Episode 182 The Role Of Sleep In Holistic Counseling: Interview With Kevin Handley

May 22, 2024

How does sleep affect mental and emotional well-being from a holistic perspective? What are the common sleep-related issues clients face, and how do these impact their overall health?

MEET Kevin Handley

Kevin Handley is a Licensed Clinical Psychologist and Professor of Psychology in Virginia.  His private practice focuses on providing Cognitive-Behavioral Therapy for Insomnia (CBT-I) and other evidence-based approaches (CBT, ACT & Positive Psychology) to help people thrive.  His coaching, consulting, and continuing education for behavioral health professionals focuses on practice growth, self-care, ethics and risk management, and practical strategies to help improve their clients’ sleep health.  As an award-winning professor and a frequent speaker, he often speaks to professional and community groups about sleep, positive psychology, and other topics in the hopes of helping as many people as possible apply psychology to improve their everyday lives.

Find out more at Kevin B. Handley, PhD, and connect with Kevin on Twitter, Instagram, LinkedIn, and Facebook

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The Ethics of Sleep Health: Efficacy, Equity, and Clinician Self-Care on June 27th


  • What is healthy sleep? 4:17
  • How is insomnia diagnosed? 9:23
  • Holistic solutions for better sleep 12:28
  • Why is sleep health so important for practitioners? 30:44

What Is Healthy Sleep?

  • Defining what healthy sleep is on an individual basis
  • How much sleep do you need?
  • Why is it important to ask clients about their sleep habits?
  • Sleep health and mental health

How Is Insomnia Diagnosed?

  • Focusing on better quality sleep
  • What puts you at risk for insomnia?
  • Examining the correlation between depression and insomnia

Holistic Solutions For Better Sleep

  • What factors go into sleep hygiene
  • How to make simple changes for better sleep
  • The importance of a sleep schedule
  • What is the R.I.S.E.U.P method?
  • What is the CBT-I Sleep program?

Why Is Sleep Health So Important For Practitioners?

  • Modeling sleep health to your clients
  • Self-care and ethics for therapists
  • How to begin addressing better sleep with your clients

Connect With Me

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Resources Mentioned And Useful Links:

Find out more at Kevin B. Handley, PhD, and connect with Kevin on Twitter, Instagram, LinkedIn, and Facebook

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The Ethics of Sleep Health: Efficacy, Equity, and Clinician Self-Care on June 27th


Chris McDonald: Do you or your clients struggle with getting a good night's sleep? This happens to so many of us and can impact so many parts of our lives. In today's episode, we unlock the power of sleep and holistic counseling. Join us in this oncoming episode as we delve into the impactful role sleep plays in keeping us healthy, mind, body, and spirit.

Discover how prioritizing rest can pave the way for profound healing and growth. Stay tuned for insights, tips, and strategies to enhance your wellbeing and how you can best help clients to get their best sleep on today's episode of the Holistic Counseling Podcast. This is Holistic Counseling, the podcast for mental health therapists who want to deepen their knowledge of holistic modalities and build their practice with confidence.

I'm your host, Chris McDonald, licensed therapist. I am so glad you're here for the journey.

Welcome to the Holistic Counseling Podcast, where we explore the interconnectedness of mind, body, and spirit to cultivate holistic wellness. I'm your host, Chris McDonald. Today, we're delving into a topic that affects every aspect of our whole well being, and that is sleep. Sleep isn't just about resting our bodies.

It's the cornerstone of our overall health. In this episode, we're taking a holistic approach to understanding sleep, examining the impact on mental clarity, physical vitality, and our overall emotional resilience. Joining us today is Kevin Hanley, a seasoned expert in holistic health and sleep therapy.

Kevin is a licensed clinical psychologist and professor of psychology in Virginia. His private practice focuses on providing CBT for insomnia, it's called CBTI, and other evidence based approaches, CBT, ACT, positive psychology to help people thrive. Together, we'll explore the profound connections between our sleep patterns and holistic wellness, from addressing underlying psychological factors to embracing natural remedies.

We'll uncover practical strategies to nurture a healthier sleep cycle. So if you're ready to embark on a journey toward better sleep, And holistic wellbeing, you are in the right place because here at the Holistic Counseling Podcast, we believe that true wellness begins first with a good night's sleep.

Welcome to the Holistic Counseling Podcast, Kevin.

Kevin B. Handley: Thank you so much for having me, Labib here.

Chris McDonald: And what first interested you in sleep? So let's start there.

Kevin B. Handley: Well, it's kind of a long story, but I'll give you the short version of it. I think two things happened about the same time. One was our daughter, who was adopted from Korea, came home to us and she was our third kid and our toughest sleeper.

And so we just sort of had sleep on the mind a lot at that time. But the story I always tell people is that I was working with a client, uh, treating panic disorder. When I kind of grew up. It was my most of my training being in the treatment of anxiety disorders and we went through the treatment and he did great and it was one of those it was a situation where he was getting ready to move right at about the time when we were done with treatment and we were just finishing up and talking and I said, well, you know, is there anything that we missed?

And he says, well, you know, I, I'm really glad I'm not panicking. I can drive again. I just wish I could sleep. And I was taken aback, you know, and I thought, well, what do you mean you wish you could sleep? And he is, well, yeah, it's like, I don't worry, lay in my bed worrying. And we had talked a lot about worry, but it never came up and I had never asked about it.

