UNT BSM Training Program FAQ

1. How many hours of BSM training does the program provide?
The program currently provides up to 1500 hours of behavioral sleep medicine (BSM) practicum training. In addition, the students complete a 500 hour behavioral medicine practicum. In terms of didactics, students receive over 1000 hours of training in behavioral medicine didactics and >50 hours in BSM (this course has not been given yet, so the exact number of hours is not certain, but we are sure it meets the requirements laid out in the application of >50, and covers both the core and other areas).

2. How is the didactic requirement covered? Please specify types of instruction, amount of time dedicated to each, and breadth of content. If there is a list of required readings, please attach. What is the total amount of time dedicated to didactic instruction?
Due to the relatively intense training in behavioral medicine, and the small number of students (i.e., one new student per year) with the time or inclination to study BSM, BSM didactics will occur through a special problems class (Psyc 5900), which will include the assigned readings, with weekly quizzes (chapters) or abstracts (for original manuscripts). Students will be required to write a single spaced one page abstract on each original manuscript they read, stating the thesis, sample if applicable, research design, and strengths and weakness of the paper (including research design). The BM didactic component comes through course work completed at the University of North Texas in Behavioral Medicine. Students in the Clinical Health Psychology program are required to complete 8 courses designed specifically to teach them theory and techniques of behavioral medicine. The courses are described in the hypothetical course of studies, but for easier reference, they are Medical and Behavioral Disorders; Developmental Health Psychology; Professional Issues in Behavioral Medicine Consultation; Psychotherapy Methods in Behavioral Medicine; Biofeedback Methods and Behavioral Medicine; Cognitive Behavioral Techniques in Health and Medicine; Psychoneuroimmunology; Cultural Aspects of Health. Students meet for each of these classes for 3-4 hours a week and have assigned readings each week that take on average 6 hours a week to complete, resulting in over 1000 hours of didactic training in behavioral medicine.

3. How is the practicum requirement covered? Please specify the typical kinds of patients or sleep disorders seen, the typical number of each seen, the typical age distribution of patients, and the typical clinical responsibilities of the BSM student. What is the total amount of time dedicated to practicum training?
The program has one mandatory BSM practicum that is now 12 months at 20 hours a week (for a total of 1000 hours) at Sleep Medicine Associates of Texas. Training at Sleep Medicine Associates of Texas will be supervised on site by a psychiatrist (Leon Rosenthal, M.D.) who is boarded in sleep medicine and has long standing research and clinical interests in BSM. The typical patient seen has psychophyiosological insomnia. However, the student will also see patients who are having trouble with sleep state misperception, CPAP compliance and need systematic desensitization, and those with phase advance or phase delay syndrome and need chronotherapy. Cognitive Behavioral Therapy of Insomnia will be administered per instructions by Morin and Espie (2004), as this is an updated version of Morin's original 1993 text, and is closely in line with the 6-8 session protocol we use in our research projects. Sessions last 30-90 minutes, and the typical patient is over 18, with an average age of 45, split equally between males and females. Students will typically see 10-15 patients per week with a total of 6-8 sessions per patient. The typical responsibilities of the BSM student include completion of intake session and therapy sessions with related progress notes, weekly review and recording of sleep log data, and keeping the primary sleep physician informed of progress and medication. The student receives supervisory assistance by the attending physician at the end of each session, and is responsible for monitoring the patient's situation to determine if CBTi continues to be the best course of action. The student will also have 1 hour weekly supervision off-site with Daniel Taylor, Ph.D., which is necessary for internship application and licensure. The student will be responsible for all areas of the patient's behavioral care, including intake, BSM treatment, and closure. The supervising physician will, when necessary, manage the patient's medications or other physical problems as required.

An optional practicum at Children's Medical Center includes observation and provision of pediatric BSM services. However, in this case patients present with a variety of issues from settling problems, nighttime waking, nocturnal enuresis, all the way to CPAP compliance. Treatment will be administered in line with recommendations made by Mindell and Owens (2003), as this is the most current clinical text available for pediatric behavioral sleep medicine. In addition, as a requirement of the Clinical Health Psychology Program students are required to complete a 500 hour behavioral medicine preceptorship practicum at The University of North Texas Health Sciences Center. A description of this experience is attached.

