0530 Hybrid Cognitive Behavior Therapy for Insomnia (CBT-I) and Acceptance and Commitment Therapy (ACT) Group Treatment Model for Insomnia and Chronic Pain

Abstract

Introduction Insomnia is a common complaint for individuals with chronic pain. CBT-I as an intervention for these patients shows strong improvement in sleep but not consistently in pain outcomes. Current treatment approaches for chronic pain focus increasingly on acceptance-based interventions. Integrating ACT into a CBT-I group protocol has the potential to optimize both sleep and pain outcomes. Methods A hybrid CBT-I/ACT 6-session weekly group protocol for chronic pain and insomnia was developed and piloted. CBT-I components included sleep education, stimulus control, and sleep restriction. ACT components included cognitive defusion, self-as-context, present moment awareness, mindfulness, and values-guided behavioral activation. Pre-post measures assessing insomnia symptoms, sleep parameters based on sleep diary, sleep catastrophizing, pain catastrophizing, pain acceptance, beliefs about pain and sleep, depression, and anxiety were analyzed using frequency analyses and paired sample t-tests. Results Group participants (4) recruited from an outpatient pain management clinic were on average 57 years old, 100% female and 75% White. Post-treatment, patients reported significantly improved insomnia symptoms (ISI Mdiff=5.8, SDdiff=3.9, p < .05, ES=1.5), sleep efficiency (SE, Mdiff=16%, SDdiff= 10%, p = .05, ES=1.5), pain catastrophizing (PCS Mdiff=7.8, SDdiff=4.6, p < .05, ES=1.6), pain acceptance (CPAQ Mdiff=11.5, SDdiff=7.5, p = .05, ES=1.5), beliefs about the relationship between pain and sleep (PBAS Mdiff=2.3, SDdiff=1.3, p < .05, ES=1.8) and anxiety (GAD-7 Mdiff=3.3, SDdiff=2.1, p