Um, and one of the reasons I guess I never asked about it is even though I learned a little bit about it here and there, I just really kind of figured that everybody knew about sleep and how to sleep, and I was really ignoring it in my clinical practice. We make that

Chris McDonald: assumption.

Kevin B. Handley: Yeah, it was a huge assumption.

Plus, I'm a clinical psychologist, and we. get pretty like niched down in our training. And so all of my training was anxiety. So, you know, I wasn't telling me about your

Chris McDonald: anxiety, right?

Kevin B. Handley: Yeah, exactly. I mean, I was part of, you know, like most therapists, unfortunately, who think that sleep problems just go away when you treat whatever the presenting problem is.

And that is not the case. So I started researching a little bit and realizing, wow, there's a whole science here of how to help treatment's really effective. And so it just sort of took off from there.

Chris McDonald: So what is healthy sleep?

Kevin B. Handley: Well, it depends on who you talk to. So

Chris McDonald: there's different answers.

Kevin B. Handley: There are different answers.

One of the things I like about your podcast is the holistic perspective. And so we are really trying to move away simply from defining healthy sleep as the lack of a sleep pattern. problem and defining healthy sleep. That is sleep that is refreshing. It's fairly regular. It is sufficient to give you enough daytime wakefulness and to meet your demands, whether they're individual demands, social demands, occupational demands, as a major contributor to psychological and mental health, well being.

That's really what we mean by healthy sleep. So it's going to look different for everyone based on their situation.

Chris McDonald: So it seems like the amount of sleep we need changes as we get older and everybody's different too.

Kevin B. Handley: Yeah. Yeah. And you know, the other thing too, is that kids have a whole different sleep schedule and they need a whole lot more sleep, particularly adolescents.

And they're just not getting enough of it. Adulthood sleep changes in terms of timing and amount as we get older timing and amount, but also the ability to stay asleep changes. It gets a little bit more difficult. So if you ask 16 different people about their sleep, they may all tell you that they're getting healthy sleep and they might all be getting healthy sleep.

But if we looked at, you know, what it actually looked like, it might look quite different from person to person.

Chris McDonald: Yeah, that's interesting. So why should counselors start asking their clients about sleep? Why does that matter?

Kevin B. Handley: Well, it matters for, I think, for a lot of reasons. First and foremost, you know, we tend to overlook things that are such a normal part of our everyday life.

We spend an awful lot of time sleeping. And now, I think in the past 10 to 15 years, the general public has become a lot more aware of the importance of sleep. We've done a pretty good job of educating people about the importance of sleep. We haven't done such a great job of educating. People don't how to sleep, and we've done a really poor job of educating practitioners in how to help their clients sleep.

But there is a really integral relationship between sleep health and mental health. As sleep problems increase. Mental health problems increase and vice versa. So when you are treating sleep and you're trying to improve your client's sleep health, it's part of a holistic approach to help them with their mental health all around.

Different studies will show you different things, but you know, somewhere around 90 percent of clients who come into therapy for anxiety and depression will have some sort of clinically significant sleep problem. Now, that doesn't necessarily mean that they meet the criteria for insomnia, although that would be the most common one.

And about 40 percent of those patients do. Um, a lot of the sleep problems people have, it's not the reason that they're coming in for counseling. And so they're not going to probably mention it unless we ask them about it.

Chris McDonald: Which I think that's why it's so important to start that initially with the intake.

That's one thing I put on my assessment form is asking about sleep and how their sleep is and how much sleep are they getting?

Kevin B. Handley: Mm hmm. Well, and when I train. So, I'm going to be talking about the subject of the day, which is suicide. about suicide.

Chris McDonald: Yeah.

Kevin B. Handley: Well, we kind of think we should be asking about it and we should be asking about it.

But then what he. Yeah. What happens if your client says, well, I don't, I don't sleep at all. Or I have terrible insomnia. And then you're sitting there with, well, gosh, maybe I shouldn't have asked.

Chris McDonald: Let me call Kevin.

Kevin B. Handley: Exactly. People do that all the time. That's great. I love when they call. Yeah. So I think, what do you think

Chris McDonald: should be?

Let's back up a minute. So if we, let's say we have a new client and they're coming in. So should we have something really clear on the intake

Kevin B. Handley: form? I think on the intake form, you could ask for a description of sleep description. And I like to just ask people the question, how are you sleeping?

Chris McDonald: Okay. Yeah.

Kevin B. Handley: If you ask people, how much sleep are you getting? Well, if you ask people these, you know, close ended questions, like, how's your sleep or, you know, what's your sleep like? Are you sleeping? Okay. They might just say, fine. Well, that's that

Chris McDonald: question every day. How are you?

Kevin B. Handley: Right.

Chris McDonald: We're not really getting much from that.

Kevin B. Handley: Not at all. Not at all. And if you ask people how much they get, everybody kind of knows the right answer. And it's remarkable how many people are getting insufficient sleep, but will report honestly that they're getting, you know, six, seven, eight hours of sleep. Or they'll look at you and they go, well, I get enough.

Well, how much is enough? Well, I get about four hours a night. Okay. We may have a little psychoeducation to do. So just asking people to describe their sleep. Describe it. A really great way to just open up the conversation.

