A case series of group videoconference-delivered cognitive-behavioral therapy with morning light therapy in adolescents with delayed sleep timing

Article

Ricketts, Emily J., Rissman, Ariel J., Swisher, Valerie S., Joyce, Daniel S., Colwell, Christopher S. and Burgess, Helen J.. 2025. "A case series of group videoconference-delivered cognitive-behavioral therapy with morning light therapy in adolescents with delayed sleep timing." Behavioral Sleep Medicine. https://doi.org/10.1080/15402002.2025.2569376
Article Title

A case series of group videoconference-delivered cognitive-behavioral therapy with morning light therapy in adolescents with delayed sleep timing

ERA Journal ID41526
Article CategoryArticle
AuthorsRicketts, Emily J., Rissman, Ariel J., Swisher, Valerie S., Joyce, Daniel S., Colwell, Christopher S. and Burgess, Helen J.
Journal TitleBehavioral Sleep Medicine
Number of Pages17
Year2025
PublisherTaylor & Francis
Place of PublicationUnited States
ISSN1540-2002
1540-2010
Digital Object Identifier (DOI)https://doi.org/10.1080/15402002.2025.2569376
Web Address (URL)https://www.tandfonline.com/doi/full/10.1080/15402002.2025.2569376
Abstract

Objectives
This case series examined the feasibility and preliminary effects of group-based, videoconference-delivered cognitive-behavioral therapy (CBT) combined with morning light therapy (LT) in adolescents with delayed sleep timing.

Method
Five females aged 14–16 years (M = 15.0, SD = 0.7) completed clinician-administered screening interviews, and baseline and post-treatment assessments, including circadian phase measurement, and validated measures of chronotype, bedtime procrastination, pre-sleep arousal, daytime sleepiness, anxiety, depression, and quality of life. Actigraphy was used for the duration of the study. The intervention included six weekly CBT sessions and short-wavelength wearable LT assigned for 1 hr daily following an advancing wake time schedule.

Results
One participant showed a 94-min circadian phase advance; others showed minimal phase advance, no change, or phase delays (n = 2). All participants reported earlier chronotype by post-treatment. Three advanced either sleep onset or wake time, with one showing both. Two showed increased total sleep time, primarily due to delayed wake time. Other objective sleep outcomes are presented. Bedtime procrastination, pre-sleep arousal, daytime sleepiness, depression, and quality of life improved, with modest reductions in anxiety. Challenges included napping, ADHD and anxiety comorbidity, scheduling barriers (homework, extracurricular activities, screen use), and resistance to earlier bedtimes.

Conclusions
Results suggest heterogeneous circadian and sleep responses but consistent behavioral improvements. Extended LT duration, motivational enhancement, executive function or time management strategies, and behavioral economics-informed interventions may improve engagement and treatment efficacy.

Contains Sensitive ContentDoes not contain sensitive content
ANZSRC Field of Research 2020520299. Biological psychology not elsewhere classified
321204. Vision science
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Byline AffiliationsUniversity of California Los Angeles, United States
School of Psychology and Wellbeing
University of Michigan, United States
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