P082 Lesson's learnt from an AOD team delivering a stepped-care intervention for sleep

Abstract

Abstract Insomnia is a prevalent issue in AOD settings. Many use substances for their sedative effect or experience insomnia as a consequence of substance use, insomnia is a common feature of withdrawal and often linked to relapse. In this study, a community-based AOD service is piloting a stepped-care intervention for insomnia. Nine AOD clinicians underwent CBT-I training to deliver a 3-step intervention: (1) a 60-minute information session, (2) A guided self-help booklet + ≤ 3 sessions with an AOD clinician, and (3) an 8-week CBT-I Group. The primary outcome is the insomnia severity index (ISI) and secondary outcomes relate to mental health and substance use. Focus groups and online questionnaires are being used to evaluate its implementation. This presentation will outline how a stepped-care model for sleep treatment was integrated within an AOD setting and discuss the available evidence on its effectiveness, feasibility and acceptability. Of the 299 enrolled to date (M=57.4 years ±14.3yrs; 74.6% women), initial findings show significant improvements in ISI scores after Step 1 (17.5 to 15.6; P < 0.01) (d = 0.33), and 54% of eligible participants have moved into Step 2. So far, participant engagement and retention rates suggest good feasibility. Clinicians report high levels of satisfaction with the program, perceiving that it addresses an otherwise inconsistently met need, and enjoy the contrast in work to their usual role. Barriers to delivering the program include limited time and resources. Findings demonstrate this stepped-care program has the potential to improve outcomes and enhance recovery in AOD settings.