ABSTRACT

Objective: Although behavioral treatments are recommended for treating insomnia disorder, these treatments are not the most commonly provided treatments due to numerous barriers (e.g., treatment length, time limitations). Brief Behavioral Treatment for Insomnia (BBTI) was developed, in part, to help overcome these barriers. The purpose of the current study was to qualitatively examine the treatment experiences of veterans with insomnia disorder participating in BBTI.

Methods: All veterans (n=46) who were randomized to receive BBTI as part of a randomized clinical trial participated in 10-20 minute semi-structured interviews one week after completing treatment. Rapid analysis procedures were used for qualitative analysis.

Results: Thirteen qualitative themes were identified: BBTI provided veterans with the skills they believed they needed to continue improving independently post-treatment; beginning BBTI with in-person sessions was valued; phone sessions helped participation; veterans did not perceive that they could cover the same content during phone and in-person sessionsl; materials could be more portable; BBTI created accountability; BBTI required discipline and willingness; BBTI facilitated buy-in; BBTI was aligned with military culture; loved ones could provide important support; BBTI could be improved with more personalization; BBTI challenged expectations of mental health; and BBTI improved awareness of health behaviors beyond sleep.

Conclusions: BBTI was successful in overcoming barriers to behavioral insomnia treatment and interviews identified critical treatment aspects that should be maintained to preserve acceptability (e.g., in-person session first). Areas in which BBTI did not fully meet the needs of veterans and targets for improvement (e.g., ameliorating understanding and expectations of phone sessions) were also identified.

摘要

目的：虽然行为治疗被推荐用于治疗失眠症，但由于存在许多障碍（例如，治疗长度、时间限制），这些治疗并不是最常用的治疗方法。失眠症的简短行为治疗 (BBTI) 的开发，部分是为了帮助克服这些障碍。本研究的目的是定性检查参与 BBTI 的失眠症退伍军人的治疗经验。

方法：作为随机临床试验的一部分，随机接受 BBTI 的所有退伍军人 (n=46) 在完成治疗一周后参加了 10-20 分钟的半结构化访谈。快速分析程序用于定性分析。

结果：确定了 13 个定性主题：BBTI 为退伍军人提供了他们认为在治疗后继续独立改进所需的技能；以面对面的方式开始 BBTI 很受重视；电话会议有助于参与；退伍军人不认为他们可以在电话和面对面会议期间涵盖相同的内容；材料可以更便携；BBTI 建立问责制；BBTI 需要纪律和意愿；BBTI 促进了买入；BBTI 与军事文化保持一致；亲人可以提供重要的支持；BBTI 可以通过更多的个性化来改进；BBTI 挑战了人们对心理健康的期望；BBTI 提高了人们对睡眠以外的健康行为的认识。

结论： BBTI 成功克服了行为失眠治疗的障碍，并且访谈确定了应保持的关键治疗方面以保持可接受性（例如，首先进行面对面的治疗）。还确定了 BBTI 未能完全满足退伍军人需求和改进目标的领域（例如，提高对电话会议的理解和期望）。