The client sleeps four or five hours a night, has for years, and mentions it at intake the way people mention the weather. You note it. Then you get on with the anxiety, or the depression, or the trauma work, because that is what they came for and that is what you were trained to treat.
Twenty sessions later the anxiety has moved a little. The sleep hasn’t moved at all. And a fair amount of what you are working on each week (the irritability, the flat mornings, the racing mind at 2 a.m., the sense that nothing is getting easier) is downstream of the thing you noted at intake and worked around.
Why sleep gets worked around
Most clinicians were never trained to treat sleep directly. Insomnia sat in a sleep-medicine box, and what filtered into general practice was a handout: no screens, no caffeine after noon, keep the bedroom cool. Sleep hygiene is reasonable advice. It is not treatment, and most clients with chronic insomnia have already tried all of it.
So the sleep problem stays in the chart as a symptom of something else, and the therapy proceeds as if it will resolve once the “real” condition does. Sometimes it does. Often it doesn’t, and the insomnia keeps feeding the condition it was supposed to be a symptom of.
What changes when you treat it directly
Cognitive behavioural therapy for insomnia (CBT-I) is a structured, short treatment that works on the mechanics of sleep: sleep drive, circadian timing, and the conditioned arousal that makes a bed feel like a place where sleep doesn’t happen. A clinician who can run it, or the briefer BBTI version, has something to offer in the first month rather than a referral to a waitlist.
The interesting clinical question is not whether CBT-I works on its own. It is how it fits inside the therapy you are already doing. What do you do with a trauma client whose nightmares make sleep the thing they are avoiding? A client with chronic pain whose sleep schedule is organized around the pain? A client on rotating shifts whose “insomnia” is partly a schedule that no protocol was written for? A client who panics on waking, or who can’t tolerate the CPAP mask their sleep clinic prescribed?
Those are the presentations you actually see, and they are the focus of Dr. Colleen Carney’s two-day workshop in Toronto this November.
Integrating Sleep Treatment into Mental Health Care
Dr. Colleen Carney, PhD, CPsych, is one of Canada’s leading experts in psychological treatments for insomnia and the Director of the Sleep and Depression Laboratory at Toronto Metropolitan University. She has more than 200 publications and a long record of clinical workshops with a reputation for being practical rather than theoretical.
The workshop is built for clinicians who are not sleep specialists and don’t intend to become one. It starts with assessment in a general clinical setting, moves through the core treatment, and spends the second day on the complex cases: sleep alongside trauma, anxiety, depression, chronic pain, nightmares, nocturnal panic, sleep apnea treatment, and shift work.
Day 1 — Thursday, November 12
- Introduction and sleep assessment
- Case formulation
- Brief Behavioural Therapy for Insomnia (BBTI)
- Night and rotating-shift insomnia
Day 2 — Friday, November 13
- Review, and integrating cognitive therapy
- Sleep and anxiety, nightmares, sleep apnea
- Integrating CBT-I into complex cases
- Adapting sleep treatment to unusual presentations
What you’ll walk away able to do
The stated learning objectives, in the workshop’s own words:
- Assess for sleep problems within a non-sleep specialty clinical setting
- Describe the three ingredients for healthy sleep and explain how they apply to insomnia and other sleep disorders
- Collaborate with clients to develop a sleep schedule that addresses sleep drive and circadian rhythm concerns
- Integrate conditioned arousal strategies into individualized sleep treatment plans
- Apply Brief Behavioural Therapy for Insomnia (BBTI) with clients experiencing irregular sleep-wake patterns
- Design behavioural experiments to evaluate and modify unhelpful sleep-related beliefs
- Describe the components of cognitive behavioural treatment for nocturnal panic
- Develop exposure hierarchies for clients experiencing claustrophobic responses to sleep apnea treatment
- Describe the principles and steps of Imagery Rescripting and Rehearsal Therapy for nightmare disorder
- Use case formulation to integrate CBT-I into the treatment of anxiety, chronic pain, depression, and trauma
- Adapt sleep treatment strategies to meet the needs of clients with unique clinical presentations
Why in person
This is one of the few Leading Edge events this season that happens in a room rather than on a screen. Two full days at Tartu College in Toronto, with the presenter, the whiteboard, and other clinicians working through the same cases. If you have been meaning to add sleep treatment to your practice and never got around to it on a webinar, two days in the room is a different kind of commitment.
Related: Beyond CBT-I: Treating the Sleep Problems Hiding Inside Every Diagnosis.
Workshop details
📅 November 12–13, 2026 · Thursday and Friday, 9:00 am – 4:45 pm each day
📍 In person · Tartu College Event Space, 3 Madison Ave, Toronto
🎓 12 CE hours of direct contact, with a Certificate of Participation
💲 $449 CAD early bird until October 13, then $499 · USD available at checkout
👩⚕️ For psychologists, social workers, psychotherapists, counsellors, physicians, nurse practitioners, occupational therapists, and graduate students in accredited programs
Seats for in-person workshops are limited by the room.
Register for Integrating Sleep Treatment into Mental Health Care →