4. Describe the research programs, if any, in which students are typically involved.
Students are typically involved in one of several research programs. There is a sleep research laboratory at UNT that conducts primarily insomnia research. Current research projects include the epidemiology of insomnia in adolescent, college, and adult populations, as well as treatment studies comparing the efficacy of CBT of primary insomnia or co-morbid insomnia. Other research programs are located at Sleep Medicine Associates of Texas, and Children's Medical Center Psychiatry Department. Both of these programs involve various sleep-related studies with adults and children and require the ability to coordinate research, run statistical analyses, and co-author manuscripts.

5. Is the 'home' program (e.g., clinical psychology or nursing graduate program or clinical psychology internship) accredited as a health provider training program? Are graduates of the home program eligible to sit for the State licensing examination for the provision of health services?
The home program is accredited by the American Psychological Association from 2004-2011. This is the longest length of initial accreditation possible. Graduates of the program who complete an APA-approved internship are eligible to sit for the state licensing examination for psychologists, and if licensed may provide mental health services to the community.

6. Is the BSM training program affiliated with a primary sleep disorders center accredited by the AASM or one that is multidisciplinary and treats a broad range of patients? What is the name of the center?
Yes, this BSM training program is affiliated with the Sleep Medicine Associates of Texas at Presbyterian Hospital of Dallas and The Children's Medical Center of Dallas, both of which are accredited sleep centers by the AASM. The physicians at Sleep Medicine Associates of Dallas include Phillip Becker, M.D., Andrew Jamieson, M.D., Leon Rosenthal, M.D., Wolfgang Schmidt-Nowara, M.D., and John Debus, M.D. The director of the sleep center at Children's Medical Center is John Herman, Ph.D.

7. Is the program directed by someone with five years experience in BSM (or BSM certified)?
The program is directed by Dr. Daniel Taylor, Ph.D., who has eight years experience in BSM. Dr. Taylor completed his clinical psychology doctoral program (4 yrs) at the University of Memphis, under the mentorship of Kenneth L. Lichstein, Ph.D., one of the authors of the text Treating Sleep Disorders: Principles and Practice of Behavioral Sleep Medicine. He then went on to one year internship at Brown Medical School, where he received research training under Mary Carskadon, Ph.D., one of the leaders of the sleep medicine field, and received clinical training under one of the leaders of the BSM field, Donn Posner, Ph.D. It is important to note that both Dr. Lichstein and Dr. Posner are certified in BSM. Finally, Dr. Taylor completed a one year post-doctoral fellowship in BSM at the University of Texas Southwestern Medical School, under the supervision of John Herman, Ph.D., Phillip Becker, M.D., Leon Rosenthal, M.D., Wolfgang Schmidt-Nowara, M.D., and Andrew Jamieson, M.D.. Finally, Dr. Taylor has been practicing and performing research in BSM as an independent scientist at the University of North Texas for the past 2 years. Dr. Taylor plans to sit for the BSM exam June 2007. All members of the BSM portion of the training program, including Dr. Taylor, are Diplomats of the American Board of Sleep Medicine.

8. How many students are currently in your program?
There are currently six doctoral students receiving BSM training at the University of North Texas. In whole, there are approximately 80 doctoral students in the Clinical Health Psychology program at the University.

9. How many students have graduated from your program? Give the names and year of completion.
As Dr. Taylor has only been in the program for 2 years, none of his students have yet to graduate with full training in BSM. One student has worked briefly (his last year at UNT) with Dr. Taylor before going on to internship at Brown Medical School. This student only helped Dr. Taylor complete one research project, of which he was made last author. However, 3 of Dr. Taylor's students will be applying for internship next year, and having trained at an accredited BSM program will greatly improve their chances of obtaining an internship at one of the internship programs offering BSM training.

10. How and how often are individual meetings with each student scheduled for the purpose of discussing progress and weaknesses during the BSM training program?
Individual progress meetings will occur formally once a year. Please see attached updated evaluation form. In addition, students meet weekly with Dr. Taylor for research supervision, where concerns will be raised, and students also meet weekly with Dr. Taylor and Dr. Rosenthal during their practicum, where concerns and weaknesses will again be addressed informally.