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• Define sleep continuity variables and understand how to define chronic insomnia with regard to diagnostic criteria (severity, frequency, and chronicity)
• Explain the consequences of insomnia as they relate to medical and psychiatric co-morbidities of insomnia as well the cost to public health, personal safety, and quality of life
• Summarize the various pharmacological approaches to insomnia and discuss the relative efficacy of CBT-I and pharmacotherapy
• Conduct a sleep assessment, understand how to use a sleep diary and when polysomnography is needed, and discuss other available assessment tools in insomnia
• Discuss how insomnia evolves into a co-morbid condition, how it requires specific and targeted treatment, and who is a good candidate for Cognitive Behavioral Therapy for Insomnia (CBT-I)
• Describe the major components of CBT-I and explain the existing literature that supports CBT-I as a well established, efficacious, and front line treatment for primary and co-morbid insomnia

Insomnia and CBT-I (Cognitive Behavior Therapy for Insomnia)

• The need for CBT-I therapists
• CBT-I is more than a simple knowledge of the procedures
• CBT-I is a multi-component therapy

Assessment and Diagnosis

• Lay and archaic definitions of insomnia
• The core of the DSM-IV-TR^®, ICD-9, and the ICSD-2 classifications
• ICSD-2: 6 types of insomnia (e.g., idiopathic, psychophysiologic, etc.)
• History in the making: DSM-V^® redefines insomnia as insomnia disorder
• DSM-V^® provides for quantitative criteria viz. frequency and chronicity but not severity
• Insomnia (and its associated costs) is not a 1st world problem
• The distinction between acute and chronic insomnia has treatment implications
• 3 subtypes of insomnia (initial, middle and late)
• Untreated chronic insomnia

Models of Insomnia

• Etiology and pathophysiology of insomnia
• Behavioral Model of Insomnia (Spielman Model)
• Concept of sleep extension
• 4 factor Model
• Conditioned arousal (activation)
• Concept of “failure to inhibit wakefulness” vs. “hyperarousal”

Treating Insomnia - Part 1

• Why “a lunar moth” is a bad mascot for eszopiclone
• Advantages and disadvantages of the various pharmacological treatments
• Why “Abe and the Beaver” are not going to help to sell Ramelteon
• Why both the objective and the subjective variables are required to evaluate treatment outcomes
• Placebo effects and pharmacotherapy for insomnia
• The last 10 years of R&D re: the medical management of insomnia
• Advantages and disadvantages of CBT-I
• CBT-I may affect both sleep continuity and sleep architecture
• Alternative methods of delivery of CBT-I (Internet and group)

Treating Insomnia - Part II (It’s all about CBT-I)

• Resources for the conduct of CBT-I
• Predisposing, precipitating and perpetuating factors of insomnia
• The mismatch between sleep ability and sleep opportunity
• Stimulus control
• Sleep restriction
• Sleep hygiene
• Role of cognitive work in CBT-I
• Advantages and disadvantages of combined CBT-I and pharmacotherapy
• Rationale for 8 session treatment
• Varying roles of the therapist in the context of CBT-I
• The relative merits of various setting sites for one’s practice (e.g. sleep center vs. pvt. office)
• “Tools” that are good to have on hand for CBT-I
• Setting patient expectations
• Essential information to chart in progress notes

Donn Posner, PhD, DBSM, is the Founder and President of Sleepwell Consultants and provides consultation to organizations and individuals on a wide variety of sleep health issues including insomnia, circadian dysrhythmia, CPAP adherence, and parasomnias. He is an Adjunct Clinical Associate Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine and a consulting psychologist for the Palo Alto VA. Dr. Posner works on a number of grants exploring the effects of CBT-I in Gulf War Veterans, and Veterans with insomnia and Mild Traumatic Brain Injury. He is also conducting a pilot aimed at using CBT-I techniques to decrease fatigue in breast cancer survivors by increasing total sleep time. Dr. Posner spent 25 years as the Director of Behavioral Sleep Medicine for the Sleep Disorders Center of Lifespan Hospitals and was a Clinical Associate Professor in the Department of Psychiatry and Human Behavior at the Warren Alpert School of Medicine at Brown University. He 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 a founding member of the Society of Behavioral Sleep Medicine, and he has achieved the status of Diplomate of Behavioral Sleep Medicine (DBSM).

Speaker Disclosures:
Financial: Dr. Donn Posner is the founder and president of Sleepwell Consultants and has employment relationships with the Stanford University School of Medicine and the Palo Alto Veterans Institute for Research. He serves as an advisory board member of Brain Train 2020 LTD and iSleep Clinic. He was a previous advisory board member for Dawn Health and Delta Sleep.io. Dr. Posner receives a speaking honorarium and recording royalties from PESI, Inc. All relevant financial relationships with ineligible organizations have been mitigated.
Non-financial: Dr. Donn Posner is a member of the American Academy of Sleep Medicine, the American Psychological Association, the Society of Behavioral Sleep Medicine, and the Association for Behavioral and Cognitive Therapies.

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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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.

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Educators/Teachers
This course consists of 6.25 self-study clock hours. 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 Educators:
6.0 ISBE Professional Development (PD) Clock Hours will be made available through Quincy University. Those requesting ISBE PD Clock Hours will need to complete an Evaluation for Workshop, Conference, Seminar, in order to receive the ISBE “Evidence of Completion for Professional Development” form. Instructions and form will be made available under the “Materials” tab. Expires: 06/30/2024.

Indiana Educators: 6.0 Professional Growth Points are available for full attendance of this self-study package per the Indiana Department of Education standards.

Montana Educators: This self-study package is offered for 6.0 Renewal Units. PESI, Inc. is an Approved Renewal Unit Provider with the Montana Office of Public Instruction.

Texas Educators: PESI, Inc., has been approved as a CPE Provider #500-981 for Texas Educators by the Texas State Board for Educator Certification (SBED). This self-study package qualifies for 6.0 CPE clock hours.

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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
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 and the certificate of completion you receive from this self-study activity. Contact us for more information on your state board or organization specific filing requirements.

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

California Psychologists: PESI, Inc. is approved by the California Psychological Association to provide continuing education for psychologists. Provider #PES010. PESI maintains responsibility for this program and its contents. PESI is offering this self-study activity for 6.25 hours of continuing education credit. Full attendance is required; no partial credits will be offered for partial attendance.

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.

Counselors, Social Workers, Psychologists, Psychotherapists, Therapists, Marriage & Family Therapists, Occupational Therapists, Teachers, School Guidance Counselors, Case Managers, School Administrators, Educational Paraprofessionals, Nurses, Other Helping Professionals that work with children