A new registry is set to transform how general practitioners (GPs) refer patients with insomnia to specialized cognitive behavioural therapy, aiming to reduce reliance on sleeping pills.
Streamlining Referrals with the CBTi Provider Registry
General practitioners now have a powerful tool to help patients struggling with insomnia. The Australasian Sleep Association (ASA) has launched an online Cognitive Behavioural Therapy for Insomnia (CBTi) provider registry. This initiative addresses the critical shortage of psychologists trained in CBTi, a recommended first-line treatment for insomnia.
Imagine trying to find a specialist and hitting a dead end. That’s the reality many GPs face today. Dr. Alexander Sweetman, Senior Program Manager at the ASA, highlights the gap: “GPs are generally aware that sleeping pills are not the recommended first-line treatment for insomnia but have often reported that it’s extremely difficult to find psychologists who can deliver CBTi.”
The registry lists psychologists who have completed CBTi training and are part of the ASA’s specialist ‘sleep’ psychologist members. It’s hosted on the ASA’s primary care sleep health website, Sleep Central, making it easier for GPs to find qualified providers.
Key Features of the Registry
- Comprehensive Listings: Includes psychologists who have completed CBTi training and ASA members specializing in sleep.
- Filter Options: GPs can search by state, territory, age group, and whether the psychologist offers in-person or telehealth sessions.
- Medicare Rebate: Patients can claim a rebate for a portion of the treatment costs through a GP Mental Health Treatment Plan.
| Feature | Description |
|---|---|
| Provider Listings | Psychologists trained in CBTi and ASA specialists |
| Search Filters | State, territory, age group, in-person or telehealth |
| Financial Support | Medicare rebates available for patients |
This straightforward structure aims to make referrals seamless, ensuring patients receive timely and effective treatment without the hassle of navigating a limited pool of providers.
Addressing the CBTi Shortage
Insomnia affects millions of Australians, yet only about 1% access CBTi. The shortage of trained psychologists is a significant barrier. The Psychologist Education Sub-Committee of the ASA audited the number of ‘sleep’ psychologists and found just 65, equivalent to around 30 full-time positions.
Dr. Sweetman emphasized, “This is completely inadequate for the three million Australians with chronic insomnia and validates what GPs have been telling us.” The registry is a direct response to this crisis, doubling the number of available CBTi providers and expanding access, especially in rural and remote areas.
Efforts to Expand CBTi Training
Over the past three years, the ASA has collaborated with the Australian Psychological Society (APS) to develop comprehensive CBTi training programs. Earlier this year, they launched an interactive six-hour CBTi education module, attracting around 450 clinicians, including GPs, psychologists, nurses, and psychiatrists. This training ensures that more healthcare providers are equipped to deliver CBTi effectively.
Reducing Dependency on Sleeping Pills
Despite guidelines recommending CBTi, sleeping pills remain a common treatment for insomnia. In 2021–22, PBS data revealed around 4.9 million benzodiazepine scripts were dispensed to 1.4 million patients. Diazepam topped the list with over two million prescriptions.
Other research shows that while benzodiazepine prescriptions have generally declined, certain demographics still rely heavily on them:
- Older Women: Higher rates of short-intermediate prescriptions.
- Younger Men: More frequent long-acting prescriptions.
The new registry aims to shift this trend by making CBTi more accessible. Dr. Sweetman hopes that increased availability will lead to a decrease in sleeping pill prescriptions, promoting healthier, non-pharmacological treatments for insomnia.
Enhancing Patient Care and Outcomes
The ultimate goal of the registry is to improve patient outcomes by ensuring timely access to CBTi. By integrating this tool into primary care, GPs can offer a more effective treatment pathway for insomnia, which is often linked to other health issues like depression and anxiety.
Benefits of Increased CBTi Access
- Improved Sleep Quality: CBTi addresses the root causes of insomnia, leading to better sleep patterns.
- Reduced Medication Dependency: Fewer patients will need to rely on sleeping pills, minimizing the risks of dependency and side effects.
- Enhanced Mental Health: Better sleep contributes to overall mental well-being, reducing the incidence of related mental health issues.
Dr. Sweetman shared, “We hope this online registry will help GPs throughout Australia, and in rural/remote locations, find psychologists that deliver CBTi. Eventually, we’re hopeful it will reduce waiting lists for CBTi, assist with sleeping pill de-prescribing, and gradually increase the use and accessibility of CBTi in primary care.”
Looking Ahead: Future Expansions and Innovations
The CBTi provider registry is just the beginning. The ASA and APS continue to work on expanding CBTi access through various initiatives:
- Digital CBTi Programs: Developing online platforms to provide CBTi remotely.
- Training Primary Care Clinicians: Ensuring more GPs and other healthcare providers are trained to support insomnia treatment.
- Policy Advocacy: Promoting policies that support non-drug interventions for insomnia.
These efforts are part of a broader strategy to enhance sleep health across Australia, addressing both current needs and future challenges posed by sleep disorders.
