Respond to the following scenario by,

1. Identify barriers, specific to the client's context that might limit therapeutic success.

2. Provide a brief, clear outline of how to implement CBT in this scenario.

3. How best to monitor the client's progress throughout the intervention.

4. Identify how to best evaluate the success of the CBT in this scenario.

5. State one way that the benefits of CBT, implemented in this scenario, could be sustained for the client.

Scenario

Peter is a 38-year-old male. He emigrated as a refugee from Sudan 11 years ago with his wife and three children. He currently works as a nurse in the emergency department of a local inner-city hospital; this role includes shift work. During his initial session with a psychologist, he listed several complaints about his sleep. He finds it difficult to get to sleep and wakes up several time during the night. He has said, "It feels like I spend all night lying awake and staring at the ceiling." He has also mentioned that he tends to wake up early in the morning and cannot get back to sleep and generally feels tired and sluggish for the rest of the day. When at work, he is irritable and finds it difficult to concentrate because of his lack of sleep. His problem has been persistent over the past five months. Its beginning coincided with a promotion at work that meant more responsibility and more pressure. He has taken to drinking a glass of spirits before going to bed to try to help him relax. He drinks a number of coffees throughout the day to help himself to keep going, but doesn't like the subtle anxiety the caffeine brings with it. His position at work will remain high-pressure and high-stress for the foreseeable future. His aim is to get the sleep he needs, to stop waking up during the night, and to manage sleep around his shift work