Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden.
J Sleep Res. 2023 Dec;32(6):e14024. doi: 10.1111/jsr.14024. Epub 2023 Aug 23.
Insomnia is common, and causes substantial individual suffering and costs for society. The recommended first-line treatment is cognitive behavioural therapy for insomnia (CBT-I), which is under-used partly due to a lack of trained providers. To train providers is thus important, but what is the current situation regarding CBT-I training? A systematic search of databases was conducted to identify scientific peer-reviewed papers describing CBT-I training with regards to: existing amounts of training, proposed curricula, trainees, delivery context, content of training, modes of delivery, evaluation of the training from a trainee perspective, and effects on patients. This systematic review shows that research on training in CBT-I is an emerging field, with the literature presenting a limited number of papers, with varying objectives. One group of papers investigate the amount of training that exists in a region or educational context and/or propose training curricula; and another group evaluate training initiatives and describe CBT-I training trainees, context, content, modes of delivery, and outcomes on trainees and on treated patients. The studies show that little training is currently provided and proposed curricula vary, and evaluations present promising results: training is feasible in different contexts and modes, digital training may be used to disseminate training efforts at a large scale, trainees' skills increase and positive effects on patients can be seen. To move the field forward, more high-quality studies on CBT-I training are needed, and we propose that training in CBT-I should be targeted towards varying levels of expertise, matching a stepped-care model.
失眠是常见的，会给个人带来巨大的痛苦，并给社会带来巨大的成本。推荐的一线治疗方法是失眠认知行为疗法（CBT-I），但由于缺乏经过培训的提供者，这种方法的应用并不广泛。因此，培训提供者非常重要，但目前 CBT-I 培训的情况如何？我们对数据库进行了系统搜索，以确定描述 CBT-I 培训的科学同行评议论文，内容涉及：现有培训量、拟议课程、学员、交付环境、培训内容、交付方式、从学员角度评估培训以及对患者的影响。这项系统综述表明，CBT-I 培训方面的研究是一个新兴领域，文献仅呈现了数量有限的、目标各异的论文。有一组论文调查了某一地区或教育背景下现有的培训量，以及/或提出培训课程；而另一组论文则评估培训计划，并描述 CBT-I 培训的学员、环境、内容、交付方式，以及对学员和接受治疗的患者的结果。研究表明，目前提供的培训很少，拟议的课程也各不相同，而评估结果则很有前景：培训在不同的环境和模式下是可行的，数字培训可以用来大规模传播培训工作，学员的技能有所提高，并且可以看到对患者的积极影响。为了推动该领域的发展，需要更多关于 CBT-I 培训的高质量研究，我们建议将 CBT-I 培训针对不同水平的专业知识，与阶梯式护理模式相匹配。
