which improvements in insomnia are associated with longer-term functional benefits. If CBT-I delivered in line with these guidelines is effective, the guidelines can be integrated into the existing national VA CBT-I trainings, manual, and online treatments to enhance the rehabilitation of this highly affected yet underserved Veteran population.

I am the Principal Investigator (PI) of the project, and Drs. Philip Gehrman, Melanie Bennett and Clayton Brown are Co-Investigators. This project is happening at both VAMHCS and the Corporal Michael J. Crescenz VA Medical Center in Philadelphia (where Dr. Philip Gehrman is site PI). The project will last for four years, and recruitment is underway! We will be enrolling a total of 156 Veterans with psychosis and insomnia. If you’re interested in learning more about what Veterans with psychosis are facing when it comes to their sleep, you might be interested in browsing this open access article, which has a collection of quotes from Veterans themselves: https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.12833

 

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