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1. Identify sleep disorders which require referrals to a sleep center.
2. Integrate strategies for pre-sleep arousal by building a stronger drive for deep sleep.
3. Discuss why CBT-I is effective for clients with co-occurring issues such as pain, depression, anxiety or trauma.
4. List treatment strategies clients can easily implement to manage their fatigue.
5. Design behavioral experiments for clients to test unhelpful beliefs about sleep.
6. Identify conditioned arousal and teach clients strategies to reverse it.

Sleep Regulation

• Sleep homeostasis
• Behaviors that interfere with the build-up of sleep-drive
• The circadian system
• Behaviors that interfere with optimal timing of sleep
• Arousal system: behaviors that cause conditioned arousal and cognitive emotional hyperarousal

Assessment

• How to get useful information from sleep diaries
• The difference between sleepiness and fatigue
• When to make a referral to a sleep clinic
• Other assessment issues

Cognitive Behavior Therapy for Insomnia (CBT-I)

Sleep Restriction Therapy (SRT): Restore the Sleep Drive

• Calculate optimal time-in-bed prescription
• Collaborate on the best “sleep window”
• Special cases: when to use sleep compression instead

Stimulus Control (SC): Addressing Conditioned Arousal

• Select an optimal standard rise time
• Fatigue management strategies to eliminate napping
• Special cases: when to use counter control instead
• Combining SC and SRT in one-session CBT-I

Counter-arousal Strategies

• Identify and change negative thoughts that keep people awake
• Behavioral experiments
• Thought records
• The buffer zone
• Socratic questioning
• Structured, scheduled problem-solving
• Mindfulness
• Troubleshooting difficulties with adherence
• High sleep anxiety vs. high arousal
• Awakenings from pain, hot flashes, panic or nightmares
• Using light and activation in those with depression

Modifications to CBT for Insomnia in Complex Cases & Comorbidity

• Major Depressive Disorder
• Chronic pain
• Anxiety disorders
• Post-Traumatic Stress Disorder

Implementation Issues

• Relapse prevention
• Delivery issues

Colleen E. Carney, PhD, is on faculty in the department of psychology at Toronto Metropolitan University, where they are the director of the sleep and depression laboratory. They are a leading expert in psychological treatments for insomnia, particularly in the context of co-occurring mental health issues. Their work has been featured in The New York Times and they have over 100 publications on insomnia.

Dr. Carney frequently trains students and mental health providers in CBT for Insomnia at invited workshops throughout North America and at international conferneces. Dr. Carney is a passionate advocate for improving the availability of treatment for those with insomnia and other health problems. For more information, please visit www.drcolleen carney.com Speaker Disclosures:
Financial: Dr. Colleen Carney has employment relationships with Toronto Metropolitan University and Duke University. They receive a grant from Canadian Institutes of Health Research, Team Research, and Sleep Research Consortium and received Faculty of Arts Travel Award. Dr. Carney receives royalties as a published author. They receive a speaking honorarium and recording royalties from PESI, Inc. Dr. Carney has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Colleen Carney is a member of the Canadian Association of Cognitive and Behavioural Therapies, the Canadian Psychological Association, the Association for Behavioural and Cognitive Therapies (ABCT), the Canadian Sleep and Circadian Network, the Canadian Sleep Society, the Sleep Research Society, and the Canadian Association for Cognitive Behaviour Therapy.

For U.S. and Canadian customers, a CE test is available for $9.99 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion may be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Addiction Counselors

This self-study course has been approved by PESI, Inc., as a NAADAC Approved Education Provider, for 6.0 CE in the Treatment Plan skill group. NAADAC Provider #77553. PESI, Inc. is responsible for all aspects of their programming. Full attendance is required; no partial credit will be awarded for partial attendance.

California Alcoholism & Drug Abuse Counselors (CCAPP): PESI, Inc. is an approved provider by the CCAPP-EI, Provider #: 0S-03-036-1025. This self-study activity meets the qualifications for 6.0 CEH's (continuing education hours).

Connecticut Addiction Counselors: Provider #120924. This course has been approved as a CCB approved training and has been awarded 6.25 hours by the Connecticut Certification Board.

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Counselors
This intermediate self-study activity consists of 6.25 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements.

Texas Counselors: PESI, Inc. has been approved as a continuing education sponsor through the Texas State Board of Examiners of Professional Counselors. Provider #: 2477. This self-study course qualifies for 6.0 continuing education credits.

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Marriage & Family Therapists
This self-study activity consists of 6.25 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.

Illinois Marriage & Family Therapists: PESI, Inc. has been approved as a provider of continuing education by the State of Illinois, Department of Financial and Professional Regulation, Division of Professional Regulation. Provider #: 168-000156. Full attendance at this self-study activity qualifies for 6.0 credits.