Chris McDonald: I also have them ask about too. Are you, do you have difficulty falling asleep? Do you have, do you wake up a lot or do you wake up early?

I think those specific questions are helpful.

Kevin B. Handley: Absolutely. Yeah. Falling, difficulty falling asleep, uh, difficulty staying asleep or waking up. Okay. Earlier than you wish or not feeling like your sleep has left you refreshed. Any of those are a reason to intervene. And also just thinking about the diagnosis of insomnia, you'd be surprised how many people are unaware that there is a diagnosis of insomnia.

Chris McDonald: So what is the diagnosis then?

Kevin B. Handley: Pretty much was just what I described. What do you just say, .

Chris McDonald: Okay, so I, I, I knew it but didn't know it. ,

Kevin B. Handley: okay. Yeah. Difficulty falling asleep, maintaining sleep, you know, uh, or waking up. You know, with sleep, that's not satisfactory to promote daytime wakefulness.

Chris McDonald: So can insomnia be temporary or does it have to the criteria have to be for a certain amount of time?

Kevin B. Handley: I, but there's always going to be time criteria in there, but I tell people not to worry as much about that. I tell people in general not to worry so much about the diagnosis per se, but to help the person sleep better. So it can be temporary. And sometimes people expect Everybody's going to have insomnia at some point.

They're going to have difficulty falling asleep or staying asleep. All kinds of things in life do that. When you're sick, you might sleep really, really well or not so well at all. Uh, and so if you ask people, they'll tell you. But it takes a little bit of time to kind of open it up and let them describe to you what it is that they're actually experiencing.

But that's literally what the diagnosis of insomnia is. And so we look at things like predisposing factors with insomnia, predisposing factors, precipitating factors, and then perpetuating factors. Everybody's going to have different predisposing factors that puts them at risk for developing specifically insomnia.

And this could be a variety of things. It could be a chronic health issue. It could be chronic pain. It could be a history of trauma. Some people are better sleeper than others. You know, I tend to be a pretty durable sleeper, which leads me to having not such great sleep hygiene. A lot of the time because I can get away with it, but I don't have a lot of predisposing factors.

A lot of the precipitating factors that will bring on about ev, about of insomnia are probably the same things that are bringing the person into counseling to begin with. There's something that's going on in their life that is resulting in them getting poor sleep, and sometimes it's the poor sleep that's getting in the way or causing the mental health problem.

They're coming into therapy for.

Chris McDonald: That's what I was going to say. Is it the chicken or the egg? Is it the anxiety causing the sleep issue or the sleep issue can be causing a mental health concern?

Kevin B. Handley: And the answer is yes.

Chris McDonald: Yeah. There we go. Solving problems here today.

Kevin B. Handley: That's exactly right. To me, one of the most exciting things is recent research because that question has been asked, uh, particularly when it comes to insomnia and depression.

When somebody comes in and they meet the criteria for insomnia and they meet the criteria for depression, what should your treatment plan look like? Which one do you start with? I always start with

Chris McDonald: depression.

Kevin B. Handley: Yeah. Well, that's great. And you can start wherever you want to start for sure. A lot of the research is coming out now is showing that if the person has insomnia in addition to depression,

Chris McDonald: yeah,

Kevin B. Handley: if you work on the insomnia.

The mood gets better.

Chris McDonald: Mood gets better. Okay. Yeah,

Kevin B. Handley: that's food for thought. Because we know when we people get sleep deprived that it's very difficult to cite things as causal factors in psychology, but in experimental studies, when we sleep deprive people, their mood gets real bad real quick. So it's not that surprising that if we work on insomnia, that people's mood gets better.

Chris McDonald: And sometimes it's hard, sometimes it's hard to know where to start, too. And there's so many different things people are dealing with, but you're right. So sleep could be a good place to start. So let's say, like you said, okay, here we are. They meet the criteria for insomnia and they have depression. So now what, Kevin, how do we holistically help them?

Kevin B. Handley: Well, I always tell people, first of all, don't, uh, don't get freaked out. If we add another variable in, it just means that there's more places that we can intersect and more places to start. The good news is that we've got really effective treatments to improve sleep health. And so when we think about sleep health, we think about a couple of different factors.

One would be regularity. Healthy sleep is usually sleep that follows a pretty predictable pattern. Usually people sleeping at night. Now you might have clients that have a hard time getting sleep at night for a variety of reasons. Work might be one of them. But regularity is important. Satisfaction with sleep.

is really important. The amount of alertness that they have during the day is really important. We also talk about how efficient their sleeping is. Are they when they're in bed? Are they sleeping? Or are they spending a lot of time in bed awake? And then there's the duration of sleep. They're not getting enough.

They're going to have I usually tell people to start in one of four different areas. And I, this is just sort of my approach, the distillation of the research sort of in the order that I've had the most success getting people to make changes. And some of this has been with. The work that I do with my college students, it's shocking how many college students, 18, 19 year olds who need conservatively seven, eight, nine hours of sleep, they're living on four or five.


Chris McDonald: easily. Yeah. Easily.

Kevin B. Handley: And in part, because my students are community college students and they're working and they're going to school and they often have families. So I always tell people to start where it's easiest to get some traction. And so the first thing that I tell people to do is to try to create a good sleeping space.

