I am a Clinical Health Psychologist in Dupont Circle, Washington DC and a behavioral sleep specialist associated with the Medstar Georgetown University’s Sleep Disorders Center for two decades.
I am also the Lead Curator and founding member of the Insomnia Hub. Collaborating with an interdisciplinary George Mason University team, we are developing ‘Share CBT-I’ … an ongoing, course-based health communication campaign to create a ‘digital bridge’ between healthcare professionals and consumers to provide open access to knowledge about ‘what works’ for insomnia and where to find it.
Address: 1234 19th Street, NW #901 Washington, DC 20036
Google Map: View here
Practice Website: DrCary.onair.cc
Hours: Friday and Saturday (9:00 – 5:30)
Payment: Out of Network Provider (no Medicare)
With over 20 years in academic medical centers, I’ve been involved in teaching Clinical Skills, assisting in clinical research trials in chronic pain, & practicing clinical health psychology, including with Georgetown University’s Sleep Disorders Center and teaching Sleep Medicine Fellows. For over 15 years in private practice, I’ve helped people learn to better manage their health and well-being.
I work with individual adults using four forms of brief, time-limited therapy. Motivational Therapy helps people be more “ready, willing, & able” to change. Cognitive-behavioral, mindfulness, motivational, and positive psychology techniques are used to help people manage challenges in these areas:
- Mental Health: depression, anxiety, anger, panic, phobias, social anxiety, obsessive-compulsive behavior, as well as other self-defeating behavior under stress
- Motivation to Change or sustain behavior: healthy lifestyle habits, like smoking cessation or weight management, procrastination with any goal
- Physical Conditions: pain, fatigue, chronic insomnia, Chronic Illness Self-Management: changes in function, relationships, self image, moods, values & other quality of life issues
- Well-Being: Increasing resilience, social intelligence, life satisfaction, & fulfillment
Having completed the Mayo Social Media Residency, I’m developing the Insomnia Hub in collaboration with George Mason University Communication professors and students. Our aim is to use social media to teach those in healthcare professions to interprofessionally communicate and spread ‘what works’ (evidence-based) for Insomnia. Also now, the CBT Hub is also being developed.
Why the Insomnia Hub?
Frankly, there are 3 things that drive me NUTS! Actually, they add up to 1 colossal healthcare failure that harms ALL of us. It goes far beyond Insomnia. And, I think it’s a dirty little secret that most in healthcare know about, but we think “It’s just so big … what can 1 person do?”
It turns out … we CAN do quite a bit … I’ve learned from Dr. Berwick and his Change Agent Network – called I-CAN … that … if you and I work together … we can make a BIG difference. So I’d like to share with you how I think we can have FUN, competing to see who among us can have the MOST impact!
My patient Ellen exemplifies this failure … when she says:
“I’ve been treated for Insomnia for the last 8 years. You and I figured it out in 4 sessions … why didn’t my doctor tell me about this sooner?”
You might be surprised that patients aren’t told what works best … even though … The Clinical Guidelines clearly state … First things first … Treat the behavior. And, that’s because insomnia is a LEARNED habit. It’s not rocket science … 70 – 80 % who use what’s called CBT-I succeed. They UNLEARN the habit.
In fact, the REAL picture of chronic insomnia, looks more like Ellen when she first came in. She was at wits end and described what actually blew up into FOUR problems:
… I can’t sleep … I get less than 5 hours a night … and … I can’t sleep without my sleeping pills … I feel out-of-control and helpless to fix this … and … I feel like there’s no end in sight … it’s hopeless!
You see? It’s not JUST insomnia … Ellen’s got DOUBLE trouble … she’s gotten hooked on ‘sleeping’ pills. She’s even got TRIPLE trouble … with anxiety (feeling helpless and out-of-control with her sleep). Still worse, her troubles QUADRUPLE with depression, or feeling hopeless that she’ll ever be able to get a decent night sleep. That’s the typical vicious cycle we see!
If Ellen had known about what’s proven to work in the first place, she could’ve kicked the insomnia habit in weeks. My typical ‘insomnia’ patient has suffered for years … despite having been ‘treated’ with several drugs.
Do the math … somewhere between 50 to 70 million are sleep deprived in the U.S. I wonder … How many are spending billions on sleeping pills … mainly because of the endless hype?
If PR folks can have such enormous success with direct-to-consumer marketing, Why don’t we (clinicians) use their PR tactics? Why don’t – we together – tell our success stories? We could easily tweet … “FIRST … Ask your doctor about CBT-I.”
