title: Long-Term Effects of Two Formats of Cognitive Behavioral Therapy for Insomnia Comorbid with Breast Cancer.
abstract: OBJECTIVE
  The goal of this randomized controlled trial, conducted in breast cancer patients, was to assess the long-term efficacy of a video-based cognitive behavioral therapy for insomnia (VCBT-I), as compared to a professionally administered intervention (PCBT-I) and to a no-treatment group (CTL). An earlier report revealed that, at posttreatment, VCBT-I patients showed significantly greater sleep improvements than CTL, but that PCBT-I produced superior effects than VCBT-I on some sleep and secondary outcomes. In this report, long-term effects are compared.
  
  
  METHODS
  Two hundred forty-two women with breast cancer and with insomnia symptoms or using hypnotic medications participated to this three-arm randomized controlled trial: (1) PCBT-I (n = 81); (2) VCBT-I (n = 80); or (3) no treatment (CTL; n = 81) group. PCBT-I was composed of six weekly, individual sessions of approximately 50 min, whereas VCBT-I comprised a 60-min animated video and six booklets.
  
  
  RESULTS
  Study measures (sleep and secondary variables) were administered at pretreatment and posttreatment, and at a 3-, 6-, and 12-mo follow-up. Treatment gains were well sustained at follow-up in both PCBT-I and VCBT-I. As at posttreatment, the remission rate of insomnia at follow-up was greater in PCBT-I than in VCBT-I, which was greater than in CTL.
  
  
  CONCLUSIONS
  Although face-to-face therapy remains the optimal format to efficaciously administer CBT for insomnia in cancer patients, a minimal intervention, such as the video-based intervention tested in this study, produces significant and sustainable treatment effects.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier NCT00674830.
authors.affiliation: School of Psychology, Université Laval, Québec, Québec, Canada.|CHU de Québec-Université Laval Research Center, Québec, Québec, Canada.|Université Laval Cancer Research Center, Québec, Québec, Canada.
authors.forename: Josée
authors.initials: J
authors.lastname: Savard
authors.affiliation: School of Psychology, Université Laval, Québec, Québec, Canada.|CHU de Québec-Université Laval Research Center, Québec, Québec, Canada.|Université Laval Cancer Research Center, Québec, Québec, Canada.
authors.forename: Hans
authors.initials: H
authors.lastname: Ivers
authors.affiliation: CHU de Québec-Université Laval Research Center, Québec, Québec, Canada.|Université Laval Cancer Research Center, Québec, Québec, Canada.
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Savard
authors.affiliation: School of Psychology, Université Laval, Québec, Québec, Canada.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Morin
mesh_terms: D001943:Breast Neoplasms / Q000150:complications*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D010174:Pamphlets; D012890:Sleep; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D014743:Videotape Recording
keywords: cognitive behavioral therapy; insomnia; long-term effects; minimal intervention; self-help