Treatment of Sleep Problems in Young Children: A Case Series Report of a Cognitive–Behavioral Play Intervention

Sleep problems and bedtime resistance are common in young children. Treatment is critical because sleep problems typically persist, and insufficient sleep is related to worse outcomes. Current behavioral treatments do not work directly with the child to reduce anxiety and distress at bedtime. Cognitive–behavioral play therapy is a treatment approach designed to teach coping skills to young children by combining cognitive–behavioral therapy with pretend play, a developmentally appropriate intervention mode. The current case series examined the effectiveness of adding a brief cognitive–behavioral play intervention (CBPI) to parent behavior management for young children with sleep difficulties. Four children (4–6 years of age) received 3 20- to 30-min individual sessions during which the child played out stories with an advanced graduate student therapist (first author, K. F.) about a child coping with sleep problems. Each child’s parent also received a 30-min sleep information session. Three parents returned questionnaires posttreatment. As expected, all 3 parents reported improvements in their child’s sleep habits, sleep anxiety, and general fears. All 3 parents also reported a high level of satisfaction with the treatment. These preliminary results suggest that the CBPI may be effective for decreasing anxiety and child distress when added to behavioral treatment, thus increasing the breadth of treatment approaches available for young children with sleep problems. These results are promising, although a randomized study is needed to further refine the intervention and establish the efficacy of a CBPI for treatment of sleep problems in young children.