Treating Sleep Problems in Patients with Psychosis: An Evidence-based Cognitive Behavioural Intervention

Sleep plays a vital role in sustaining physical and emotional wellbeing.  In patients with schizophrenia or bipolar disorder however, sleep problems are complex, pervasive and often persist without intervention. Sleep problems predict the occurrence of both paranoid thoughts and hallucinations and are associated with poorer quality of life. Sleep disturbance is an important target for treatment.

CBT has been developed to address sleep problems and is recommended by NICE and international treatment guidelines as the evidence based treatment of choice for insomnia. The Oxford Cognitive Approaches to Psychosis research group and Oxford Sleep and Circadian Neuroscience Institute have been leading developments in the application of CBT for sleep problems in psychosis. Our group have recently completed a randomised controlled trial (RCT) which demonstrated the effectiveness of CBT in improving sleep in this population (Freeman et al., 2015). It is an engaging and effective stand-alone therapy which is popular with patients. Our ongoing research includes investigation in to the treatment of sleep disturbance during acute psychiatric admission. This research forms the basis of this clinical skills workshop. The workshop will include an overview of the core techniques used to improve sleep and their adaptations for patients with psychotic experiences. This will include adaptations for working within both community and inpatient settings.

This clinical skills workshop describes the theoretical and empirical background to the intervention as well as the key adaptations needed for patients with psychosis or bipolar disorder. Using presentation, role play, video examples and case studies, participants will observe and practice skills including monitoring, psychoeducation, developing and sharing maintenance formulations, use of stimulus control and circadian realignment strategies and relapse management. By the end of the workshop, participants should be able to confidently use the brief intervention with their own clients.

The workshop is particularly suitable for health professionals who have some experience of working with adults with psychosis and the underlying principles of CBT.


Waite F., Myers E., Harvey AG., Espie CA., Startup H., Sheaves B., & Freeman D. (2016), Treating sleep problems in patients with schizophrenia. Behavioural and Cognitive Psychotherapy, 44, 273 – 287

Freeman D., Waite F., Startup H., Myers E., Lister R., McInerney J., Harvey AG., Geddes J., Zaiwalla Z., Luengo-Fernandez R., Foster R., Clifton L., & Yu LM. (2015), Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot trial. Lancet Psychiatry, 2, 975 – 983

Waite F., Evans N., Myers E., Startup H., Lister R., Harvey AG., & Freeman D. (2016), The patient experience of sleep problems and their treatment in the context of current delusions and hallucinations. Psychology and Psychotherapy: Theory, Research and Practice, 89, 181 – 193



Bryony Sheaves

Bryony Sheaves is a Research Clinical Psychologist working in the Oxford Cognitive Approaches to Psychosis research group and Oxford Sleep and Circadian Neuroscience Institute. She is currently co-ordinating a series of three trials aiming to gain a better understanding of the association between sleep and psychosis, and further the development of cognitive behavioural therapy (CBT) for sleep difficulties in this group.  Bryony is lead clinical psychologist for the Sleep Study, a pilot RCT of CBT for insomnia designed specifically for psychiatric inpatients.  She is the trial therapist for the Nightmare Intervention Study (NIteS), a pilot RCT of CBT targeting nightmares, for people experiencing persecutory delusions and also co-ordinates the OASIS study, a RCT recruiting over 3,000 university students to test the effects of CBT for insomnia on paranoid thoughts and hallucinatory experiences.  Bryony is an honorary clinical psychologist within Oxford Health NHS Foundation Trust and an HCPC registered Clinical Psychologist.

Felicity Waite

Felicity Waite is the Lead Clinical Psychologist and Trial Coordinator of the Feeling Safe Study, within the Oxford Cognitive Approaches to Psychosis (O-CAP) clinical research group. The Feeling Safe Study is a trial of a novel psychological intervention for overcoming persecutory delusions. Felicity has previously worked on a number of trials developing and evaluating Cognitive Behavioural Therapy (CBT) for distressing psychotic experiences. Key targets of treatment have included sleep disturbance and self-confidence.

