Limits...
Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders.

Babson KA, Ramo DE, Baldini L, Vandrey R, Bonn-Miller MO - JMIR Res Protoc (2015)

Bottom Line: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future.The mood app was rated as not helpful, and there was low likelihood of future participation.This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, United States. kimberly.babson@gmail.com.

ABSTRACT

Background: Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention.

Objective: This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone-delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt.

Methods: Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually.

Results: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation.

Conclusions: This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.

No MeSH data available.


Related in: MedlinePlus

Example screenshots from CBT-i Coach.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4527004&req=5

figure1: Example screenshots from CBT-i Coach.

Mentions: Cognitive behavioral therapy for insomnia (CBT-I) was administered via the CBT-I Coach mobile app for iOS [39]. The content of CBT-I coach mirrors that provided by traditional CBT-I and includes four main interactive content areas: “My Sleep”, “Tools”, “Learn”, and “Reminders”. “My Sleep” provides individualized tracking of sleep and sleep prescriptions for sleep restriction (see Figure 1). Here, individuals can complete sleep diaries, update and track sleep prescriptions, complete sleep assessments to determine patterns in sleep disruption, and obtain individualized suggestions for improving sleep. Guidelines for sleep restriction and determining the prescribed sleep and rise times were completed during the baseline session with study staff. Sleep and rise times were then entered into the CBT-I Coach, which created alarms and reminders as well as tracking wake and rise times for compliance to the sleep restriction prescription. The “Tools” section provides (1) psycho-education consistent with CBT-I strategies and framework including sleep hygiene tips and stimulus control instructions, (2) guided relaxation tools that can be used in the moment to assist in treatment outcomes (eg, guided relaxation, guided worry time, cognitive restructuring exercises), and (3) individualized recommendations for relapse prevention. The “Reminders” section includes menus to customize and set reminders to (1) complete assessments, (2) set alarms for prescription bed and rise times, and (3) begin wind-down time. Finally, the “Learn” section includes psycho-education on stages of sleep, why we sleep, additional sleep disorders, and treatment including CBT-I. A glossary of terms is also provided as well as recommended good sleep habits. Participants randomized to this condition were provided with an iPod touch with CBT-I coach for the duration of the study.


Mobile App-Delivered Cognitive Behavioral Therapy for Insomnia: Feasibility and Initial Efficacy Among Veterans With Cannabis Use Disorders.

Babson KA, Ramo DE, Baldini L, Vandrey R, Bonn-Miller MO - JMIR Res Protoc (2015)

Example screenshots from CBT-i Coach.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4527004&req=5

figure1: Example screenshots from CBT-i Coach.
Mentions: Cognitive behavioral therapy for insomnia (CBT-I) was administered via the CBT-I Coach mobile app for iOS [39]. The content of CBT-I coach mirrors that provided by traditional CBT-I and includes four main interactive content areas: “My Sleep”, “Tools”, “Learn”, and “Reminders”. “My Sleep” provides individualized tracking of sleep and sleep prescriptions for sleep restriction (see Figure 1). Here, individuals can complete sleep diaries, update and track sleep prescriptions, complete sleep assessments to determine patterns in sleep disruption, and obtain individualized suggestions for improving sleep. Guidelines for sleep restriction and determining the prescribed sleep and rise times were completed during the baseline session with study staff. Sleep and rise times were then entered into the CBT-I Coach, which created alarms and reminders as well as tracking wake and rise times for compliance to the sleep restriction prescription. The “Tools” section provides (1) psycho-education consistent with CBT-I strategies and framework including sleep hygiene tips and stimulus control instructions, (2) guided relaxation tools that can be used in the moment to assist in treatment outcomes (eg, guided relaxation, guided worry time, cognitive restructuring exercises), and (3) individualized recommendations for relapse prevention. The “Reminders” section includes menus to customize and set reminders to (1) complete assessments, (2) set alarms for prescription bed and rise times, and (3) begin wind-down time. Finally, the “Learn” section includes psycho-education on stages of sleep, why we sleep, additional sleep disorders, and treatment including CBT-I. A glossary of terms is also provided as well as recommended good sleep habits. Participants randomized to this condition were provided with an iPod touch with CBT-I coach for the duration of the study.

Bottom Line: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future.The mood app was rated as not helpful, and there was low likelihood of future participation.This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, United States. kimberly.babson@gmail.com.

ABSTRACT

Background: Cannabis is the most frequently used illicit substance in the United States resulting in high rates of cannabis use disorders. Current treatments for cannabis use are often met with high rates of lapse/relapse, tied to (1) behavioral health factors that impact cannabis use such as poor sleep, and (2) access, stigma, supply, and cost of receiving a substance use intervention.

Objective: This pilot study examined the feasibility, usability, and changes in cannabis use and sleep difficulties following mobile phone-delivered Cognitive Behavioral Therapy for Insomnia (CBT-I) in the context of a cannabis cessation attempt.

Methods: Four male veterans with DSM-5 cannabis use disorder and sleep problems were randomized to receive a 2-week intervention: CBT-I Coach mobile app (n=2) or a placebo control (mood-tracking app) (n=2). Cannabis and sleep measures were assessed pre- and post-treatment. Participants also reported use and helpfulness of each app. Changes in sleep and cannabis use were evaluated for each participant individually.

Results: Both participants receiving CBT-I used the app daily over 2 weeks and found the app user-friendly, helpful, and would use it in the future. In addition, they reported decreased cannabis use and improved sleep efficiency; one also reported increased sleep quality. In contrast, one participant in the control group dropped out of the study, and the other used the app minimally and reported increased sleep quality but also increased cannabis use. The mood app was rated as not helpful, and there was low likelihood of future participation.

Conclusions: This pilot study examined the feasibility and initial patient acceptance of mobile phone delivery of CBT-I for cannabis dependence. Positive ratings of the app and preliminary reports of reductions in cannabis use and improvements in sleep are both encouraging and support additional evaluation of this intervention.

No MeSH data available.


Related in: MedlinePlus