Evidence map›Paper›PMID 40296081›Full record

ArticleBMC psychiatry2025

Applying therapist-guided digital cognitive behavioral therapy for insomnia in psychiatry: a mixed-methods process evaluation.

J E Reesen, F M van de Kamer, A E van Keeken, S L C Ikelaar, P van Oppen, N Batelaan, J Lancee, E J W van Someren, F van Nassau

Abstract read
In one paragraph

Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

J E ReesenDepartment of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands, Academy of Arts and Sciences, Amsterdam, the Netherlands. j.e.reesen@amsterdamumc.nl.
F M van de KamerDepartment of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands, Academy of Arts and Sciences, Amsterdam, the Netherlands.
A E van KeekenDepartment of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands, Academy of Arts and Sciences, Amsterdam, the Netherlands.
S L C IkelaarDepartment of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands, Academy of Arts and Sciences, Amsterdam, the Netherlands.
P van OppenDepartment of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
N BatelaanDepartment of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
J LanceeDepartment of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
E J W van SomerenDepartment of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands, Academy of Arts and Sciences, Amsterdam, the Netherlands.
F van NassauDepartment of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands.

Funding

Health~Holland LSHM19118-HSGFHersenstichting DR-2019-00322Hersenstichting DR-2019-00345Wellcome TrustWellcome Trust UNS144029ZonMw Leefstijlgeneeskunde 555003203ZonMw Open Competition 09120011910032
6 · The paper itself

Abstract

introductionInsomnia is prevalent, particularly among individuals with mental health complaints. However, Cognitive Behavioral Therapy for Insomnia (CBT-I), the first-line treatment, is underutilized in care settings. This study evaluated a therapist-guided digital CBT-I (i-Sleep), gathering insights from participants and therapists to optimize the intervention and inform implementation strategies.

methodsA mixed-methods process evaluation, guided by the RE-AIM framework, was conducted alongside an effectiveness trial. Data were collected from i-Sleep participants with clinically relevant insomnia and various mental health complaints across all care levels, ranging from pre-clinical (unattended), to those referred to general or specialized care. Additionally, data were collected from i-Sleep therapists.

resultsA total of 181 i-Sleep participants (mean age = 46.7 years, SD = 13.2) enrolled, with an attrition rate of 21.6%. Participants reported benefits including faster sleep onset, fewer nighttime awakenings, increased daytime energy, and positive lifestyle changes, though some experienced minimal gains or adverse effects. Satisfaction with the intervention ranged from 7.1 to 7.3 across care levels. Post-intervention, 89.4% of all participants indicated they would recommend iCBT-I. Satisfaction with therapist guidance was high (M = 7.7-8.3), though preferences for format and frequency varied. Therapists (n = 15, mean experience = 0.8 years, SD = 1.1) suggested addressing practical constraints and enhancing training for better integration into routine care.

conclusionOur findings highlight the feasibility and potential of therapist-guided iCBT-I to improve sleep in individuals with mental health complaints across all care settings. Universal implementation could offer significant benefits, while adaptable content and flexible guidance may better meet individual needs.

trial registrationNetherlands Trial Register (NL9776) registered on 07/10/2021.

Indexed as

Cognitive Behavioral TherapySleep Initiation and Maintenance DisordersAdultFemaleHumansMaleMiddle AgedTreatment OutcomeCBT-IHybrid type 2InsomniaProcess evaluation

Identifiers

PMID40296081
PMCPMC12039299

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.