FAQs

What is CBT-I and how is it different from regular therapy? CBT-I (Cognitive Behavioral Therapy for Insomnia) is a structured, evidence-based treatment specifically designed for chronic insomnia. Unlike general therapy, which focuses broadly on mental health, CBT-I targets the specific thoughts, behaviors, and habits that keep insomnia going including racing thoughts at bedtime, irregular sleep schedules, and unhelpful beliefs about sleep. It's a focused, skills-based treatment, typically completed in 4–12 sessions.

Is CBT-I really effective? Yes! CBT-I is the most well-researched treatment for chronic insomnia that exists. The American College of Physicians recommends CBT-I as the first-line treatment for insomnia, ahead of sleep medication. Clinical studies consistently show that CBT-I produces lasting improvements, and unlike medication, the benefits tend to hold up long after treatment ends.

How is CBT-I different from sleep hygiene tips? Sleep hygiene (like avoiding caffeine and keeping a cool bedroom) is a small piece of CBT-I, but CBT-I goes much deeper. It includes techniques like sleep restriction therapy, stimulus control, and cognitive restructuring — approaches that directly address the cycle maintaining your insomnia, not just surface-level habits.

Do I have to stop taking sleep medication to start CBT-I? No. You don't need to stop or change your medication before starting CBT-I. Many people come to CBT-I precisely because they want to reduce their reliance on sleep medication over time, and CBT-I provides the skills to make that transition more manageable. Any decisions about medication are between you and your prescribing physician.

How many sessions will I need? Most people see meaningful improvement within 4–12 sessions. The exact number depends on the nature and history of your insomnia, how consistently you're able to practice the techniques between sessions, and your individual goals. We'll discuss what to expect during your free 15-minute consultation.

Will CBT-I work if I've had insomnia for years? Yes. CBT-I is specifically designed for chronic insomnia which is defined as sleep difficulties lasting at least three months. In fact, long-standing insomnia is exactly what CBT-I is built for, because chronic insomnia is typically maintained by deeply ingrained patterns that CBT-I directly addresses.

Does CBT-I help with anxiety and depression too? Often, yes. Sleep and mental health are deeply connected. Research shows that as sleep improves through CBT-I, mood, anxiety levels, and emotional regulation frequently improve as well. CBT-I can also enhance the effectiveness of treatment for anxiety and depression when those are present alongside insomnia.

What does a typical CBT-I session look like? Sessions typically involve reviewing your sleep diary from the past week, identifying patterns, and working on specific techniques, whether that's adjusting your sleep schedule, addressing unhelpful thoughts about sleep, or building new habits around bedtime. You'll leave each session with concrete things to practice before the next one.

Do you offer telehealth CBT-I sessions? Yes. All sessions are conducted via secure video telehealth, which means you can work with me from the comfort of your home. I'm licensed to see clients throughout Rhode Island and Massachusetts.

How do I get started? Reach out to schedule a free 15-minute consultation call. We'll talk about what you're experiencing, answer any questions you have, and figure out together whether CBT-I is the right fit for you. You can contact me at elise@elisemcdonaldlicsw.com or 401.424.1551.