Patient Perceptions of Treatment Delivery Platforms for Cognitive Behavioral Therapy for Insomnia.
Stepped care has given rise to the proliferation of abbreviated CBT-I programs and delivery formats. This includes interventions delivered by allied health professionals and those delivered electronically through the Internet. This article aims to explore patient perceptions between electronic and face-to-face (FTF) delivery platforms for (abbreviated) CBT-I.



Patients with insomnia from specialist sleep or psychology clinics and those from the general community in Sydney, Australia.



Semistructured interviews were conducted with patients with insomnia, guided by a schedule of questions and a choice task to explore patient perceptions of the different CBT-I treatment delivery platforms (e.g., perceived advantages and disadvantages or willingness to engage with either platform). Interviews were transcribed verbatim and analyzed using Framework Analysis. Participants also completed a battery of clinical mood and insomnia measures.



Fifty-one interviews were conducted with patients with insomnia from specialist sleep or psychology clinics (n = 22) and the general community (n = 29). Synthesis of the qualitative data set revealed three themes pertinent to the patients' perspective toward electronic and FTF CBT-I delivery: Concepts of Efficacy, Concerns About Treatment, and Treatment on My Terms. Participants' choice to engage with either platform was also informed by diverse factors including perceived efficacy of treatment, personal commitments, lifestyle, and beliefs about sleep and insomnia.



Clarifying patient treatment priorities and allaying potential concerns about engaging with an electronic treatment platform represent important steps for disseminating eCBT-I into mainstream practice.
a Faculty of Pharmacy , University of Sydney , Sydney, Australia.|b CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney , Sydney , Australia.
Janet M Y
JMY
Cheung
b CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney , Sydney , Australia.
Delwyn J
DJ
Bartlett
c Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney , Sydney , Australia.|d Sydney Local Health District , New South Wales Health, Sydney , Australia.
Carol L
CL
Armour
e The George Institute for Global Health, University of Sydney , Sydney , Australia.
Tracey-Lea
TL
Laba
a Faculty of Pharmacy , University of Sydney , Sydney, Australia.|b CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney , Sydney , Australia.
Bandana
B
Saini
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception; D007319:Sleep Initiation and Maintenance Disorders / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome