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MEMORANDUM

Introduction

The participant that I interviewed for the Single-System Evaluation research paper is a 26-year-old female; who is also my colleague from the Rutgers School of Social Work program. The participant has identified insomnia as her targeted problem behavior ever since she started graduate school at Rutgers University on September 1, 2017. The participant struggles because she has anxiety about completing her school work on time, getting up early for her field internship, and dealing with her own personal barriers. The participant wants to improve her overall well-being by getting more hours of sleep throughout the night. Her symptoms include fatigue, closing her eyes frequently, and paying attention less in her social work classes (Seow, 2018). The participant will be utilizing a log to record her hours of sleep from Monday through Friday; she will report her results every morning. I will be observing her through self-report and communication through cell phone daily beginning at 12:30pm.  The participant has committed to a three-week study from October 8^th to October 26^th2018 to decrease her anxiety and increase her hours of sleeping at night by utilizing Cognitive Behavioral Therapy intervention.

Intervention and rationale

The subject will be seeing the mental health Dr from agency for therapy on Mondays and Wednesday from 4:30-5:30pm after her field internship. Cognitive behavioral therapy is an intervention that focuses on changing the subject’s mental health (Jones, 2012). In a previous study, CBT has worked more effectively than using medication for an intervention (Cunningham, 2018). CBT helps the subject process their negative thoughts and turn them into more positive thinking, increases the subject’s self-confidence, and it teaches the subject how to advocate for themselves (Cunningham, 2018). CBT improves the subjects sleeping pattern, controls their dreams, and how they function throughout the day (Cunningham, 2018). According to Cognitive Behavioral Therapy for Insomnia (Cunningham, 2018) to treat depression: A systematic review, “African Americans, ages of 30-59 years-old experience insomnia the most; Caucasians experience insomnia more than other races throughout their whole lifetime” (Cunningham, 2018). The prevalence rates for Insomnia are 16.4% to 28.3 % Caucasians, 15.3% to 23.7% African Americans, and 13.4 to 17.1% Hispanic (Cunningham, 2018). Women experience insomnia more than men from teenage years to adulthood (Cunningham, 2018). In a DSM-5 Insomnia disorder study, Insomnia was mostly prevalent in young adults from the ages 21 to 31 years-old (Seow, 2018). However, 12.5% out of 400 people stated that they received some type of treatment and cognitive behavioral therapy (Seow, 2018).

I noticed in the readings that people with insomnia rarely report their difficulties to the doctor because they were ignoring their barriers and never contacted any therapist or psychoeducational professional about it. I found that my results from the single subject research and my literature review correlate with each other because in the CBT article, it stated that young adults of 21-31 are at high risk for insomnia (Seow, 2018). The subject of the study is a young adult, female of Caucasian descent, and her demographics tie into the prevalence rates of insomnia.

Discussion and Conclusion

This Single Subject Evaluation Research Paper was accurate within the literature review and within my results. Cognitive behavioral therapy is effective because the study has been tested every year since 1993 and the results were proven that CBT helps people improve their mental health and social functioning (Anderson, 2018). According to Cognitive Behavioral Therapy for Insomnia (Cunningham, 2018) to treat depression: A systematic review, CBT is most effective for middle aged adults. (Cunningham, 2018). In addition, insomnia affects populations of major depressive disorder, anxiety disorder, medication users, people that are unemployed, and cancer patients (Seow, 2018). Another intervention would be to seek psychotherapy from a clinician or to get prescribed for medication by a medical doctor. As a result, Rachel would use the intervention again as a coping skill to help improve her barriers. In addition, no one is exempt from having symptoms of insomnia such as having anxiety, depression, and severe pain.

Results

The results were shown in Appendix 1. The A-baseline results from Week 1:October 8^th to October 12^th, were that Rachel sleeps on Monday for six hours, Tuesday for six hours, Wednesday for three hours, Thursday for five hours, and Friday for three hours. The

