Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia

Wing Fai Yeung, Ka Fai Chung, Fiona Yan Yee Ho, Lai Ming Ho

Research output: Journal article publicationJournal articleAcademic researchpeer-review

17 Citations (Scopus)

Abstract

Dropout from self-help cognitive-behavioral therapy for insomnia (CBT-I) potentially diminishes therapeutic effect and poses clinical concern. We analyzed the characteristics of subjects who did not complete a 6-week internet-based CBT-I program. Receiver operator characteristics (ROC) analysis was used to identify potential variables and cutoff for predicting dropout among 207 participants with self-report insomnia 3 or more nights per week for at least 3 months randomly assigned to self-help CBT-I with telephone support (n = 103) and self-help CBT-I (n = 104). Seventy-two participants (34.4%) did not complete all 6 sessions, while 42 of the 72 (56.9%) dropped out prior to the fourth session. Significant predictors of non-completion are total sleep time (TST) ≥ 6.82 h, Hospital Anxiety and Depression Scale depression score ≥ 9 and Insomnia Severity Index score < 13 at baseline in this ranking order. Only TST ≥ 5.92 h predicts early dropout. Longer TST and less severe insomnia predict dropout in this study of self-help CBT-I, in contrast to shorter TST as a predictor in 2 studies of face-to-face CBT-I, while greater severity of depression predicts dropout in both this study and a study of face-to-face CBT-I. Strategies for minimizing dropout from internet-based CBT-I are discussed.
Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalBehaviour Research and Therapy
Volume73
DOIs
Publication statusPublished - 1 Oct 2015
Externally publishedYes

Keywords

  • CBT
  • Dropout
  • Insomnia
  • Internet
  • Online
  • Self-help

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Clinical Psychology
  • Psychiatry and Mental health

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