Health researchers DID create consumer demand … for proven practices for quitting smoking – using PR tactics. But that was research, NOT reality. In real life, we in the health professions FEAR using media.
Just ask my colleagues at Mayo … For 5 years, they’ve encouraged their doctors to use social media. So Mayo offers a Social Media Residency. Here’s my class … a lot of us, right? Yes but, they were all PR professionals from other hospitals – except for 3 doctors and 1 psychologist (me).
This is a major GAP in education across the health professions. Over 10 years ago, thought leaders from all of our clinical fields put together a Curriculum Framework … fully recognizing that clinicians MUST promote health … at the population level. How else are we going to REACH the millions of Ellen’s .. or smokers … or diabetics?
The Framework specifies it … TEACH the use of mass media …& use hands-on methods to do it. But, it’s not happening in the health professions. In fact, when I tried to teach it at a medical school, I was politely told by their lawyer to ‘cease and desist.’
So, to sum up … Here’s what I believe is the colossal healthcare failure.
It’s true. Clinicians need to refer individual patients to CBT-I first. But, it’s exponentially worse that clinicians aren’t taught to share what they know on the Web. That’s where most people look for health information now. When clinicians don’t stand up for science … misinformation spreads all over social media – at EVERYBODY’S peril. And, when people don’t know what’s PROVEN to work – at the population level – millions needlessly suffer. Think about the millions who don’t know about science-based treatments that work …
- 80% of smokers WANT to quit … but, they fail 6 or 7 times … I know, I was one of them
- TOO MANY go under the knife (many back & knee surgeries are NOT proven to work).
- Too many are hooked on PAINKILLERS.
- Too many don’t VACCINATE kids.
This is why I believe we need ONE platform to practice using social media together.
An aim of the Insomnia Hub is to FILL that training GAP – with ONE hands-on social media module –- a quick training in how to promote proven practices on the web.
Why not add a service-learning unit to existing clinical health courses? It would teach how to convey and spread ‘what works and where to find it’ for Insomnia – using the Insomnia Hub as one common training platform. It would also teach students to collaborate interprofessionally online.
- Let’s say a psychology student creates a post about SHUTi, an App for CBT-I
- Then, a Sleep Medicine Fellow curates it. She checks the post for accuracy and then publishes it on the Hub.
- Then, a Psychiatry resident comments on the post about non-addicting medicine he prescribes (& tweets out a link to the post)
- Then, a Pharmacy student adds more to that tweet & re-tweets it.
Thus, service-learners could co-create & curate the best science-based knowledge … together
Look, primary care providers mainly just lack the TIME in a clinical visit to relate ALL the needed information AND – they lack ACCESS … often, they don’t know WHERE to find CBT.
So, here’s the change I’m hoping for. Imagine if ‘Primary Care’ Residents practice using the Hub as a ‘Digital Bridge’… right in the exam room … using a smartphone. They’d learn to say …
“I’ll prescribe pills as a LAST option, but FIRST … I really want you to go to the Insomnia Hub …
- Check out the pros and cons of using pills – from a number of professionals
- Check out CBT-I and those success stories of people who used it
- And, when you’re ready to try CBT-I, I highly recommend Dr. Smith – here in the Hub Directory.
I bet … using the Insomnia Hub as a digital bridge … in primary care … clinicians could refer 100% of adult patients with insomnia to CBT-I (as recommended by the Clinical Guideline) – effectively and quickly. Why not ask that as a Dissertation question?
How might YOU get involved?
- It’s communications professors like Drs. Kreps, Rowan, and Samoilenko … Who offer their students the option to help develop the health communication campaign, Share CBT-I.
- It could be clinical learners who want to practice health literacy skills or using the Digital Bridge in a Practicum or a Sim Center
- It could be public health learners who want to practice dissemination skills
- It could be residents or fellows who need to learn more about Sleep Medicine, rotating as a curator
- It’ll be clinicians who will share what they know AND be found in the Directory.
- And, it’ll be patients … who want to share how they kicked their insomnia habit.
Why not have FUN together?
Let’s compete to see how far and wide we can spread ‘what works’ for insomnia … and measure how much more of an impact my class can have over yours … OR … My school or even hospital against yours! GMU pilots have shown how this could organically grow into an intercollegiate competition.
And … My ultimate hope is that we develop Health Hubs for you-name-it-health-topic.
What’s YOUR passion … What Health Hub would you want to help LEAD?
Let’s get started … contact me!