Insomnia Counselling in Vancouver — CBT for Insomnia and Sleep Problems - Dr. Samuel

Notice: For general interest only; may contain inaccuracies. Not a diagnosis, treatment, prognosis, or professional, clinical, or legal advice. Reading this creates no counsellor-client relationship. By reading this page, you agree to these terms. Full disclaimer. In an emergency, call 911.

Insomnia counselling in Vancouver using the treatment the sleep-medicine guidelines recommend first

Talk to Samuel directly. No receptionist, no intake forms. Call 604-721-0604 · Text what is going on · Book a free 20-minute call. In-person in downtown Vancouver or by video across BC; evenings available.

Chronic insomnia has a first-line treatment, and it is not a pill or a sleep-hygiene handout

The American Academy of Sleep Medicine’s clinical practice guideline is unambiguous: “We recommend that clinicians use multicomponent cognitive behavioral therapy for insomnia for the treatment of chronic insomnia disorder in adults. (STRONG)” (Edinger et al., 2021, p. 255). The same guideline advises against the most common advice people are given: “We suggest that clinicians not use sleep hygiene as a single-component therapy for the treatment of chronic insomnia disorder in adults. (CONDITIONAL)” (Edinger et al., 2021, p. 255).

Cognitive behavioral treatment for insomnia (CBTI) is currently considered to be the preferred treatment” (van Straten et al., 2018, p. 3).

What insomnia counselling in Vancouver looks like here

Session one. A two-week sleep diary, a review of what is keeping the insomnia going (bed-time worry, irregular hours, napping, alcohol, shift work, pain, a partner’s snoring), and a check for depression, anxiety or trauma, which often travel with poor sleep.

The method. CBT for insomnia (CBT-I) combines sleep restriction, stimulus control, cognitive work on the fear of not sleeping, and relaxation. A meta-analysis of 87 randomized trials found “significant effects on: insomnia severity index (g = 0.98), sleep efficiency (g = 0.71), Pittsburgh sleep quality index (g = 0.65), wake after sleep onset (g = 0.63) and sleep onset latency (SOL; g = 0.57)” (van Straten et al., 2018, p. 3). Neurofeedback is available as an adjunct for people whose arousal stays high at night.

What works best. Face-to-face treatment over several sessions outperformed shorter and self-help versions: “Face-to-face treatments of at least four sessions seem to be more effective than self-help interventions or face-to-face interventions with fewer sessions” (van Straten et al., 2018, p. 3). Results were “quite robust (similar for patients with or without comorbid disease, younger or older patients, using or not using sleep medication)” (van Straten et al., 2018, p. 3).

Common reasons people come

Lying awake for an hour or more; waking at 3 a.m. and staying awake; dreading bedtime; years of sleeping pills with diminishing returns; insomnia after a concussion or crash (ICBC-funded sessions are available on the ICBC counselling page); sleep wrecked by shift work, grief, anxiety or depression.

Your insomnia counsellor

Samuel Ezzatilord, PhD, RCC, CCC, LMCC, is a Registered Clinical Counsellor (BCACC #23405) with more than 25 years of clinical experience and a doctorate in health sciences, so the physiology of sleep and the effect of medications are part of the plan. He does not prescribe; if you are on sleep medication, tapering decisions stay with your physician.

Frequently asked questions

What is the recommended treatment for chronic insomnia?

Multicomponent CBT for insomnia. The American Academy of Sleep Medicine gives it its only STRONG recommendation: “We recommend that clinicians use multicomponent cognitive behavioral therapy for insomnia for the treatment of chronic insomnia disorder in adults” (Edinger et al., 2021, p. 255).

Isn’t sleep hygiene enough?

Not on its own. The guideline states: “We suggest that clinicians not use sleep hygiene as a single-component therapy for the treatment of chronic insomnia disorder in adults” (Edinger et al., 2021, p. 255).

How effective is CBT-I?

Large effects on the main measures. Van Straten et al. (2018) reported effects on “insomnia severity index (g = 0.98), sleep efficiency (g = 0.71)” (p. 3) and concluded “that CBTI, either its components or the full package, is effective in the treatment of insomnia” (p. 3).

How many sessions does insomnia counselling take?

Usually a short, structured course. The research found “face-to-face treatments of at least four sessions seem to be more effective than self-help interventions or face-to-face interventions with fewer sessions” (van Straten et al., 2018, p. 3).

Does it work if I also have depression, pain or take sleeping pills?

The evidence says yes: results were “similar for patients with or without comorbid disease, younger or older patients, using or not using sleep medication” (van Straten et al., 2018, p. 3). Medication changes stay with your physician.

Can relaxation alone help?

It can help as one component. The guideline suggests “relaxation therapy as a single-component therapy” with a CONDITIONAL recommendation (Edinger et al., 2021, p. 255); the multicomponent program is the stronger recommendation.

Is insomnia counselling covered by insurance in BC?

Fees and expenses are covered by ICBC, CVAP, FNHA, IFHP, RCMP, VAC, and most other insurers, and direct billing is available. Most extended-health plans reimburse RCC sessions.

Can I do it by video?

Yes. In person in downtown Vancouver or by secure video across BC. Sleep diaries and session homework work the same either way.

What happens when you call

The first conversation is a free 20-minute phone call with Samuel Ezzatilord, PhD, RCC, CCC, LMCC (RCC #23405). You describe what is going on; he tells you plainly whether what he offers fits and what a first session would involve. Sessions are available in English and Farsi, in person at Suite 1300, 1500 West Georgia St, Vancouver, or by secure video anywhere in BC. Fees and expenses are covered by ICBC, CVAP, FNHA, IFHP, RCMP, VAC, and most other insurers, and direct billing is available.

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Related pages: Anxiety counselling · Depression counselling · Neurofeedback · Individual therapy

References

Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2), 255–262. https://doi.org/10.5664/jcsm.8986

van Straten, A., van der Zweerde, T., Kleiboer, A., Cuijpers, P., Morin, C. M., & Lancee, J. (2018). Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Medicine Reviews, 38, 3–16. https://doi.org/10.1016/j.smrv.2017.02.001