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Behavioral Interventions for Night Terrors and other Sleep Disorders
10 CEUs Behavioral Interventions for Night Terrors and other Sleep Disorders

Section 29
Appendix: Client Reproducible Worksheets

Answer Booklet | Table of Contents
| Sleep Disorders CEU Courses
Counselor CEUs, Psychologist CEs, Social Worker CEUs, MFT CEUs

Behavior Documentation
Review CD track 2 for more information regarding this technique.
Parent reviews and utilizes the following procedures to discover underlying fears resulting in child or adolescent’s type ‘A’ night terrors.
1.  Obtain a notebook to use as a ‘Terror Log.’
2.  Observe and note night terror related actions.
3.  Observe and note comments the child or adolescent makes or dialogue regarding the night terrors.  
4.  After each week, review the ‘Terror Log’ for insight as to the child or adolescent’s underlying fear.

Assisted Recall
Review CD track 2 for more information regarding this technique.
Parent reviews and utilizes the following procedures to obtain additional information about night terrors.
1.  Casually talk to the child or adolescent regarding the night terror if he or she wakes up or the following morning.
2.  Ask, "Do you remember your dreams last night?" or "Could you draw a picture of your dream?"
3.  Combine any information with behavior documentation to enhance your analysis of the child or adolescent’s underlying fears. 

Associative Connections
Review CD track 2 for more information regarding this technique.
Client reviews and utilizes the following procedures to speed the natural process of the subconscious making connections regarding unreasonable or childhood fears.
1.  Allow the child or adolescent to spend time around children of the age closest to when the night terrors first started. 
2.  If possible, place the children in an environment where the night terror sufferer can see that the younger children may be afraid of events they do not understand.
3.  Think of ways to encourage the child or adolescent to spend time with younger kids so that he or she does not lose self-esteem. 

The Six Step Psychotherapeutic Approach
Review CD track 4 for more information regarding this technique.
Client reviews and utilizes the following procedures as a behavioral intervention regarding type B night terrors.
1.  Follow recommended sleep guidelines.
2.  Validate your trauma and evaluate related family ties.
3.  Explore present circumstances that may replicate satellite emotions linked to your traumatic experience.
4.  Address any resultant health problems. 
5.  Allow yourself some time alone to relax.
6.  Implement the other five steps in concert.

Behavioral Sleep Therapy for Children
Review CD track 5 for more information regarding this technique.
Client reviews and utilizes the following procedures to desensitize a young child to the fear of being alone.
1.  On the first day, wait five minutes after your child starts to cry before attempting to comfort the child. 
2.  Comfort the child for two or three minutes and then leave.
3.  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. 
4.  After the third visit, wait at this level, fifteen minutes, before entering for each later visit until the child falls asleep alone.
5.  If the child falls asleep and wakes later, repeat the process from step one.
6.  On each of the subsequent days begin the first waiting period with an increase of five minutes above the previous day’s first level.  For example, on the second day you will wait ten minutes before attempting to comfort the child.
7.  Continue with periodic increases as on the first day until the amount of wait time reaches the previous day’s high level plus the additional five minutes. 
8.  Continue with gradual increases of five minutes each day for the initial level and for the maximum level for the night.
9.  You may not want to exceed three increases in any one night.  Instead, keep the child up for the day.

Stimulus Control Therapy
Review CD track 6 for more information regarding this technique.
Client reviews and utilizes the following procedures to condition themselves to falling asleep when going to bed.
1.  Avoid your bed and preferably your bedroom for anything other than sleep or sexual activity.
2.  Get into your bed at your predetermined bedtime, or later if you’re not sleepy at your usual bedtime.
3.  Allow no more than ten or fifteen minutes to fall asleep.
4.  If you are still awake after ten or fifteen minutes, get out of bed, go to another room, and do something relaxing until you feel tired.
5.  Get out of bed at your predetermined rise time.  You may get out of bed earlier, but avoid sleeping in.
6.  Repeat steps 1 through 5 as many times as necessary throughout the night.

Sleep Restriction Therapy
Review CD track 6 for more information regarding this technique.
Client reviews and utilizes the following procedures to limit time spent in bed.
1.  Begin and maintain a sleeping log for 7 to 10 days.
2.  Analyze the collected data.
3.  Subtract your average total nightly sleep time from your average total nightly time in bed to find the excessive amount of time you are spending in bed.
4.  Eliminate the excess time spent in bed by changing your bed time and rise time.
5.  If your bed time or rise time changes, avoid going to bed earlier or waking up later.
6.  Avoid naps.
7.  Begin another sleep log to track progress. 

Altering Circadian Rhythms with Light
Review CD track 8 for more information regarding this technique.
Client reviews and utilizes the following procedures to adjust circadian rhythms.
1.  Obtain a bright light.
2.  Rise earlier each day and sitting next to the light for a brief time. 
3.  After a week or so, monitor improvements.

Phase Delay
Review CD track 9 for more information regarding this technique.
Client reviews and utilizes the following procedures to adjust circadian rhythms.
1.  Decide how much of your schedule you can interrupt and how great of an adjustment your rhythms need.
2.  Begin to go to bed 3 hours later each night or morning.
3.  Each subsequent night or morning, go to bed three more hours later than before until you are going to bed at the correct time. 
4.  Once you have established the new rhythm, maintain it.