B-intervention results from Week 2: October 15^th to October 19^th, were Monday for seven hours, Tuesday for seven hours, Wednesday for four hours, Thursday six for hours., and Friday for four hours. The A-follow up results from Week 3: October 22^nd to October 26^th, were that Rachel’s results were Monday for 7 hours, Tuesday for seven hours, Wednesday for seven hours, Thursday for seven hours, and Friday for seven hours. Rachel’s insomnia decreased within the three weeks with her receiving cognitive behavioral therapy from her Mental health clinician twice a week on Mondays and Wednesday at 4:30pm. The B-intervention changed the A-baseline when it was implemented on Monday, October 15^th, 2018. On October 15th, the follow up increased by one hour after the intervention was implemented. The A-follow up indicated that Rachel went back to her normal sleeping pattern of seven hours during Monday through Friday after the intervention had been enacted. The cognitive behavioral therapy helped Rachel with relieving her stress, anxiety about school, having more positive thoughts, and increased moments of sleep. During Week 2, Rachel stated that she was able to express her feelings to the therapist, she felt comfortable around her therapist, and the therapist worked on a goal-setting plan on how she can decrease her anxiety on October 19th to increase her hours of sleep. The therapist helped her with her coping skills by acknowledging her, validating her emotions, and asked Rachel well-developed open-ended questions to assess her needs.

Appendix 1

Chart 1: Utilizing CBT Interventions on Insomnia

Appendix 2

Investigator:

I have been asked to participate in a single-system evaluation study to assess the successfulness of cognitive behavioral therapy as a treatment for insomnia.

Purpose:

I understand that the purpose of this study is to assess the successfulness of cognitive behavioral therapy as a treatment for insomnia.

Duration and Location:

I understand that this study will be managed for a time-frame of three weeks and I will be communicating with the investigator through telephone from Monday through Friday at 12:30pm. In addition, I will be meeting with the investigator in class every Wednesday at 12:30pm and communicating with her.

Procedures:

I understand that participation in this study I will be self-reporting and will be recording my hours of sleep from Monday through Friday for three weeks. I’ll record the dates, my thoughts and feelings; time in my writing log.

Risks/Discomforts:

I understand that my personal information will not be self-disclosed, and I will not experience any risks or discomforts.

Benefits:

I understand that participate in this study will help Rachel with her with improving her issues with insomnia.

Confidentiality:

I understand that my right will be protected, and all my personal information will remain confidential.

Payments:

I understand that I would not be getting paid for the single-subject evaluation study.

Rights to Withdraw:

I understand that my participation in the study is optional and I can withdrawal from the single-subject evaluation study and any voluntary services that I sign up for will not be deceased.

Signatures:

I have reviewed this consent form and I know that my rights are protected as a research participant. I give you consent for me to be a participant in this Single-Subject Evaluation study.

References

• Anderson, K. (2018). Insomnia and cognitive behavioural therapy—how to assess your patient and why it should be a standard part of care (Vol. 1, US National Library of Medicine National Institutes of Health) [US National Library of Medicine National Institutes of Health]. Retrieved January 10, 2018, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC5803038/.
• Bohra, M. (2013). Is cognitive behavioural therapy for insomnia effective in treating insomnia and pain in individuals with chronic non-malignant pain? (Vol. 1, US National Library of Medicine National Institutes of Health) [NCBI]. Retrieved August 7, 2013, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC4590137/.
• Cunningham, J. E. (2018). Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review (Vol. 106, Elsevier) [Science Direct]. Science Direct. Retrieved March 1, 2018, from //www-sciencedirect-com.proxy.libraries.rutgers.edu/science/article/pii/S0022399917308486.
• Dragioti, E. (2017). Insomnia severity and its relationship with demographics, pain features, anxiety, and depression in older adults with and without pain: Cross-sectional population-based results from the PainS65 cohort. Insomnia Severity and Its Relationship with Demographics, Pain Features, Anxiety, and Depression in Older Adults with and without Pain: Cross-sectional Population-based Results from the PainS65 Cohort, 1-18. Retrieved February 23, 2017, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC5324239/.
• Gaudiano, B. (2011). Cognitive-Behavioral Therapies: Achievements and Challenges (US Library of Medicine National Institutes of Health). NCBI. Retrieved February, 2011, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC3673298/.
• Jones, C. (2012). Cognitive behavioural therapy versus other psychosocial treatments for schizophrenia (Vol. 1, US National Library of Medicine National Institutes of Health) [US National Library of Medicine National Institutes of Health]. Retrieved April 18, 2018, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC4163968/.
• Seow, L. (2018). Evaluating DSM-5 Insomnia Disorder and the Treatment of Sleep Problems in a Psychiatric Population (Vol. 1, U.S. National Library of Medicine National Institutes of Health). Retrieved February 15, 2018, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC5786843/.
• Williams, J. (2013). Cognitive Behavioral Treatment (Vol. 1, Chest). Chest. Retrieved February, 2013, from //www.ncbi.nlm.nih.gov/pmc/articles/PMC4694188/.