Additional Information

Cancellation & changes policy

If you cancel more than 14 days prior to your booked event, we will refund your fee minus a charge of 15% to cover our administration costs. We regret that cancellations 14 days or less before the booked event cannot be refunded or changed/transferred.

If you wish to change/transfer your booking after confirmation we will do our best to accommodate you if you notify us 14 days prior to your booked event, and if there is space to do so. However there will be an administration charge of £15 per change/transfer.


Workshops often contain clinical material. This is always anonymised as far as possible but delegates are none the less reminded to respect confidentiality.

All that is discussed in your therapy sessions will be treated as confidential, with the following exceptions.
We are required to seek supervision by our professional body (The British Psychological Society or equivalent) as a means of ensuring good practice. We will usually inform your referrer of your progress, but the details that we disclose will be discussed with you. We do have a statutory obligation to break confidentiality under rare circumstances, namely, if we believe that a client is of danger to themselves or to others (under the Mental Health Act, 2001) or if we believe that a child is at actual risk of physical or sexual abuse (The Children Act, Section 47, 1989).

If we felt that it would be helpful to request additional medical, social or legal information, we could only do this with your consent. Similarly, should another medical, social or legal professional request information from us, we would not release this without your consent.


OCTC makes every effort to ensure that this programme is delivered as advertised. However, should a presenter have to cancel, we will endeavour to find another suitable presenter. We will inform attendees as soon as is reasonably practical and, if requested, will offer a refund. In the rare event that we are unable to substitute a presenter, we may cancel a workshop and refund payments already made by attendees. OCTC will not refund travel and accommodation costs that attendees may incur.
All the workshops in this programme are carried out by highly experienced therapists and trainers. The individual presenter is responsible for the content of the workshop and any views expressed do not necessarily represent those of OCTC.
Although highly informative, none of the open workshops or workshop series confer a formal qualification or assurance of competence in CBT (or a specialist area of CBT) since we are unable to assess attendee competency within the training event. However, credit and award-bearing courses that lead to formal qualifications are offered by OCTC in conjunction with the University of Oxford. More about these courses is available on our website

Levels of competence

Before booking a place on a workshop, please ensure that it is pitched at the appropriate level of competence for you. The guide to levels is as follows:


Basic workshops are for people from a variety of backgrounds, who have at least one year’s clinical experience. Cognitive behavioural knowledge is not necessary for attendance at these workshops, though in practice, a number of attendees will have some skills in the area, and are refreshing/updating their knowledge.


Intermediate workshops are directed towards people who already have knowledge of CBT, and experience in using cognitive formulations and treatment methods – for instance, they are able to identify and test automatic thoughts, and design behavioural experiments. Most participants will be using CBT as part of their clinical practice, and may still be acquiring new CBT skills.


Advanced courses are directed towards those professionals who use CBT routinely as part of their clinical practice. They have probably undertaken a significant number of training courses and/or workshops, and use a broad range of cognitive behavioural strategies to work with a range of presentations at varying levels of complexity.

Making reservations

Bookings can only be considered confirmed after we have received your online registration or application form and payment (or invoicing details, including an official purchase order document). Please note that registration to workshops closes 7 days prior to the event date.

If you are booking a workshop place for someone else, you must complete your own details in the billing field, but ENTER THE WORKSHOP PARTICIPANTS NAME/ADDRESS in the shipping field. If you wish to order items using a paper order form instead of online, you can view or download an order form in Adobe Acrobat (PDF) format. Once downloaded, print it out, fill it in, and send off with your payment [cheque made payable to OXFORD HEALTH NHS FOUNDATION TRUST] to the address on the form.


The cost of the workshops includes hot drinks on arrival, mid-morning and mid-afternoon, but not usually lunch unless stated. However, for workshops that do include lunch, if you have any special dietary requirements please let us know at the time of application.

Special needs

We welcome applications from diverse backgrounds. If you have any particular needs, please contact us
prior to booking.