People generally are pretty willing to go home and take a look around their bedroom and see what they can do to make it a little bit more cool and dark and quiet and comfortable. That can be kind of fun. You go on a little bit of a scavenger hunt. It's like to see if we can find that the light, the one thing about intervening with sleep that I, I really emphasize with people is don't get obsessive about it.

You will read so many things in here. So there's a hack for this. And if you don't do it this way, you know what you do the best you can do the best you can be flexible, be really flexible, you know, I mean, if you have a client who has a A trauma history that might be related in some way to the bed, you know, a completely dark room might be really difficult for them.

So don't do it. So

Chris McDonald: we'll keep it trauma informed. There

Kevin B. Handley: you go. You create a sleep space that works for the individual. There's no one size fits all. The other thing you can work on is helping people create a sleep schedule. The sleep schedule that we prescribe is to go to bed when you're sleepy and wake up at roughly the same time every day.

People don't like the weekend element of it, but you know what, if somebody's. It's waking schedule is all over the place. Then, you know, I'm happy if they can get it relatively consistent five days a week. I would, that would be a big improvement, but you're, you can't really control when you fall asleep.

And so we don't ever want to be in the position of chasing sleep. Therefore we don't like to prescribe a bedtime. Now there are, when you're treating insomnia, in some cases, you might want to prescribe some kind of bedtime, but in most cases, you start with a wake up time because that you can control. You wake up to an alarm clock every day and go to bed when you're sleepy.

One of the things I have to tell you that I really liked about your book is that you were focused a lot on a nice wind down routine, right? Which is. That's the third area that I ask people to focus on, which I just call wind down wisely. Find a wise way to wind down that just sort of settles and helps you relax.

Not in the service of chasing after sleep. We're not trying to make sleep come.

Chris McDonald: Yeah. Right.

Kevin B. Handley: And we don't want to sit around and wait for the, you know, the little sleep fairy to put Mr. Sandman, right. Couldn't remember the name of that person that comes in and messes with your sleep, but you want to find a way to reduce your overall level of physiological arousal.

Anything you can do, that would be great. That would be great. It's at that point, you'll start to get better at understanding the difference between sleepy and tired. People walk around tired all the time because they're not getting enough sleep, but they may not be sleepy. So when I say sleepy, I mean, the likelihood that you'll fall asleep when you get into bed,

Chris McDonald: Oh, okay.

Kevin B. Handley: Don't go get in bed when you're tired because you might not be anywhere near ready to fall asleep. But unless you spend a little bit of time winding down wisely, well, you might not know the difference between when you're buying. I was going

Chris McDonald: to say, how do you know the difference?

Kevin B. Handley: It's really hard. It's really hard.

So when I tell people to pick any yoga nidra that they find on YouTube and try it in the evening, I said, no, so you fall asleep and you, you were sleeping.

Chris McDonald: Gotcha.

Kevin B. Handley: And, you know, if you can try to wind down wisely, I, the other thing about winding down wisely is I don't, I don't, you kind of beat people over the head with this idea of you got to give up screens because number one, they're probably not going to do it.

Chris McDonald: I know they're not. They're not going to do it. And that's okay. I say reduce time. Reduce time.

Kevin B. Handley: Maybe don't have it in bed staring at it, you know, I think

Chris McDonald: that's the biggest thing I see is people on their phones for a long time before bed that that causes problem.

Kevin B. Handley: Yeah, I think it causes a problem for a couple of reasons.

1 is light is what's necessary for the brain to understand that it's time to be awake. So if you're using it close to bedtime, you're trying to wind down. But you're then sending a signal to your brain that it's time to wake up. And that's a little bit confusing. The other thing is that most people are on social media, and it's a good way to get amped up.

And it's a good way to keep scrolling over and over and over again. And the other thing we talk a lot about, and I think it comes up a lot in counseling, and it's getting more played out, is this idea of revenge, bedtime, procrastination. where people stay up later than what is useful for them in terms of sleep health, because I finally get some me time.

Chris McDonald: That's it. Yeah, I hear that all the time.

Kevin B. Handley: Yeah, of course. Of course. And you know, it's just like anything else that you work with in counseling. You absolutely have a need, for sure. You need that me time, that alone time, that quiet time. Is it timed well so that you're not sacrificing sleep in order to get it?

Chris McDonald: That's true.

Kevin B. Handley: Can we make a little bit of an adjustment? Just a small adjustment. That could make a big difference.

Chris McDonald: Yeah. So there's a balance there.

Kevin B. Handley: Absolutely. Absolutely. And another way, you know, there's creating your sleep space, winding down wisely, creating a sleep schedule. But then one thing that people often forget about, and this is relatively new, and this is the importance of waking up well.

When you wake, a lot of people have a hard time waking up in the morning, for good reason. They're, they're trying to wake up to go to work when they're not sufficiently refreshed from sleep. Um, this could be they haven't received enough sleep. They were restless. They maybe have undiagnosed sleep apnea.

There's any number of reasons, but if you can wake up and start sending a message to your brain, that it's time to be awake and alert, it is amazing what a difference that will make when you're trying to fall asleep the next night. So I always tell people that the time of day that you start working on your sleep is when you wake up in the morning.

