Sleep disruption is highly common in the United States and this difficulty can have a powerful effect on our well-being. We are currently aware of numerous behaviors, termed sleep hygiene factors, which are shown to disturb sleep. What is unclear is the extent to which these behaviors are problematic in the community. To answer this question we used a nationwide internet-based sample, and asked good and poor sleepers how frequently they performed these sleep-related behaviors. Although sleep hygiene behaviors were generally good, individuals reporting an uncomfortable nighttime temperature and those sleeping in a noisy environment were more than twice as likely to report poor sleep. Poor sleepers were also significantly more likely to engage in activating or arousing behaviors near bedtime. In particular, poor sleepers were prone to 'worry, plan, or think about important matters' in the bed. This investigation did not find increased usage of nighttime caffeine, alcohol or nicotine among poor sleepers.

Gellis, L.A., & Lichstein, K.L. (2009). Sleep hygiene practices of good of good and poor sleepers in the United States : An Internet-based study. Behavior Therapy, 40, 1-9.

Exposure therapy helps to reduce behavioral avoidance that strengthens anxiety symptoms through systematic contact with a feared situation, object, thought, or memory. Although this treatment is very effective for many disorders, few therapists use it. This is partially due to concerns that exposure therapy is ‘cruel’ and unethical. However, a review of the literature suggests that exposure therapy is safe, tolerable, and even preferred by many patients. Despite such attributes, exposure therapy may place patients at greater risk than other forms of psychotherapy. Therefore, exposure therapy must be conducted by a competent clinician. Among other things, competency requires a comprehensive evaluation of whether the risk associated with exposure is acceptable. Acceptable risks of doing exposure may require some traditional therapy boundaries to be crossed but not violated. For example, exposure therapy may require sessions that are conducted outside of the office, but only if this is in the patient’s best interest. Consideration of this and other ethical concerns will allow for a safe context in which exposure therapy can be successfully utilized.

Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cognitive and Behavioral Practice, 16, 172-180.

Benzodiazepines (BZs) are often used for the treatment of anxiety disorders and many clients presenting for Cognitive Behavioral Therapy (CBT) are already using them. Research suggests several good reasons for clients to consider discontinuation, including dampening benefit from CBT for anxiety, and the preference of many clients for nonmedical strategies for managing anxiety. Most clients require assistance in successfully discontinuing BZs, and this paper offers a brief step-by-step self-help handout for doing so. The handout helps clients decide whether they are ready to attempt BZ discontinuation, helps them plan the discontinuation effort, and suggests specific coping strategies for dealing with common discontinuation symptoms, including how to manage typical thoughts surrounding BZ discontinuation. The handout is especially useful after the client has experienced some success in reducing anxiety with CBT. The clinical use of the handout is discussed and suggestions offered for integrating it effectively into CBT for anxiety.

Ahmed, M., Westra, H.A., & Stewart, S.H. (2008). A self-help handout for benzodiazepine discontinuation using cognitive behavioral therapy. Cognitive and Behavioral Practice, 15, 317-324.

Once a drug has been approved by the Federal Drug Administration (FDA) as a result of clinical trials, practitioners have the opportunity to offer feedback to the FDA on any shortcomings in the use of the drug in clinical practice. The Society of Clinical Psychology, Division 12 of the American Psychological Association, is in the process of establishing a mechanism whereby practicing psychotherapists can report their clinical experiences using empirically supported treatments (ESTs).

This is not only an opportunity for clinicians to share their experiences with other therapists, but also can offer information that can encourage researchers to investigate ways of overcoming these limitations. We are starting with the treatment of panic disorder, but will extend our efforts to the treatment of other problems at a later time.

Our Web site provides the opportunity for therapists using cognitive-behavior therapy (CBT) in treating panic to share their clinical experiences about those variables they have found to limit the successful reduction of symptomotology. Although research is underway to determine if other therapies can successfully treat panic, CBT is the only approach at present that is an EST. However, in order for the field to move from an EST to an evidence-based treatment that works well in practice settings, we need to know more about the clinical experience of therapists who make use of these interventions in actual clinical practice. By identifying the obstacles to successful treatment, we can then take steps to overcome these shortcomings.

Your responses, which will be anonymous, will be tallied with those of other therapists and posted on the Division 12 Web site at a later time. The results of the feedback we receive from clinicians will be provided to researchers, in the hope they can investigate ways of overcoming these obstacles.

The survey, which should take 10 minutes, can be found at:
www.div12.org/panic

Register now for early-bird discount.

Boston University housing and workshop tickets will be on-line soon.

https://www.yesevents.com/wcbct