Philip Gehrman1,2, Mauli T Shah3, Ashley Miles4, Samuel Kuna1,2, Linda Godleski5,6. 1. 1 Corporal Michael J. Crescenz VA Medical Center , Philadelphia, Pennsylvania. 2. 2 Perelman School of Medicine of the University of Pennsylvania , Philadelphia, Pennsylvania. 3. 3 Durham VA Medical Center , Durham, North Carolina. 4. 4 Carl Vinson VA Medical Center , Dublin, Georgia . 5. 5 VA Connecticut Healthcare System , New Haven, Connecticut. 6. 6 Yale University School of Medicine , New Haven, Connecticut.
Abstract
BACKGROUND: Clinical video telehealth provides a means for increasing access to psychotherapy. Insomnia is prevalent, is associated with a number of negative sequelae, and can be effectively managed with cognitive behavioral treatment of insomnia (CBT-I). Telehealth technologies can provide a means for increasing access to CBT-I. MATERIALS AND METHODS: The Tele-Insomnia program is a Veterans Health Administration (VHA) initiative in which CBT-I is delivered in a group format by telehealth. Veterans received six weekly sessions of group CBT-I, completing the Insomnia Severity Index (ISI) and daily sleep diaries throughout treatment. Paired-samples t-tests were used to examine differences in each measure from the first to the last session of treatment. RESULTS: There were statistically and clinically significant improvements in the ISI and all sleep diary variables with the exception of total sleep time. Video quality was excellent, and there were few connectivity problems. CONCLUSIONS: Clinical video telehealth technology can be used to deliver group CBT-I in a manner that produces clinically significant improvement. This model is scalable and has been used to develop a national clinical telehealth program.
RCT Entities:
BACKGROUND: Clinical video telehealth provides a means for increasing access to psychotherapy. Insomnia is prevalent, is associated with a number of negative sequelae, and can be effectively managed with cognitive behavioral treatment of insomnia (CBT-I). Telehealth technologies can provide a means for increasing access to CBT-I. MATERIALS AND METHODS: The Tele-Insomnia program is a Veterans Health Administration (VHA) initiative in which CBT-I is delivered in a group format by telehealth. Veterans received six weekly sessions of group CBT-I, completing the Insomnia Severity Index (ISI) and daily sleep diaries throughout treatment. Paired-samples t-tests were used to examine differences in each measure from the first to the last session of treatment. RESULTS: There were statistically and clinically significant improvements in the ISI and all sleep diary variables with the exception of total sleep time. Video quality was excellent, and there were few connectivity problems. CONCLUSIONS: Clinical video telehealth technology can be used to deliver group CBT-I in a manner that produces clinically significant improvement. This model is scalable and has been used to develop a national clinical telehealth program.
Entities:
Keywords:
behavioral health; military medicine; telehealth; telepsychiatry
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