Chris McDonald: How do you do that?

Kevin B. Handley: It's an acronym, it's called the rise up routine. And most of this comes from the work of two researchers, Allison Harvey at Stanford and Daniel Boise at University of Pittsburgh. They take into account the importance of using the circadian rhythm to your advantage. And so if you can increase your essentially your movement and your light exposure first thing in the morning, you end up having a better, better energy during the day and falling asleep better at night.

So first of all, with the rise up protocol is to resist snoozing. The snooze button is. It's such a killer for people and it's amazing how much anxiety people have about not getting up on time to go to work. And so they set multiple alarms to wake themselves up. So can you get them to back off that a little bit?

You know, when you hit that snooze button, you're not, your brain isn't sure what to do. You know, the bed is for sleeping. So if you hit the snooze button, am I supposed to be waking up with the alarm or I'm supposed to be going back to sleep?

Chris McDonald: Yeah, exactly.

Kevin B. Handley: It's a little bit confusing. Eyes for increased activity.

Get moving. It's Do something. Uh, you've talked a lot in recent podcasts about the importance of movements in terms of self care. You can

Chris McDonald: do some bed yoga before you get out of bed.

Kevin B. Handley: There you go. And bring your knees to your

Chris McDonald: chest. Give us, give yourself a hug.

Kevin B. Handley: Better than hitting the snooze button.

Chris McDonald: I'll take it.

Kevin B. Handley: A lot of people like to shower at night to save time in the morning, but a shower in the morning can really help you wake up and get moving and exposure to light. Get up in the morning. direct sun, not direct sunlight, but sunlight is really important for maintaining healthy circadian rhythms and helping you sleep.

So the more light exposure you get during the day, particularly in the morning, the better you'll sleep at night. Interestingly, one of the most vexing problems when people have trouble sleeping is the problem of staying asleep. Two things really that have been shown to have Facilitate that fairly. Well, our 1 exposure to sunlight and 2 movement during the day.

So when you tell people,

Chris McDonald: you need to do something to make your body tired

Kevin B. Handley: too. Absolutely. Well, you know, we choose to tell people don't make your body too tired at night because then, you know, you'll be too amped up as you do it. But the type of, uh, intervention that makes your body really tired is exposure to sunlight.


Chris McDonald: Yes, definitely.

Kevin B. Handley: It's really, I tell people, if you remember a time, perhaps when you've gone to the beach, where you just spend a lot of time outside, you come back and you're so tired. Well, the brain reacts to that differential light exposure to, you know, when it goes from a really bright to really dark, it's like, ah, it's time to sleep.

That's really great. Sleep really

Chris McDonald: good when I'm at the beach. Exactly.

Kevin B. Handley: People sleep well at the beach. And then you can do things like play upbeat music, You can phone a friend, do anything to kind of get you up and moving in the morning. And if you can rise up and really wake up well, but falling asleep the next night gets easier.

Now, none of these things are going to work overnight, of course. You can see that when you start thinking about all the different ways to intervene with Improving sleep health, a lot of it is just consistent with what you do as a holistic practitioner to improve overall health.

Chris McDonald: Are you feeling stressed and overwhelmed as a counselor?

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Start prioritizing your wellbeing today. Go to hcpodcast. org forward slash workbook. That's hcpodcast. org forward slash workbook to discover how your journey to self care begins today. Yeah, that makes a lot of sense. I think that's so interesting. The research on doing things in the morning to help you sleep for the.

The nighttime. Yeah, that's something for listeners to think about too. And to what you can be telling your clients and to really experiment with this and talk to your clients and see what could work, you know, it might be different for everybody to practice

Kevin B. Handley: this. Well, one of the first things we do in cognitive behavioral treatment for insomnia, is we have to explain how the sleep system works.

Um, and when you start explaining how the circadian rhythm works and the idea that you want to work with your body's natural biorhythms instead of against it, well, it really starts to make sense.

Chris McDonald: Yeah. It's like,

Kevin B. Handley: Oh, in the morning, my body's trying to alert me to get me ready for the day. Oh, okay. Well, I guess it does make sense to do some things to help that along.

Oh, in the evening, my body is ramping down. Oh, okay. Well, maybe I should join in the party and try to wind down wisely. So it's really just working with your body and your natural sleep ability in order to get a good night's sleep. The problem people have with sleep is that they're working against their biological systems.

Chris McDonald: That's true. So that helping that education portion, maybe for clients to understand. So can you tell us more about the CBTI, how that can help clients?

Kevin B. Handley: Sure. So CBTI is the most studied and demonstrably best treatment for insomnia that there is. Um, it's usually delivered in four to six sessions, depending on the protocol.

Uh, there are some protocols where it's very, very brief. Wow, that's really brief. It's very brief. Now, it does require some commitment on the part of the client. Sure, I'm sure. But it essentially starts off with something that everybody could start with, and that is just having people track their sleep. We have a way of tracking sleep using what's called the consensus sleep diary.

Paper and pencil work. You can have them fill out a diary in the morning. Once you collect a little bit of data, And you get an idea of what their sleep looks like. Well, then you can start teaching them. Okay, here's what I want you to do in terms of when I want you to time your wake up. So that you're waking up with your body, not against your body, make adjustments based.

