Behavioral Sleep Medicine FAQs

I’m Jessica Fink, LCSW-S (Texas license #50905), a psychotherapist who has practiced since 2007 and specializes in behavioral sleep medicine. My training includes advanced Cognitive Behavioral Therapy for Insomnia through the University of Pennsylvania, and I am a member of the Society of Behavioral Sleep Medicine and the American Academy of Sleep Medicine. These answers reflect how I work in my Texas telehealth practice.

How is behavioral sleep medicine different from general therapy?

Behavioral sleep medicine uses structured psychological and behavioral treatments developed for specific sleep disorders. It is different from general talk therapy and goes well beyond offering basic sleep hygiene advice.

The treatment depends on the condition. I may use Cognitive Behavioral Therapy for Insomnia (CBT-I), Cognitive Behavioral Therapy for Nightmares (CBT-N), circadian rhythm interventions, Cognitive Behavioral Therapy for Hypersomnia (CBT-H), and/or targeted approaches for PAP adherence. Treatment usually includes education, a clear plan, and strategies to practice between sessions.

Behavioral sleep medicine does not replace medical sleep care. If your symptoms suggest sleep apnea, narcolepsy, idiopathic hypersomnia, or another condition requiring medical evaluation, I will recommend working with a sleep physician or other appropriate provider.

How long is each session?

Most therapy sessions are 45 minutes. I also offer 60-minute sessions if you prefer more time or if we decide that a longer session would be helpful for your treatment.

What happens during the first session?

Before your first session, you’ll complete the standard consent and privacy forms along with two clinical intake forms. One screens for mental health concerns that could affect your sleep or treatment. The other is a comprehensive sleep intake based on the Structured Clinical Interview for Sleep Disorders (SCISD), which helps me look beyond the problem that brought you in and screen for other sleep disorders that may need attention.

During the session, we’ll review your responses, and I’ll ask follow-up questions about your sleep, symptoms, daily functioning, and relevant medical and mental health history. I’ll share my initial impressions and explain whether I recommend treatment with me, further evaluation from a medical provider, or both. For example, if your symptoms suggest sleep apnea or another disorder requiring medical testing, I may recommend a sleep study.

I’ll also get you started with a daily sleep diary. The diary gives us a clearer picture of your sleep patterns over time, helps guide treatment recommendations, and allows us to track whether the treatment is producing the changes we expect.

How do I know whether behavioral sleep medicine is right for me?

Behavioral sleep medicine may be a good fit if a sleep problem is interfering with your daily life, has not improved despite effort, or is making it difficult to follow a medical treatment such as CPAP. My approach is especially well suited to people who want a structured treatment plan and are willing to practice new strategies between sessions.

Each sleep treatment page explains who that particular service is designed for and what the treatment involves. If you’re still uncertain, we can discuss what is happening during a consultation call. I’ll let you know whether one of my services appears appropriate or whether I recommend medical evaluation or another type of provider first.

How often will we meet?

Most clients begin with weekly sessions. Behavioral sleep treatments are structured, and each session typically builds on what you practiced and observed during the previous week. Meeting weekly also allows us to review your progress and make adjustments without losing momentum.

Depending on the treatment, your progress, and your scheduling needs, we may later meet every other week or less frequently. We’ll decide together what is both clinically appropriate and realistic for you.

How long does treatment normally last?

Most of the treatment I provide is short-term and typically lasts 6–8 sessions. The exact length depends on the condition we are treating, whether more than one sleep problem is involved, and how you respond to treatment. After the initial assessment, I’ll give you a clearer idea of what the timeline is likely to be.

How much does each session cost?

My fee is $175 per 45-minute session and $200 per 60-minute session.

Do you take insurance for therapy?

No. I am a private-pay provider and am not in-network with any insurance companies. You will pay me directly after each session. If your plan includes out-of-network mental health benefits, you may be eligible for partial reimbursement. I can provide a superbill for you to submit to your insurance company, but reimbursement is determined by your individual plan and is not guaranteed.

How do I seek reimbursement from my insurance company for therapy sessions? 

Before beginning treatment, contact your insurance company and ask whether your plan includes out-of-network benefits for outpatient mental health services provided through telehealth. You may also want to ask about your deductible, the percentage or amount your plan reimburses, whether prior authorization is required, and how to submit a claim.

You will pay me directly after each session. Upon request, I can provide a superbill containing the information your insurance company needs to process an out-of-network claim. You will submit the superbill according to your plan’s instructions, and your insurance company will determine whether any reimbursement is available. A superbill does not guarantee reimbursement.

If you have Medicare, including a Medicare Advantage plan, please tell me before scheduling. I have opted out of Medicare, so treatment is provided under a private contract: you pay for services yourself, and neither you nor I may submit the sessions to Medicare for reimbursement.

Do you have evening and weekend sessions available?

I offer appointments Monday through Friday. The earliest starts at 9:00 AM and the latest starts at 4 PM Central Time. I do not offer evening or weekend appointments.

Where do sessions take place?

All sessions take place online through Google Meet using my HIPAA-compliant Google Workspace account. I do not maintain a physical office. Because I am licensed in Texas, you must be physically located in Texas at the time of each session.

Who do you work with?

I work exclusively with adults ages 18 and older. My practice primarily focuses on behavioral sleep medicine, including treatment for insomnia, chronic nightmares, circadian rhythm disorders, difficulty adjusting to PAP or CPAP therapy, and the behavioral effects of narcolepsy and idiopathic hypersomnia.

CBT-H is available to adults who have already been formally diagnosed with narcolepsy or idiopathic hypersomnia by an appropriate medical provider. I also work with a limited number of adults seeking treatment for chronic pain, OCD, or maladaptive overcontrol.

What if I’m not getting better?

If you feel that what we’re doing is not helping, I want you to tell me. At the beginning of every session, we review your sleep log, how the previous week went, and whether treatment is moving you toward your goals. For insomnia and nightmare treatment, I also use standardized symptom measures to help us track change over time.

If progress has stalled, we may revisit the original assessment, identify barriers to applying the treatment, or adjust the plan while remaining grounded in the evidence-based approach we selected. If your needs fall outside my expertise, I may seek professional consultation, recommend additional medical evaluation, or help you find a provider who is better suited to address the problem.

Can I continue to see my regular therapist while working with you?

Yes. Much of the work I provide is short-term and adjunctive to ongoing therapy. Other therapists often refer clients to me specifically for behavioral sleep treatment and then resume their longer-term work after the sleep treatment is complete.

In some cases, you may continue seeing your regular therapist while working with me. We’ll clarify each therapist’s role so that treatment remains coordinated and we are not duplicating the same work. With your written permission, I can communicate with your regular therapist when doing so would support your care.

Can I continue my sleep medicine while working with you?

Yes. You do not need to stop taking sleep medication before beginning behavioral sleep treatment, and I will not ask you to discontinue it before you are ready. Behavioral treatment can be provided while you continue taking medication.

If reducing or discontinuing sleep medication becomes one of your goals, that decision should be made with your prescriber. I can provide education, help you prepare for the change, and support the behavioral part of the process, but your prescriber is responsible for determining and managing the medication taper.

Content reviewed and updated by Jessica Fink, LCSW-S | September 2026

Still Have Questions?

If you don't see your question here, feel free to reach out.

I'm always happy to answer questions about whether Behavioral Sleep Medicine is likely to be a good fit for your situation before we schedule an appointment.