Texas Marriage & Family Therapists: PESI, Inc. has been approved as a continuing education sponsor through the Texas State Board of Examiners of Marriage and Family Therapists. Provider #: 503. This self-study activity qualifies for 6.0 continuing education credits.

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Nurses, Nurse Practitioners, and Clinical Nurse Specialists
This intermediate activity consists of 6.25 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please contact your licensing board to determine if they accept programs or providers approved by other national or state licensing boards. A certificate of attendance will be awarded at the end of the program to participants who are in full attendance and who complete the program evaluation.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 6.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Occupational Therapists & Occupational Therapy Assistant: PESI, Inc. is an approved provider with the Florida Board of Occupational Therapy. Provider Number 50-399. This self-study course qualifies for 6.3 continuing education credits.

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Psychologists & Physicians
PHYSICIANS: PESI, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. PESI, Inc. designates this enduring material for a maximum of 6.0 AMA PRA Category 1 Credit(s)™. This activity was originally recorded on 10/14/2015. It was last reviewed on 12/25/2018 and is valid until 12/25/2021. Physicians should only claim credit commensurate with the extent of their participation in the activity.

PSYCHOLOGISTS: The following state psychologist boards recognize activities sponsored by PESI, Inc. as an approved ACCME provider: Alaska, Arkansas, California, Colorado, Georgia, Illinois, Indiana, Kentucky, Maine, Maryland, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Oklahoma, Pennsylvania, South Carolina and Wisconsin. This self-study activity consists of 6.0 clock hours of continuing education instruction. Certificates of attendance will be issued for you to submit to your state licensing board to recognize for continuing education credit. You are required to successfully complete and submit a post-test prior to receiving a certificate of completion.

Canadian Psychologists: PESI, Inc. is approved by the Canadian Psychological Association to offer continuing education for psychologists. PESI, Inc. maintains responsibility for the program. This program is approved for 6.0 self-study continuing education hours. Full credit statement at: https://catalog.pesi.com/page/ceinformation#psychologists

Florida Psychologists: PESI, Inc., is an approved provider with the Florida Board of Psychology. Provider Number 50-399. This product qualifies for 6.3 self-study continuing education credits. Please make sure to bring your license number to the seminar so that we can report your attendance to CE Brokers.

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Social Workers
PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this self-study course. ACE provider approval period: January 27, 2017 - January 27, 2020. Social Workers completing this course receive 6.25 Clinical Practice continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation.

Canadian Social Workers: PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this self-study course. ACE provider approval period: January 27, 2017 - January 27, 2020. Social Workers completing this course receive 6.25 Clinical continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation. Canadian provinces may accept activities approved by the ASWB for ongoing professional development.

Illinois Social Workers: PESI, Inc. is an approved provider with the State of Illinois, Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 159-000154. Successful completion of this self-study activity qualifies for 6.0 contact hours.

Minnesota Social Workers: PESI, Inc. is an approved provider with the State of Minnesota, Board of Social Work. Provider #: CEP-140. This self-study course has been approved for 6.0 continuing education hours. A certificate will be issued upon successful completion of a post-test.

New York Social Workers: PESI, Inc. is recognized by the New York State Education Department's (NYSED) State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0008. This self-study activity will qualify for 7.5 contact hours. Full attendance is required; no partial credits will be offered for partial attendance.

California Social Workers/ Counselors/Marriage & Family Therapists/Licensed Educational Psychologists: The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs. A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level activity consists of 6.0 clock hours of continuing education instruction.

Florida Social Workers, Marriage & Family Therapists, and Mental Health Counselors: PESI, Inc. is an approved provider with the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling. Provider Number 50-399. This self-study course qualifies for 6.25 continuing education credits.

Ohio Social Workers, Counselors, and Marriage & Family Therapists: PESI, Inc. is an approved provider with the State of Ohio Counselor, Social Worker and Marriage & Family Therapist Board. Provider approval #: RCST071001. Successful completion of this self-study course meets the qualifications for 6.25 clock hours of continuing education credit.

Pennsylvania Social Workers/Counselors/Marriage & Family Therapists: This intermediate activity consists of 6.25 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please contact your licensing board to determine if they accept programs or providers approved by other national or state licensing boards. A certificate of attendance will be awarded at the end of the program to participants who are in full attendance and who complete the program evaluation. Full attendance is required, variable credits may not be awarded per the Pennsylvania State Board.

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Other Professions
This self-study activity qualifies for 6.25 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Addiction Counselors, Case Managers, Counselors, Marriage & Family Therapists, Nurses, Psychologists, Social Workers, and other Mental Health Professionals