It's all dated, very much data driven. That's the behavioral part of it. The cognitive part of it is the worry and other things that get in the way of falling asleep. So it starts with psychoeducation, correcting, you know, errant beliefs about sleep. Lots of people have them. I never, I never cease to be amazed by the number of questions I get about sleep.

It's like that information's out there. It doesn't make any sense, but okay. So if you can correct some stuff and then people feel more confident, it's like, Oh, okay. Now that I understand how sleep works.

Chris McDonald: Because I'm wondering too, is it like people looking at the clock? Oh, my God, I only have four more hours to sleep and I got to get up.

Oh, my God, I can't get to sleep.

Kevin B. Handley: Does it

Chris McDonald: help with that?

Kevin B. Handley: It absolutely does. And so. When we talked about the precipitating factors that lead to insomnia, the thing about cognitive behavioral therapy for insomnia is that it focuses on the next level, which are the perpetuating factors. So there's predisposing factors that put you at risk, precipitating factors that cause the insomnia, and then perpetuating factors where your attempts to get a good night's sleep are probably working against you.

So if we can change the way that you think about sleep, think about the importance of sleep. People freak out about, Oh, I'm not going to be able to fall asleep. It's say, I'll be laying here, I'm watching the clock, all sorts of things. Sleep related worry is something that we focus on. And I tell people, you know, who aren't trained in CBTI to help your clients with worry.

Like you would help them with any other worry, whatever methodology you use is great. And so they tend to worry at bed, in bed about life in general and about sleep itself. Okay. So once you hit, once you get past 10 PM, but particularly after midnight, there's a great paper I would recommend. It's called the mind at midnight.

It's all about the neuropsychology of how the frontal lobes operate after midnight. And boy, after midnight is not the time when you want to be trying to solve problems.

Chris McDonald: No, definitely not.

Kevin B. Handley: But that's really what happens. We, people lie in bed and they're just trying to solve the world's problems, but it's not, they're not going to engage in good problem solving.

I always tell people that. Problem solving is the antidote to worry. So if you're laying in bed, it's probably just going to be worry about stuff. So interventions like having people actually deal with their worries earlier in the evening.

Chris McDonald: Yeah.

Kevin B. Handley: Rather than when they get into bed at night. Things like that.

Can I

Chris McDonald: ask you something that I've tried with clients and let me know what you think about that. This is CBTI related, but because I've told people to keep a notebook by their bed and to write down worries and write down potential solutions, even if they don't know if it's going to work and just let it go.

Yeah. I don't know if that could be related to this, but to me, that was just a way to let the brain know that I'm working on this. I'll get to it.

Kevin B. Handley: That's a great idea. We like to have that happen outside of the bed. Outside of it.

Chris McDonald: Okay. Okay. That's good to know.

Kevin B. Handley: But again, if, if people find it comforting to have something to just lean over and write down.

Especially if they fear us, Oh, I'm going to forget this, right? Cause

Chris McDonald: I have a lot of people that type a just like, Oh my God, I have this. And then I have this thing I got to do tomorrow. Oh my gosh. And I'm thinking about this meeting and be at it.

Kevin B. Handley: Yeah. Then another problem with type A's is they'll wake up in the middle of the night and they'll wake up say after three, four hours and they feel refreshed.

And now it's like, let's get into things. Let's get to work. Exactly. Right. Exactly. Right. So the behavioral model of worry is that worry is conceptualized as an avoidance strategy. We're running things through our head and what we need to do is we need to actually approach the problem to try to solve it.

So when you're asking people to write down the problem in a potential solution, you're asking them to approach the problem rather than just spinning it. And that's what you don't want. So, yeah, I think that's, you know, very CBTI consistent.

Chris McDonald: It's a start because a lot of people, a lot of people, people do get stuck in the head too.

I mean, I do the body based stuff too, but, but I always say with sleep too, that before sleep to, to get some things out of their head, but also get into the body to do, like you said, the physiological, the wind down routine to calm things down, to do some gentle movement, to slow things down, even if they can do meditation too, to kind of help the body calm itself.

Yoga nidra. If you haven't tried that listeners, it's a wonderful practice.

Kevin B. Handley: Oh, it's fantastic.

Chris McDonald: It is

Kevin B. Handley: fairly well studied to as a method of relaxation and remember that the goal of winding down wisely is not to put you to sleep,

Chris McDonald: right? It's

Kevin B. Handley: to reduce your overall level of physiological reactivity to hopefully help you sleeps as a night.

Chris McDonald: Yes, absolutely. And

Kevin B. Handley: it really does. work well. But yes, sometimes you'll have clients who they lay in bed and they're just like, Oh, I

Chris McDonald: can't fall asleep. I can't.

Kevin B. Handley: And they're not worrying about anything because they're trying to fall asleep, get out of bed, go do something until you're sleepy and then go back to bed.

So some clients, Alison Harvey's group at Stanford, they have, it's for people who don't want to do the worry part of it. They've replaced that or substituted that in some studies with practicing gratitude.

Chris McDonald: Oh, okay.

Kevin B. Handley: Um, which is something if you're not trained in really doing a lot of work with worry, but you're much more comfortable helping people work on gratitude and people are more willing to do that.

That's a great wind down routine.

Chris McDonald: Yeah. Yeah.

