Table Of ContentCognitive Behavior Therapy for
Insomnia in Those with Depression
Cognitive Behavior Therapy for Insomnia in Those with Depression is the book for
clinicians who recognize that insomnia is more often a comorbid condition that merits
separate treatment attention. These clinicians know that two thirds of those who present
for depression treatment also complain of significant insomnia and that one third of
such patients are already taking sleep medication, and they may be familiar with the
research showing that treating insomnia is often important in the management of
depression. But what strategies should clinicians use for treating insomnia? How can
motivation be enhanced? What about medications? Students and professionals alike will
find the pages of Cognitive Behavior Therapy for Insomnia in Those with Depression
replete with advanced tools to address the adherence problems often encountered
in this group, and they’ll come away from the book with a wealth of techniques for
improving both sleep and overall symptom management as well as for treating the
insomnia that occurs in comorbid disorders.
Colleen E. Carney, PhD,is an associate professor in the department of psychology at
Ryerson University and the director of the Sleep and Depression Laboratory in Toronto,
Canada. She was previously on faculty at Duke University Medical Center, where
she was awarded the prestigious National Sleep Foundation Pickwick Fellowship and
where she also established the Comorbid Insomnia Clinic. She is the president of the
Behavioral Sleep Medicine Special Interest Group of the Association for Behavioral and
Cognitive Therapies and a fellow of the Canadian Psychological Association. She is also
certified in cognitive behavior therapy by the Canadian Association for Cognitive and
Behavioral Therapies, and is an active writer, presenter, and workshop trainer.
Donn Posner, PhD, is currently working at the Palo Alto VA on clinical research in
insomnia. Before this he served as a clinical associate professor of psychiatry at the
Warren Alpert Medical School at Brown University and as director of behavioral sleep
medicine for the Sleep Disorders Center of Lifespan Hospitals. Dr. Posner is a member
of the American Academy of Sleep Medicine and is one of the first certified behavioral
sleep medicine specialists recognized by that group. He is also a founding member of
the Society of Behavioral Sleep Medicine and was recently awarded the society’s Peter
Hauri Career Distinguished Achievement Award.
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Cognitive Behavior Therapy
for Insomnia in Those with
Depression
A Guide for Clinicians
Colleen E. Carney and
Donn Posner
First published 2016
by Routledge
711 Third Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2016 Colleen E. Carney and Donn Posner
The right of Colleen E. Carney and Donn Posner to be identified as authors
of this work has been asserted by them in accordance with sections 77 and 78 of
the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or
reproduced or utilized in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including photocopying
and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification
and explanation without intent to infringe.
Library of Congress Cataloging in Publication Data
Carney, Colleen.
Cognitive behavior therapy for insomnia in those with depression:
a guide for clinicians/Colleen E. Carney, PhD and Donn Posner, PhD.
pages cm
Includes bibliographical references and index.
1.Insomnia—Treatment—Popular works. 2.Depression, Mental—
Complications—Popular works. 3. Cognitive therapy—Popular works.
I. Posner, Donn. II. Title.
RC548.C363 2015
616.8′49820651—dc23
2015016125
ISBN: 978-0-415-73837-8 (hbk)
ISBN: 978-0-415-73838-5 (pbk)
ISBN: 978-1-315-81740-8 (ebk)
Typeset in Minion
by Florence Production Ltd, Stoodleigh, Devon, UK
I dedicate this book to my family, Shannon, Sydney, and Theo. Their love,
support and understanding, allows me to pursue my passion.
Colleen E. Carney, PhD
I dedicate this book to my wife Karen and son Max who definitely put
the drive into my life each and every day. Thank you for your bottomless
reservoir of support. I would also like to thank my co-author Colleen for
giving me the opportunity to be part of this thought provoking project.
Donn Posner, PhD
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Contents
Acknowledgment ix
1 Depression and Insomnia: An Overview 1
2 Non-psychological Treatments for Those with Insomnia
and Depression 14
3 Cognitive Behavior Therapy for Insomnia (CBT-I):
Treatment Considerations 26
4 Assessment of Insomnia in Those with Depression 37
5 Behavioral Strategies for Insomnia 60
6 Cognitive Factors and Treatment 79
7 Encouraging Adherence and Troubleshooting Potential
Barriers 96
8 Rumination Strategies for Insomnia 120
9 Combining Depression and Insomnia Therapies 134
10 Case Study 157
Appendices
A Core Sleep Diary 185
B Expanded Sleep Diary 188
C Daytime Insomnia Symptom Response Scale 194
viii Contents
D TRAP or TRAC Worksheet 195
E Daily Activity Monitoring Form 196
F Goal Tracking Form 197
G Blank Pro-Depression and Anti-Depressant Worksheet 198
H Blank Pro-Sleep versus Pro-Insomnia Worksheet 199
I Blank Pro-Energy versus Pro-Fatigue Worksheet 200
J BABIT Continuum Exercise 201
K Behavioral Experiment Monitoring 202
References 203
Index 225
Acknowledgment
We thank Dr. Rachel Manber for her intellectual contributions to this book and her
contributions to the field in the area of sleep and depression.
