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On the last track we discussed a six step psychotherapeutic approach to treating type B night terrors. The six steps I used with Jerry were following sleep guidelines, validating trauma and evaluating family ties, exploring present circumstances, addressing resultant health problems, allowing solitude, and implementing the steps simultaneously.
On this track let's shift from night terrors to other forms of sleep problems. We will discuss behavioral sleep therapy for children. As you know, when children have difficulty settling and falling asleep alone in their own beds, some parents are faced with conflicts about how to handle these situations. Dr. Richard Ferber, a leader in pediatric sleep medicine has devised a desensitization method for dealing with the problem.
In brief, Dr. Ferber recommends a scheduled progressive approach where the parent waits a specific amount of time before going into the bedroom to comfort the child. The amount of time the parent waits before entering is progressively lengthened until the child learns to fall asleep alone. For the purpose of this course, one method of behavioral sleep therapy for children will be explained in two parts. Behavioral sleep therapy for children consists of initial progression and subsequent progression. As you listen to this track, consider your client or clients if you are treating a couple.
Part #1: Initial Progression
To describe the initial progression of behavioral sleep therapy for children, I stated, “The idea is to desensitize Chelsea to the fear of being alone in her own bed by using a tapered separation schedule.” Pamela asked, “What type of separation schedule?” I responded, “For example, on the first day wait five minutes before going into Chelsea’s bedroom if she is crying and cannot sleep. Comfort Chelsea for two to three minutes and then leave. If more visits are necessary due to continued crying, wait an additional five minutes for each of the next two visits before going into the room. After the third visit, wait at this level, fifteen minutes, before entering for each later visit until Chelsea falls asleep alone.”
Brad stated, “Ok, but Chelsea wakes frequently during the night. What do we do then?” How might you have responded to Brad? I stated, “If the child wakes during the night, begin again at the original level for the night, five minutes, and continue increasing time in five minute increments as before.” What other information could your clients use to implement the initial progression of behavioral sleep therapy for children? Perhaps sleeping tips as discussed on the rest of this course may benefit your client.
Part #2: Subsequent Progression
Brad asked, “What is the maximum level for the night?” I responded, “You may not want to exceed three increases in any one night. If Chelsea continues in a state of wakeful crying until about 6:00 a.m., do not continue the program. Instead, keep the child up for the day.”
Would you agree that, like sleep reduction therapy, this behavioral treatment for children could lead to Chelsea becoming accustomed to going to bed without her parent’s coddling and constant attention? Could playing this track benefit clients that you are treating who have a Chelsea? Of course you have eliminated other possible causes for the waking prior to implementing this timed method.
On this track we discussed behavioral sleep therapy for children. For the purpose of this course, one method of behavioral sleep therapy for children will be explained in two parts. Behavioral sleep therapy for children consists of initial progression and subsequent progression.
On the next two tracks we will discuss behavioral interventions for insomnia. Four behavioral interventions for insomnia that we will discuss are stimulus control therapy, sleep restriction therapy, relaxation therapies, and cognitive therapy. The focus of the next track will be on the first two interventions, stimulus control therapy and sleep restriction therapy
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