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Insomnia Treatment in Texas: How CBT-I Works Without Medication

Cognitive Behavioral Therapy for Insomnia (CBT-I) treats chronic insomnia through weekly sessions with a clinician, not medication. Over those sessions, you work on your sleep schedule, your habits in bed and the thoughts that keep you awake.

Most patients see a Texas-licensed clinician by video. A limited number of clinicians also provide in-person visits; availability is confirmed at booking.

In network with Aetna, Blue Cross Blue Shield, Blue Cross Blue Shield (HMO plans), Blue Cross Blue Shield Medicare Advantage, Cigna / Evernorth, Medicare, UnitedHealthcare / Optum, UnitedHealthcare Medicare Advantage

Paying for CBT-I with a Texas health plan

CBT-I is billed as outpatient behavioral health, the insurance category used for counseling. In network means we bill your plan directly and you pay your usual share, such as a copay (a set fee per visit) or a deductible (what you pay each year before coverage starts).

We are in network with Aetna, Blue Cross Blue Shield, Blue Cross Blue Shield (HMO plans), Blue Cross Blue Shield Medicare Advantage, Cigna / Evernorth, Medicare, UnitedHealthcare / Optum and UnitedHealthcare Medicare Advantage. Your benefits are checked before your first visit. Ask us about plans not listed here, or about paying for sessions yourself.

The clinicians who provide CBT-I

Each clinician shown here holds a Texas license and has trained in CBT-I. They are based in Arlington, San Antonio and Wylie and see patients anywhere in the state. Credentials and areas of focus for the whole team are on Our Clinicians.

Savita Abrahams, LPC, CBT-I

Savita Abrahams, LPC, CBT-I

Insomnia Specialist


Specialities

Insomnia, Anxiety, Family and relationships, Women's issues

Approaches

Cognitive Behavioral Therapy, Mindfulness, Solution-focused


Dr. Savita Abrahams believes in people’s resilience while recognizing that support can be invaluable during life’s challenges. As an experienced counselor, she helps clients gain insight into their struggles, build on their strengths, and develop practical solutions for meaningful change. Her approach is compassionate and collaborative, empowering individuals to clarify and achieve their goals. Dr. Abrahams also has specialized training in Cognitive Behavioral Therapy for Insomnia (CBT-I), offering evidence-based treatment for sleep concerns.

Ashleigh Jewett, LCSW, CBT-I

Ashleigh Jewett, LCSW, CBT-I

Insomnia Specialist


Specialities

Insomnia, Anxiety, ADHD, Trauma and PTSD, Career and work stress

Approaches

Cognitive Behavioral Therapy, Mindfulness, Motivational interviewing


Ashleigh Jewett, LCSW, received her Masters of Social Work from Baylor University. She has also received additional training in Cognitive Behavioral Therapy for Insomnia (CBT-I) and specializes in helping clients overcome insomnia. During the initial sessions, clients will dive into the issues they are experiencing and create a treatment plan together. Most clients see a gradual lifting of symptoms within the first month and sustained improvement thereafter. Ashleigh enjoys helping clients from various walks of life.


Ashleigh's approach to therapy:


I understand that every single person has been molded and formed by their environments around them. In order for effective change to take place, therapy must be a safe and welcoming place in order for you to feel comfortable learning and discovering which route to take in your self-discovery journey. I prefer to be the passenger while you are in the driver’s seat telling me the route you want to take, and me helping you navigate the way to get there. I can’t promise that the journey will always be rainbows and sunshine, and there will be tough truths and strategies that seem hard to implement, but the destination will be one that you have longed for and are ready to receive.

Axel R. Cristales, LPC, CBT-I

Axel R. Cristales, LPC, CBT-I

Insomnia Specialist


Specialities

Insomnia, Anxiety, Trauma and PTSD, Veterans, Self Esteem

Approaches

Cognitive Behavioral Therapy, Motivational interviewing, Solution-focused


Axel Cristales is a licensed professional counselor specializing in insomnia treatment using CBT-I. He has a Master's in Applied Psychology from Texas A&M University Commerce and has also seen many patients with anxiety, depression and trauma.


Axel's approach to therapy:


My role as a therapist is to help clients see themselves not through the lens of their mental illness or emotional struggles, but through the strength and resilience that empower them to overcome. It is a privilege to walk alongside people in their pain, their love, and their hope—to witness and honor the depth of their stories. The first step is always the hardest, but it can also be the most powerful. I hope that, when ready, you find the courage to begin. You owe it to yourself—and to those who care about you.


I am committed to providing you with a safe, judgment-free space where you can openly express your thoughts, emotions, and experiences. Here, you will always be met with active listening, empathy, and unconditional positive regard—support and acceptance. Beyond self-understanding, I will encourage you to take meaningful risks that foster growth and change.