Kevin B. Handley: Yeah.

Chris McDonald: Cause I've heard a lot of people doing that with journaling cause I like to assign journaling as well. I think that could be helpful. Kind of. Cause that to me, that's like a, a good way to end the day too.

Kevin B. Handley: Yeah. Absolutely. Whatever quiets the body and quiets the mind a little bit.

Quiets the mind. Yeah. You know, have an experimental mindset about it. Try it out. Yeah,

Chris McDonald: that's true. What's going to work for one person isn't

Kevin B. Handley: going to work for another person.

Chris McDonald: So can we talk about practitioner self care?

Kevin B. Handley: Absolutely.

Chris McDonald: So why is sleep health important for that?

Kevin B. Handley: Sleep health is really important.

You know, I have to tell you that I, I loved the opening observation you made in your book, where you took the time to realize that when you were tired, the work didn't go so well, but when you were refreshed, the work went well. Goes so much better.

Chris McDonald: Yeah. It's

Kevin B. Handley: fantastic.

Chris McDonald: Where am I? Yeah. Depends. It really flex on the sessions.

I do.

Kevin B. Handley: That's exactly right. So we know the sleep deprivation reduces your ability to pay attention to problem solve, to have empathy. We know it's a long term risk factor for things like Alzheimer's disease and dementia. So we know that sleep deprivation affects your ability to process problems.

Information and to emotionally regulate. Well, I'm not sure what else you need to be focused on in therapy, if you're not regulating your emotions and you're not able to pay attention and work with people. So I think if you really want to show up and do well with your clients, then paying attention to your sleep health is really, really important.

Just in terms of doing good work. A lot of ethical codes have now mentioned practitioner self care as something that's an ethical responsibility. And I think that it is. I think that it is. Now it's going to look a little different from person to person, but you know, there's still this resistance among practitioners to take care of themselves and to go get help when they need it.

Chris McDonald: Absolutely. Yeah. And, and still to push themselves more and my clients need, I see that sometime on Facebook, my clients need me though. And I'm like, like for right now I have some physical issues, but you know, I've had to switch around my thinking too, that, you know, my clients need me, but if I'm not, well, I gotta take care of myself.

I gotta do what I gotta do. And I'm changing my schedule. I'm telling my clients, I'm like, look, this is the way it is.

Kevin B. Handley: Absolutely. You know, I care

Chris McDonald: about you. I'm going to take care of you, but your appointments might have to change.

Kevin B. Handley: Every clinician that I've ever worked with, you know, coaching or whatever, when they've decided that they've needed to adjust their schedule to take care of themselves.


Chris McDonald: the hardest thing for them.

Kevin B. Handley: It's really hard to do. It's really hard. I've never seen it backfire. And I mean, Oh my God,

Chris McDonald: my clients are reaching out. They're like, are you okay? Oh my God. Yeah,

Kevin B. Handley: exactly. Clients are so understanding and really, what do you want to be modeling for them?

Chris McDonald: And that's it. And you know, that's what I did.

I actually wrote them an email and said, look, you know, life has happened. You know, I've had to go to these doctors. I have an MRI, you know, blah, blah, blah. But I'm like, you know, I'm taking time to reflect. I'm resting, I'm meditating, I'm journal, you know, do all those things I tell them to do. So it's like, I'm trying to show them that I'm taking care of myself.


Kevin B. Handley: would

Chris McDonald: I be showing them if I was like, you know, burned out, not taking care of myself, making my condition worse? Well,

Kevin B. Handley: I think you know what you'd be showing them exactly those things

Chris McDonald: what not to do what

Kevin B. Handley: not to do, but you know, I think there's a reason for that a sociological explanation for that.

And that is from the time that most people practicing today were in high school, they were forced into a really horrible sleep deprivation experiment. Where their schooling started earlier than they should have even been awake, and nobody ever paid much attention to it. So what happened? Everybody, okay, who's high achieving, and you have to be high achieving to be a professional, learned how to function under sleep deprivation conditions.

Yeah, exactly. And brush it off. Combine that with the, a bit of a myth or mythology around the high performing individual not really needing sleep, I think it's a recipe for disaster. It

Chris McDonald: is, yeah.

Kevin B. Handley: It really is. And I

Chris McDonald: tell people, too, in our field, we need more sleep, we need more self care than other fields, whether you want to hear this or not.

Kevin B. Handley: Absolutely.

Chris McDonald: I think so. We're taking in that we have to offer so much space for other people, so much different, especially work with trauma. Oh, my God.

Kevin B. Handley: Absolutely. You need more. Absolutely. And so some of these factors that affect our, you know, increase the need for sleep are the same ones that get in the way of getting enough sleep.

Chris McDonald: Yeah. You know, it is really tough.

Kevin B. Handley: It's very, very, very tough. You know, if we were professional athletes, it would be stipulated in our contract that we had to be sleeping more than we should be, right? It would be great if we all got training in this in graduate school, but we don't. I know. I've been really trying to get into graduate training programs and talk to people about the importance of sleep to, you know, start working on this now and do a little experiment.

Chris McDonald: Yeah. My

Kevin B. Handley: college students, I have them, I teach them about sleep and I give them the tools to track their sleep. And I tell them, I was like, if you track your sleep for a couple of weeks, come to me at the end of the semester, I'll show you exactly what to do either over the December break or the summer break and try it for a couple of weeks.