Methods for Decreasing Narcoleptic Occurrences
Review CD track 10 for more information regarding this technique.
Client reviews and utilizes the following procedures to avoid narcoleptic occurrences.
1.  Maximized the efficiency of your nightly sleep by setting a regular sleep schedule.
2.  Take short day time naps.
3.  Use caffeine sparingly.
4.  Face any feelings of guilty, inadequacy, anger, or depression. 

Mental Imagery Techniques
Review CD track 11 for more information regarding this technique.
Client reviews and utilizes the following procedures to learn mental imagery.

1.  The ‘Float Along’ Technique
1.  Lie in bed and imagine a scene in which you are floating, surrounded and supported by a soft surface. 
2.  Visualize feeling yourself lying on a billowy cloud with warm breezes all around.  Or perhaps imagine drifting in a gentle sea. 

2.  The ‘Drifting Downward’ Technique
1.  Imagine yourself walking slowly down a staircase. 
2.  When you reach the bottom, imagine a dark room with lots of soft couches and pillows. 
3.  Lie down and start slowly sinking into the couch.

3.  The ‘Count Down to Relaxation’ Technique
1.  Begin to count down slowly from one hundred. 
2.  Try to picture each number as you count down. 
3.  Each time you count down, imagine the preceding number slowly floating away.

4.  The ‘On Vacation’ Technique
1.  Imagined your ideal vacation. 
2.  Visualize packing, boarding a plane, taking off and each subsequent detail of the vacation. 

Relaxation and Stretching
Review CD track 13 for more information regarding this technique.
Client reviews and utilizes the following procedures to improve relaxation.
1.  Consult your physician to find out if you are healthy enough for these exercises.
2.  Stand with your legs apart and bend at the waist.  Shake your arms and hands loosely.  Let your head hang and sway from side to side.  Shrug your shoulders.  Hang loosely for a few moments to relax completely.               
3.  Drop your chin to your chest.  Rotate your head to the right and turn your chin to your shoulder.  Circle the head  back and around and over your left shoulder to make a complete revolution.  Repeat in the opposite direction.            
4.  Extend your right arm straight up and reach for the ceiling.  Reach as high as you can.  Pretend you’re picking dollar bills off the ceiling.  You should feel your entire right side stretch from the fingers of your right hand to your right foot.  Repeat the stretch with your left arm                      
5.  Sit on the edge of a chair with your knees apart and your feet on the floor.  Place your hands on your knees with your elbows slightly bent.  Press your hands into your knees and lean forward.  Rotate your shoulders and ribs to the left and then to the right           
6.  Lie flat on your back in bed.  Push your spine into the bed, flattening your back and pulling in your abdomen.  Release, go limp in all muscles, and breathe deeply.  Repeat several times.  After the last time, remain limp and breathe deeply.

The Be a Sponge Technique
Review CD track 13 for more information regarding this technique.
Client reviews and utilizes the following procedures as another relaxation technique.
1.  Lie on your back, completely relaxed, and imagine you are a sponge. 
2.  Let your arms lie limp and away from your body, relax your shoulders, and relax your legs. 
3.  Close your eyes and breathe deeply through your nose.  Let each part of your body relax while imagining that you are a sponge soaking up peace and tranquility. 

The Sighing Breath Technique
Review CD track 13 for more information regarding this technique.
Client reviews and utilizes the following procedures as another relaxation technique.
1.  Inhale deeply through the nose and then exhale slowly through the mouth for as long as possible.
2.  Concentrate on the long sighing sound.
3.  Begin to feel tension dissolve.

The Creating Pictures Technique 
Review CD track 13 for more information regarding this technique.
Client reviews and utilizes the following procedures as another relaxation technique.
1.  Close your eyes and pay attention to the various patterns and colors on the inside of your eyelids. 
2.  When you go to bed tonight close your eyes and focus on those colors and patterns.  In a dark room, you might find that with enough thought you can not only see different patterns and hues, but you might also see them continually blending and changing. 
3.  Focus on influencing the changes in color or pattern through thought.

Worry Time
Review CD track 14 for more information regarding this technique.
Client reviews and utilizes the following procedures to get some sleep in spite of everyday worries.
1.  Go into a quiet room so your family won’t bother you, not even for telephone calls. 
2.  Take 30 or 40 blank three-by-five cards and a pencil with you.  Then, just sit and relax.  As a worrier, you won’t have to do anything and before long worries will start buzzing around. 
3.  As the worries come, write each one down on one of the cards.  They don’t all have to be important worries.  They can be dumb worries or little worries, but whatever bothersome thought comes into your head, write it on a separate card. 
4.  Categorize your worries.  You might have one batch of worries about your finances, another for your relationships, and so on.  About three to seven categories should suffice. 
5.  Once you have your worries categorized, think about each group carefully and see what you can do with the worries in that group.  At the bottom of each card, write down what seems to be the best solution.
6.  If you have concluded that you have done everything you can, write that down on your card next time.  You might write, ‘I have done everything I can.’

 
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