Introduction: Cognitive Behavioural Therapy for Insomnia (CBT-I) is the first-choice treatment for insomnia disorders. Although CBT-I is primarily provided by trained psychologists, evidence shows that other healthcare providers can also successfully apply interventions based on CBT-I principles in absence of complex psychiatric comorbidities. Because insomnia and chronic pain often co-occur, integrating CBT-I-based interventions into physical therapy is relevant.
Objectives: To identify implementation barriers for CBT-I in physical therapist practice and to formulate implementation strategies to address them.
Methods: 16 stakeholders (8 physical therapists, 3 psychologists, 2 general practitioners, and 3 individuals with chronic pain and insomnia) were invited for 3 group-interviews and 1 online questionnaire. Implementation barriers were identified through thematic analysis according to the Consolidated Framework for Implementation
Research (CFIR). Implementation strategies were matched to barriers and ranked based on evidence and stakeholder feedback.
Results: 33 implementation barriers were identified across all CFIR domains, and 13 final strategies were formulated to address these barriers. Key strategies included education and training for physical therapists, structural changes, and raising awareness among general practitioners and the public. Secondary strategies focussed on adaptability of CBT-I, developing supporting tools, and multidisciplinary collaboration.