For physicians and clinicians
Refer a patient for CBT-i
CBT-i is the recommended first treatment for chronic insomnia. The American College of Physicians (2016) and the American Academy of Sleep Medicine (2021) both recommend it before sleeping pills. Most patients never get it, because there's nowhere nearby to send them.
I'm a Registered Associate Marriage and Family Therapist at Echo Park Creative Psychology, trained in CBT-i by the Center for Deployment Psychology. CBT-i is the center of my practice, in person in Echo Park and online anywhere in California.
To refer: have your patient book a free 20-minute consult at ledamaliga.com/book, or email me at leda@cognito.agency.
What to know
Who's a good fit. Adults in California with trouble falling or staying asleep three or more nights a week for three months or longer. That includes patients who want to come off sleep medication, and women whose sleep changed in perimenopause or menopause.
What I screen for first. Every patient starts with a free 20-minute consultation and a sleep interview. If I see signs of sleep apnea, bipolar disorder, seizure disorder or anything else where sleep restriction needs medical oversight, I send them back to you before we begin.
Medication stays with you. If your patient takes sleep medication, any change or taper happens under your direction.
What treatment looks like. Six to eight sessions of standard CBT-i: a sleep diary, a sleep window, stimulus control, cognitive restructuring and relapse prevention. Patients can do it one-on-one ($175 a session, in network with Aetna) or in the eight-week Insomnia Group ($140 a week).
Updates for you. With your patient's written consent, I'll send you a short update at the start and at the end of treatment.
How to refer. Have your patient book a free consult at ledamaliga.com/book, or email me at leda@cognito.agency.
About me
I came to CBT-i as a patient first. I had insomnia for years and tried the medications, which left me sedated, not rested. CBT-i is what helped me sleep again. I trained in it through the Center for Deployment Psychology, where I continue in consultation, and I bring in mindfulness and tools to calm the nervous system when they help.
Patients outside California, or not ready for therapy?
They can start with Notes from 3:00 a.m., my free six-week email course, or the Sleep Class, a live six-week course on Zoom that's open worldwide. Both are education, not therapy.
The fine print
CBT-i therapy is provided through Echo Park Creative Psychology by Leda Maliga, Registered Associate Marriage and Family Therapist (AMFT #161245), supervised by Vanessa Spooner, PsyD, Licensed Psychologist PSY24942. Notes from 3:00 a.m. and the Sleep Class are offered by Cognito. They're education, not therapy or medical advice.