Hope is what carries us forward. As a guide in your journey of healing and transformation, I look forward to working with you. If you're ready to take the first step, please don't hesitate to reach out— you've made it this far, why not go a little further?

Is CBT-I recommended before sleep medication?

For adults with chronic insomnia, yes. The American College of Physicians recommends that adults with chronic insomnia receive CBT-I as their initial treatment. In its 2021 guideline, the American Academy of Sleep Medicine also gave CBT-I a strong recommendation. Follow-up research has found that its improvements can last after sessions end.

General sleep hygiene advice, such as cutting back on caffeine, is sensible, but on its own it does not treat chronic insomnia. CBT-I is more structured and builds on your own sleep records.

Does insomnia go away after CBT-I?

For many people, sleep improves in a meaningful way. In clinical trials, some people no longer met the criteria for insomnia after treatment. Results vary. Stressful events, illness or travel can still bring poor nights later, so before treatment ends you and your clinician write a plan for those times.

What CBT-I sessions cover

A typical course is six to eight weekly sessions, and most include these parts.

A morning sleep diary

Each morning, spend about two minutes noting when you went to bed, roughly when you fell asleep, time awake in the night and when you got up. Estimates are fine.

A set sleep window

You and your clinician choose a regular bedtime and wake time from your diary. The window may start shorter than your current time in bed, a step sometimes called sleep restriction, and it widens as your sleep steadies. The first week or two can feel harder.

Keeping the bed for sleep

Clinicians call this stimulus control: using the bed mainly for sleep, getting up for a while if you are wide awake, and keeping the same wake time every day.

Working with thoughts about sleep

You test beliefs such as “I must get eight hours” against what your diary shows, which can ease the worry that keeps you alert.

A plan for setbacks

Before the last session, you write down what helped and what to do if poor sleep returns.

Starting with an evaluation

The first appointment runs for roughly 50 minutes. Your clinician asks how your nights go, how long the problem has lasted and what you have tried. They also ask about snoring, mood and health conditions that can affect sleep. Together, you decide whether CBT-I fits. How It Works describes the full process.

Who CBT-I is for

Signs of chronic insomnia

Sleep trouble counts as chronic insomnia when it shows up on three or more nights a week and has lasted at least three months. It can mean difficulty getting to sleep, waking in the night or waking too early, even with enough time in bed, and it affects your days. Habits such as extra time in bed, and worry about sleep, can keep it going after the original stress has passed.

If you use sleep medication now

You can begin CBT-I while on sleep medication. Let your clinician know about every prescription, over-the-counter sleep aid and supplement you use. Our clinicians do not prescribe. Any dose change or taper should be planned and managed by your prescriber.

Snoring or pauses in breathing

Sleep apnea means breathing repeatedly stops or becomes shallow during sleep; loud snoring is a common sign. Sleep apnea and insomnia often occur together. We treat insomnia and coordinate referrals to partners who treat sleep apnea. If you are unsure about testing, read when a sleep study may help.

When worry keeps you awake

Anxiety and poor sleep can feed each other, and the same clinician can work on both in one plan. Read about anxiety therapy.

CBT-I anywhere in Texas

Our clinicians can treat you in any part of the state, provided you are in Texas at the time of each appointment. Local details are on our pages for Houston, Dallas and Austin, and for care across the whole state.

Questions to ask before starting CBT-I

Will my health plan pay for CBT-I?

Often, yes, if it is one of the plans we are in network with. CBT-I is billed as outpatient behavioral health, like counseling. What you pay depends on your copay and deductible, and we verify your coverage ahead of the first visit.

How many sessions does CBT-I take?

CBT-I is usually a short course of six to eight weekly sessions after the first appointment. Some people notice a change within the first few weeks, and others need longer. Your clinician reviews your diary each week and adjusts the plan with you.

Is CBT-I better than taking sleeping pills?

Treatment guidelines recommend CBT-I as the first treatment for chronic insomnia in adults, and its benefits can last after sessions end. Decisions about medication belong with your prescriber. Our clinicians do not prescribe, but with your permission they can keep your prescriber informed.

Why might I feel more tired in the first weeks?

A shorter sleep window can leave you sleepier for a while as your sleep settles. This often eases as the window is widened. Tell your clinician if you feel very sleepy in the daytime, especially before driving.

Can I be treated if I live in a small town or rural part of Texas?

Yes. Most sessions take place by video, so you need a quiet, private room and a steady internet connection. You must be in Texas during each session.

Schedule a CBT-I evaluation

Book a first appointment to talk through your sleep and whether CBT-I suits you, or call us.

Book AppointmentCall (214) 216-2330