CBT-I therapy for insomnia, in Echo Park and online across California
For when your sleep is tangled up with anxiety, stress, trauma or a mind that won’t stop.
Therapy group: 8 weeks, Mondays at 6:00 pm Pacific, online. Starts February 1. In person in Echo Park if enough people want it.
One-on-one: In person in Echo Park or online.
Is this for you?
CBT-I Group Therapy is for adults in California who want more support than what I offer in my educational Sleep Class. It’s the same method, plus therapy: tools to calm your nervous system, work on what’s keeping you up, and a weekly one-on-one check-in with me. If your insomnia comes with anxiety, stress, trauma, perimenopause, or hyperarousal, you might consider doing the Therapy Group instead of the Sleep Class. Or if you’ve tried CBT-I on your own and found it too challenging, you may find the group or even one-on-one therapy a better fit.
Why CBT-I
The American College of Physicians recommends CBT-I as the first treatment for chronic insomnia in adults, ahead of medication.
In a pooled analysis of the MsFLASH trials in women with hot flashes, CBT-I improved insomnia more than estradiol, two antidepressants, yoga or exercise.
SMALL GROUP
The CBT-I Therapy Group
Eight weeks with the same six to eight people. You do the full version of the method, and I set and adjust each person’s sleep window every week, based on the sleep data you share with me. Because it’s therapy, you can talk about what’s actually keeping you up. You also get a 15-minute one-on-one check-in with me each week, and tools to calm your nervous system that you practice daily, plus parts work. Prefer in person? If enough people want it, I’ll run an in-person group in our group room at Echo Park Creative Psychology, with movement, breathwork and simple art-making woven in. Mention it on your free consult.
8 weeks, 75 minutes a week
Mondays, 6:00 pm Pacific, from February 1
6 to 8 people, online, California residents
$1,120 ($140 a week)
Includes the workbook, guided audios, including the relaxation audio, a weekly 15-minute check-in, a booster session a month after the group ends, and 15-minute check-ins with me for 3 months after that.
ONE-ON-ONE
Individual CBT-I
The same method, built entirely around you, with more room for what’s tangled up with your sleep.
In person in Echo Park or online anywhere in California
$175 a session. In network with Aetna.
The 8-week group, week by week
WEEK 1
How sleep works, and the 3:00 thoughts that keep you up
Light sleep, deep sleep and REM, the two systems that run your nights, and why insomnia sticks. You start your sleep diary and learn to catch the thoughts about sleep that keep you awake, and swap in truer ones.
WEEK 2
Your sleep window, and where sleep meds fit
One steady wake time, and a sleep window I set with you from your diary. How sleep medications fit in, and how people taper with their prescriber if they choose to.
WEEK 3
Getting your bed back
The bed rules that teach your brain the bed is for sleep, what to do when you’re lying awake, and your first relaxation practice.
WEEK 4
When your body won’t stand down
What stress does to your nights, how your nervous system shifts between on alert and settled, and practices that help it settle: different kinds of breathwork, fake yawning and autogenic relaxation.
WEEK 5
Cognitive restructuring
Often we aren’t aware of the automatic thoughts shaping how we feel at night. Mindfulness and a compassionate witness can help you see your blind spots, and we work on the thoughts keeping you stuck. The sleep hygiene basics come in along the way, as small supports, not a week of their own.
WEEK 6
Calming tools you can carry
Simple practices to settle your body and mind, including for the moments at night when everything feels like too much. We practice them together so they’re there at 3:00.
WEEK 7
The part that stays up
An introduction to parts work. Getting to know the part of you that keeps watch at night, what it’s guarding, and whether it can step back for a few hours.
WEEK 8
When a bad night comes back
Your progress since week 1, and a plan for the next bad night so it stays one night.
A booster session follows a month later.
The next group starts Monday, February 1, once at least five people have joined. Everyone starts with a free 20-minute consult, so we can both see if it’s the right fit.
One-on-one CBT-I
For some of us, sleep has a lot of nuance. Sometimes insomnia is brought on by one thing, but often it’s years of habits combined with stress, trauma, or loss. Working one-on-one gives us more time to explore the details of your situation and your relationship with sleep. We can follow the same eight weeks as the group, or open it up and go slower and deeper. If it seems right, we can bring EMDR into the work. I also like to use parts work alongside CBT-I, getting to know the parts of you that keep you up and what they’re protecting.
Questions
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No. The sleep class isn’t therapy. It’s an educational program designed for people who don’t need a lot of individual treatment. The small therapy group will give you more direct access to me and we’ll be able to address your specific concerns in more detail.
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No. Perimenopause brings a lot of people to insomnia, so I really want to help those women. CBT-I works for adults with any kind of chronic insomnia and all are welcome.
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No. Any change goes through your prescriber, and we can plan around it. If you want to titrate off during the program, we can talk about it!
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I can’t promise, but the odds are good. In research, 70 to 80% of people who go through CBT-I get a real improvement in their sleep, and the gains tend to last after treatment ends. That’s why sleep medicine recommends it first, ahead of sleeping pills.
When it doesn’t help as much as expected, there’s usually something else in the way: an undiagnosed sleep problem like sleep apnea, a medical condition, or anxiety or trauma that keeps your body on alert at night. If that’s what’s going on, we look at it together. That might mean a check with your doctor or a sleep study, or one-on-one work with me, where we can use EMDR and somatic work on what’s keeping you up.
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Not always. Untreated sleep apnea, bipolar disorder, a seizure disorder, pregnancy and night-shift work can make parts of CBT-I unsafe. We go over this on the free consult, and I’ll tell you if you need a medical look first.
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Group $1,120 ($140 a week)
Individual: $175
I take Aetna
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Therapy, in the group or one-on-one, is for California residents. The Sleep Class is open to adults anywhere: see ledamaliga.com/sleep.
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The group costs less per week, follows a set eight-week schedule, and you get a one-on-one check-in with me every week, so you’re not doing it alone. One-on-one starts any week, fits your schedule, can be in person, and gives more room for anxiety, trauma or whatever else is tangled up with your sleep. We’ll figure out which fits on the free consult.
It starts with a free consult
Twenty minutes. We talk about your sleep, your health, what you've tried so far, and work out whether the group or one-on-one sessions are the right place to start. Group: $140 a week for 8 weeks online. One-on-one: $175 per session, in person in Echo Park or online anywhere in California. In-network with Aetna.
If you're in crisis, call or text 988.