Developing a Cognitive Behavioural Therapy for insomnia intervention for adolescents with co-morbid mental health using an iterative expert consultation process

Insomnia is prevalent in adolescents with co-morbid mental health problems but is often overlooked due to limited access to training for practitioners in the assessment and treatment of insomnia. Whilst Cognitive Behavioural Therapy is the recommended treatment for insomnia in adults (CBTi), there are no standard treatment guidelines for adolescents and limited research with adolescents with co-morbid mental health problems. Therefore, our aim was to develop a CBTi intervention for adolescents with co-morbid mental health problems. This study utilised an iterative expert consultation approach to develop a CBTi intervention and define the appropriate target population, components and delivery. Eighteen experts were identified from literature searches and professional networks and invited to participate. Three iterative rounds of questionnaires were conducted and included both open-ended and closed-ended questions. In total, seven experts participated (R1 = 7, R2 = 5 and R3 = 1). In R1, four main themes emerged: (1) CBTi is appropriate for early–mid adolescents with anxiety/depression, (2) the proposed content and format were appropriate but required adaptation, (3) the proposed method of delivery was appropriate (i.e., in-person, by trained practitioner) and (4) parent/caregiver involvement is necessary. In R2, the intervention protocol was reviewed and finalised. In R3, the intervention materials were reviewed. The newly developed intervention comprises 4 weekly sessions, intervention materials and a training package for non-sleep experts. To our knowledge, this is the first study to utilise an iterative expert consultation process to develop an insomnia intervention for adolescents with co-morbid mental health.