0927 Shining Light on Nightmare Treatment: Expert Panel Recommendations for Cognitive Behavioral Therapy for Nightmares
Kristi E. Pruiksma, Katherine E Miller, Joanne L. Davis, Daniel J. Taylor, Jessica R. Dietch, Philip Gehrman, Michael R Nadorff, William Brim, Rebecca Campbell, Hannah Tyler, William Price, Alan L Peterson
Sleep April 20, 2024 DOI: 10.1093/sleep/zsae067.0927 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 17 |
| Population | Licensed providers (nightmare, trauma, and sleep disorder experts and provider testers) |
| Topics | Dreaming |
| Key findings | A web-based CBT-N provider training was developed and iteratively refined through provider feedback, with positive reactions to content and usability. Item Response Theory analysis identified 40 of 80 multiple-choice items for replacement. The authors hypothesize that the web-based course will be equivalent to a live virtual workshop, a question the final testing phase will examine. |
Abstract
Few providers are trained to deliver Cognitive Behavioral Therapy for Nightmares (CBT-N) despite the impact of nightmares on physical and mental health. Reduced access to treatment is partially due to limited training opportunities. Web-based training resources are valuable because they are easily accessible, are cost-efficient, and can be reviewed by providers as needed. This presentation describes the development, testing, and launch of a web-based provider training for CBT-N. Nightmare, trauma, and sleep disorder experts collaborated to develop material for the web-based CBT-N training. Next, 17 providers tested a first draft of the web-site. After feedback was integrated, 50 providers were recruited to complete the updated draft of the website and will complete feedback in January 2024. To assess learning, providers completed multiple-choice questions before and after each of the 10 training modules. Item Response Theory (IRT) analyses were used to identify items of low discrimination and difficulty for further refinement. Overall, testers had positive reactions to the training content and website. The training content was improved by adding more figures, animations, and therapy demonstration videos and integrating more cultural considerations. Usability was improved by addressing bugs and enhancing intuitive site navigation. Based on IRT analyses of multiple-choice questions, 40 (out of a total 80) items were replaced and will be re-evaluated at the conclusion of beta testing. Launching in June 2024, CBTnightmares.org is a comprehensive, engaging, and accessible training after two phases of development and feedback from almost 70 licensed providers. The final phase of testing, to be conducted in April 2024, will examine the equivalence of online training compared to a live virtual workshop (Target N = 100). Providers will complete questionnaires and a mock session with a standardized patient to examine therapist proficiency and fidelity. The hypotheses are that this web-based course will be equivalent to a live virtual workshop. This project directly addresses the dissemination and implementation cliff of empirically supported treatment for nightmares. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Peer Review Medical Research Program under Award No. W81XWH-21-1-0576.
Comparable studies
Other qualitative studies on dreaming, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The Other as a Nightmare: The Israeli-Arab Encounter as Reflected in Children's Dreams in Israel and the West Bank Jewish and Arab fifth to seventh graders living in various settings in Israel and the... | 1989 | Qualitative content analysis | n = 212 |
| Nonwaking Responses to Waking Stressors: Dreams and Nightmares1 Men from the cohort eligible for military duty during the Vietnam Conflict, varying in... | 1990 | Survey interview study | n = 442 |
| Communing with the Gods: The Dreaming Brain in Cross-cultural Perspective | 2011 | Phenomenological study | |
| Partial memory reinstatement while (lucid) dreaming to change the dream environment. Lucid dreamers | 2020 | Qualitative study | |
| Strange themes in pandemic dreams: Insomnia was associated with more negative, anxious and death‐related dreams during the COVID‐19 pandemic Global survey participants | 2022 | Longitudinal mixed-methods study | n = 2,240 |