Our Blog: Upward Alabama

Integrating Medication Tapering into Cognitive Behavioral Therapy for Insomnia (CBT-I)

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

Insomnia Evidence-Based Psychotherapy Sleep

Posted: February 7, 2026

For many patients, prescription sleep aids—such as benzodiazepines, Z-drugs, or other sedative-hypnotics—are the first line of defense against insomnia. While these medications can provide short-term relief, long-term reliance can lead to dependence, tolerance, or diminished effectiveness. Cognitive Behavioral Therapy for Insomnia (CBT-I) is widely recognized as the gold standard for treating chronic insomnia, and research increasingly supports the integration of a structured medication taper with CBT-I for sustainable results. This comprehensive overview explores the rationale, strategies, and benefits of combining medication tapering with CBT-I, culminating in a practical case example and an invitation to partner with Upward Behavioral Health for expert support in your insomnia recovery journey.

Up Close with Upward: Running on Empty

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

Advice

Sleep Insomnia

Posted: October 16, 2025

Dear Upward, My days are crammed with work, kids, and responsibilities. By the time I fall into bed it's late, and I'm up again before sunrise. On rare weekends when I could sleep in, my body refuses. I see two options: (1) wake up naturally and hope to drift back to sleep a few times, or (2) knock myself out with sleep meds or herbal remedies. Which path actually helps my body recover? What's worse for my health: too little sleep or too much medication? —Running on Empty

The Importance of Integrated Treatment for Co-occurring OCD and PTSD

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

PTSD

OCD

Posted: June 29, 2025

Individuals dealing with both Obsessive-Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder (PTSD) often face unique challenges. These two conditions, while distinct, can intertwine in ways that exacerbate symptoms, making effective treatment more intricate. While both have effective treatments, the treatments are not interchangeable between disorders. Misdiagnosis is common. OCD can be mistaken for a number of conditions, including Generalized Anxiety Disorder, depression, and PTSD. This is why it’s crucial to seek a therapist trained in both OCD and PTSD to ensure an integrated, comprehensive approach to recovery.

Embracing the Shortest Night: June 20th as World Insomnia Day

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

Insomnia Sleep Nightmares

Posted: June 20, 2025

While many celebrate the extended daylight hours, for those grappling with insomnia, even the briefest night can feel endless. Insomnia affects millions globally, manifesting as difficulty falling asleep, staying asleep, or waking up too early without being able to return to rest. This condition not only impacts physical health but also mental well-being, leading to fatigue, mood disturbances, and decreased performance in daily activities.