A feasibility study of a two-session home-based cognitive behavioral therapy-insomnia intervention for bereaved family caregivers
Abstract
OBJECTIVE: In 2008 over two million family caregivers will become bereaved. The vast majority of these caregivers have provided 'round-the-clock care for a period ranging from months to years. Bereaved family caregivers report insomnia symptoms that persist beyond 1 year, longer than what is seen in bereaved noncaregivers, placing them at increased risk of depression and complicated grief. Despite some rewarding elements, caregiving is a stressful and exhausting role that often requires the caregiver to restructure his or her life around the needs of the patient. Once the patient dies, the structure is lost. Cognitive behavioral therapy interventions are effective in providing structure. This pilot study explored the feasibility of a two-session home-based cognitive behavioral therapy-insomnia (CBT-I) intervention for bereaved family caregivers. METHOD: A 5-week longitudinal descriptive study design was used with 11 adult primary family caregivers of patients who died from cancer. A master's prepared nurse delivered two CBT-I intervention sessions in participant homes. Data collection sessions occurred at baseline, 3, and 5 weeks. A debriefing session was held at Week 6. RESULTS: Participant evaluations of the intervention indicated that it was feasible and acceptable (e.g., 100% would recommend it to others); objective data further supported its feasibility (e.g., 100% completed the trial). In addition, when comparing baseline with Weeks 3 and 5, participants demonstrated improvement in insomnia and depressive symptoms. SIGNIFICANCE OF RESULTS: The results of this pilot study suggest that the intervention is feasible and acceptable and produces promising effects on insomnia and depressive symptoms in bereaved family caregivers.
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Preliminary results of that pilot study indicated improved sleep and reduced levels of distress, but the absence of a control group limits interpretation.
“Preliminary results indicated improved sleep and reduced levels of distress, but the absence of a control group limits the interpretation of the results and more rigorous research is needed in bereaved individuals examining the effect of cognitive behavioral therapy for insomnia (CBT-i).”
From Feasibility and preliminary efficacy of guided internet-delivered cognitive behavioral therapy for insomnia after the loss of a child to cancer: Randomized controlled trial (2021) · cites this paper as Carter et al., 2009
Only one pilot study has evaluated feasibility and preliminary efficacy of an insomnia treatment in cancer-bereaved caregivers.
“Despite insomnia being common in bereaved individuals, only one pilot study (Carter et al., 2009) has evaluated feasibility and preliminary efficacy of an insomnia treatment – a brief two-session home based cognitive behavioral therapy (CBT) – in cancer-bereaved caregivers.”
From Feasibility and preliminary efficacy of guided internet-delivered cognitive behavioral therapy for insomnia after the loss of a child to cancer: Randomized controlled trial (2021) · cites this paper as Carter et al., 2009
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- Authors
- Carter, P. A., Mikan, S. Q., & Simpson, C.
- Affiliations
- The University of Texas at Austin (US)
- Corresponding author
- Carter, Patricia A.
- Venue
- Palliative and Supportive Care
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-06
- Volume
- 7
- Issue
- 2
- Pages
- 197-206
- ISSN
- 1478-9515 (ISSN-L)
- 1478-9523
- OpenAlex
- W2085671990
- Cited by
- 31
- References
- 25
- Citations by year
- 2026: 1 · 2025: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 3 · 2013: 4 · 2012: 1
- FWCI
- 2.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Palliative & Supportive Care (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute of Mental Health (R21MH067600)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- insomnia, cognitive behavioral therapy for insomnia, home-based intervention, caregiver depression, complicated grief, cancer bereavement, feasibility, nurse-led intervention, brief intervention
- MeSH terms
- Adaptation, Psychological, Bereavement, Depression, Feasibility Studies, Female, Home Care Services, Humans, Sleep Initiation and Maintenance Disorders, Longitudinal Studies, Male, Middle Aged, Pilot Projects, Social Support, Cognitive Behavioral Therapy, Caregivers
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