And see what happens and see if you don't feel better.

Chris McDonald: What do they say?

Kevin B. Handley: Some of them take, I mean, maybe 1 percent of them take me up on it, but then they do. And then they come back and like, Oh my gosh, I sleep so much. Isn't that amazing. I've had people come back years later and say that was really important.

I'm like, wow. Okay, great.

Chris McDonald: See, it really can work. You know, you know what's amazing though? If you can get to the place in your life, like I have my own business, so I can, I don't wake up, I don't have an alarm unless I have an appointment or something, but if my body goes naturally to wake up when it wants to wake up now, which I think is so healthy and it's so amazing.

But when I worked in the school system and I had to get up at five, eight, I was sleep deprived all the time, and it was miserable, and I had more sickness in my body, and I had so much going on all the time, I caught every kind of sickness out there, I had more migraines, I had more problems, but since I've had my own practice, it's just like I've been so much more healthy, I'm not tired all the time, I was tired all the time

Kevin B. Handley: when

Chris McDonald: I worked in the school system, it was the best thing I ever did to leave, but, but I'm telling you, but that makes a difference, doesn't it though, it

Kevin B. Handley: makes a huge difference, I think it's a really good point you make that, you know, clients are going to come in and there's going to be just Parts of their lives that they can't make different.

And that's it. And that's it. And so it's okay. Well, given what you've got, what's the best that we can do?

Chris McDonald: Where can we make changes, right?

Kevin B. Handley: Absolutely. One for everybody who works with kids. I mean, this is your whole life. I mean, you, you have to figure out a way to help adolescents sleep a little bit more.

Chris McDonald: Oh, for sure. I know you made a face, but it's tough.

Kevin B. Handley: It really is tough.

Chris McDonald: Yeah. But we can find ways. So if a

Kevin B. Handley: kid does better by coming home and taking a nap and then getting up and starting their homework, then okay, that was great.

Chris McDonald: Yeah, yeah, exactly. We got to do what works. So, so what's the takeaway to counselors who might be listening but unsure of how to start with sleep with clients?

What would you tell them?

Kevin B. Handley: You know, I would tell you just to try to make a small change and just start the conversation.

Chris McDonald: Start the conversation.

Kevin B. Handley: Just ask. Just tell me how to, tell me what your sleep looks like.

Chris McDonald: Yeah, yeah. Tell me what your sleep

Kevin B. Handley: looks like. Yeah. And you might hear some things that really scare you or make you go, well, I don't know what to do about that.

And then you can consult with somebody and you can refer out if you need to. And there's lots of people who can help you. So, but you have to start asking if you want to start intervening. If you think there might be some challenges there, Have them keep a sleep diary.

Chris McDonald: That's true. It's a pretty easy thing to

Kevin B. Handley: do.

Use your own skills. Everybody just think about. You have these skills. You have these skills, right? Think about what you're good at. Think about, you know, when you're, when you're at your best with your clients, when are you at your best? It's like, okay, well, how can I leverage that in the area of sleep?

Chris McDonald: Well, what's the best way for listeners to find you to learn more about you?

Kevin B. Handley: Ah, but they can go to my website. It's kevinhandley. com. There's a little events. I'm not an online instructor, so I don't necessarily have a have a training product kind of page there about coming events. I do trainings every so often, people can call me up and consult with me.

They can find me that way to set up, get up my mailing list. I don't have a real big social media thing going.

Chris McDonald: You have a training coming up too, right?

Kevin B. Handley: I do. Well, in the middle of June, I have a training. It's a two hour online training on, I can't remember the date off the top of my head. That's okay. I set up my calendar.

Chris McDonald: We'll have it in the show notes.

Kevin B. Handley: It's on Monday afternoon from like 11 to one. And I find that it's useful to combine Uh, sleep with ethics because people tend to get their ethics, uh, that way and

Chris McDonald: June is perfect time for North Carolina too. I don't know what other states we are.

Kevin B. Handley: There you go.

Chris McDonald: Excellent.

Kevin B. Handley: And it's just sort of a taster. It's like, okay, if you want to get started with clients, here's some basics that you need to know about how sleep works and then what to do about it. And really trying to encourage people to start with themselves and putting a little self care for themselves and model that for their, their clients.

Chris McDonald: Well, this was a great conversation. Thanks for coming on the podcast, Kevin.

Kevin B. Handley: Thanks so much for having me. I'm glad to be a part of helping more practitioners pay attention to sleep. Awesome.

Chris McDonald: And thanks to my listeners and as a gift to you and to help support you on your holistic journey. I have a free 30 day aura meditation app guest pass for you.

To help you find peace and get your restful sleep, check it out today at hcpodcast. org forward slash better sleep. That's hcpodcast. org forward slash better sleep. And once again, this is Chris McDonald sending each one of you much light and love. Till next time. Take care. Thanks for listening. The information in this podcast is for general educational purposes only, and it is given with the understanding that neither the host, the publisher, or the guests are giving legal financial counseling.

The Holistic Counseling Podcast is proudly part of the Psych Craft Network.

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Self-Care for the Counselor - a holistic guide for helping professionals by Christine McDonald , MS,NCC,LPCS