Session 1: Assessment, Sleep Education, and Laying the Foundation We begin with a thorough assessment of both nightmares and insomnia. Many people who experience chronic nightmares also develop disrupted sleep patterns - frequent waking, delayed bedtimes, hypervigilance, or inconsistent sleep schedules. We evaluate all of it. We’ll look at: Nightmare frequency and intensity Triggers Nighttime awakenings Safety behaviors (checking, lights on, sound scanning) Bedtime routines and sleep timing Sleep environment and habits This session also includes education about how sleep works - circadian rhythms, sleep pressure, REM sleep, and how habits unintentionally reinforce nightmares. When you understand the science behind your symptoms, the work feels less mysterious and more manageable. I'll introduce: Stimulus control (retraining the brain that bed = sleep, not vigilance) Core sleep hygiene principles How to begin tracking your sleep with a simple sleep log You’ll leave with a clear plan. Following the program consistently gives you the best outcomes - and I’ll be supporting you closely as we review your sleep log data each week and adjust strategically.

Session 2: Stress, Hypervigilance, and Building Regulation Skills Nightmares don’t occur in isolation. They are often intensified by daytime stress and nighttime hyperarousal. In this session, we look closely at how stress, scanning for danger, checking behaviors, and “worry time” in bed contribute to disrupted sleep. Safety behaviors make sense - they are protective - but they also keep the nervous system alert. We’ll: Review your sleep log data Adjust your sleep plan if needed Identify safety behaviors that may be reinforcing night waking Introduce structured relaxation training You’ll learn specific techniques - such as diaphragmatic breathing or guided relaxation - to use before bed and after awakenings. These are skills, that need practice, so your body knows what to do at night.

Session 3: Targeting the Nightmare Directly This is where we begin working directly with the nightmare itself. You’ll write the dream out in first person, present tense, identifying its key themes and emotional core. This is done carefully and intentionally - not to overwhelm you, but to clarify the pattern your brain is replaying. We look for: Themes Discuss emotional triggers The moment of peak fear The meaning your brain may be assigning to it - such as worries if you let go of the nightmare you let go of the honor or care you feel for the person or event. At the same time, we continue consolidating sleep skills - breathing, relaxation, and consistent sleep habits - so your nervous system is more regulated while we do this work. This session helps move the nightmare from something that happens to you into something we can work with deliberately.

Session 4: Rescripting and Introducing Imagery Rehearsal Therapy (IRT) In this session, we begin structured rescripting. You’ll rewrite the nightmare in a way that inserts positive themes of safety, control, or esteem. This does not deny what happened. It changes the brain’s skipping record. We introduce Imagery Rehearsal Therapy (IRT) - a well-established cognitive-behavioral method for reducing nightmare frequency and intensity. You will rehearse the new version of the dream while awake in a controlled, supported way. We also troubleshoot: Any return of checking behaviors Sleep habits that may have slipped Areas where vigilance is creeping back in This is where many people begin noticing meaningful shifts.

Session 5: Strengthening the New Pathways By now, you’ve begun building new associations around sleep. In this session, we: Review your relaxation skills Review sleep log data Refine and reinforce IRT practice Continue strengthening your revised dream imagery Work on rescripting another nightmare that has been troubling you A helpful metaphor: your brain has been traveling down a well-worn road - the nightmare pathway. IRT helps your brain build a new road. The more we rehearse it, the more natural it becomes. Nightmares often decrease in intensity first (like you're watching it on a screen) then frequency.

Final Session: Reviewing Progress and Preventing Relapse In our final session, we review: Changes in nightmare frequency and intensity Sleep log trends (see how far you've come!) Reduced safety behaviors Regulation skills you’ve developed We also plan for the future. What if a nightmare returns during a stressful period? What if sleep becomes disrupted again? You’ll leave with: A clear plan for responding to setbacks Flexibility in your sleep habits Confidence in your ability to regulate your nervous system The goal isn’t perfection. It’s resilience.

Additional Session if Tackling Insomnia and Nightmares If you are experiencing both chronic nightmares and significant insomnia, treatment may be structured over approximately 8 weeks to fully integrate CBT-N with CBT-I. When both conditions are present, addressing them together often leads to the strongest and most lasting results.

Booster Sessions (optional) Booster sessions for nightmares are brief, targeted check-ins designed to help you maintain the progress you’ve made and manage any challenges that arise after completing the core CBT-N program. Think of them as a “tune-up” for your sleep and your brain’s new nighttime pathways - a chance to reinforce skills, review strategies, and prevent nightmares from returning. Even with consistent effort, life events, stress, or changes in routine can sometimes disrupt your sleep. A booster session gives us the chance to review your sleep diary, troubleshoot areas where your habits may have slipped, and reinforce the skills you’ve already learned.