Psychology Ph.D. Dissertations


Evaluating Acceptance and Commitment Therapy for Insomnia: A Randomized Controlled Trial

Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)



First Advisor

William O'Brien (Advisor)

Second Advisor

Jeffrey Brown (Other)

Third Advisor

Howard Cromwell (Committee Member)

Fourth Advisor

Harold Rosenberg (Committee Member)


Insomnia is a subjective perception of dissatisfaction with the amount and/or quality of sleep and is associated with a number of significant health concerns. Individuals with insomnia often report dysfunctional beliefs about sleep, heightened pre-sleep arousal, and sleep-incompatible behaviors. While traditional behavioral interventions have well addressed the dysfunctional beliefs about sleep and sleep-incompatible behaviors, Acceptance and Commitment Therapy (ACT) may add unique and useful treatment components to existing interventions. A pilot ACT study by Baik and O’Brien (2013) using an ACT protocol revealed promising outcomes for persons with insomnia; the present study examined the efficacy of ACT for insomnia by modifying the previous study using a randomized controlled group. The overall results of the study indicate that the participants viewed the treatment as acceptable and beneficial. They experienced reduced symptoms of insomnia and pre-sleep arousal. Additionally, participants showed improvements in acceptance, use of thought control strategies, and present-focused thinking to variable degrees. The direct indicators of change in sleep activities through the sleep diaries suggest that the participants experienced some improvements in the sleep parameters; however, these changes may not be strongly accounted for by the treatment effect, but are most likely explained by self-monitoring. Despite several limitations observed in the current study, it is meaningful as the first randomized controlled group outcome study that provides empirical data on the benefits of ACT for insomnia. As a relatively new intervention approach for insomnia, ACT is promising and it will likely continue to benefit from future refinement.