About insomnia
Chronic insomnia means difficulty falling or staying asleep several nights a week for months. Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first treatment and works on habits, schedules and the thoughts that keep sleeplessness going.
Psychotherapists are professionals trained in one or more models of psychotherapy (psychodynamic, systemic, humanistic, cognitive-behavioural…). The protected title and requirements vary by country; profiles show each professional’s training and registration.
Getting mental health care in the United States
Public health system · No single public system (Medicaid, Medicare, community mental health centers)
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator. More information
How to check that a professional is licensed
- State boards of psychology (umbrella body: ASPPB). Psychologists are licensed by each state board; check the board of the state where you live. Use of the title psychologist generally requires a state license.
- State medical boards (umbrella body: Federation of State Medical Boards). Psychiatrists are physicians licensed by each state medical board. The FSMB DocInfo service lets you look up a physician's license and disciplinary history. Search the official register
- State licensing boards. Clinical social workers, counselors and marriage and family therapists are licensed state by state; check the relevant board in your state.
Insurance and coverage
Federal parity law (MHPAEA) requires most group health plans that cover mental health to do so on terms no more restrictive than for physical health; deductibles, copays and in-network rules still apply.
Online therapy in the United States
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.
Urgent help in the United States
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 911 · Emergency (911)
- 988 · 988 Suicide & Crisis Lifeline
Information reviewed in November 2026 · Sources: findtreatment.gov, docinfo.org
Signs to look out for
Everyone sleeps badly sometimes, especially during stress. Insomnia may need attention when you regularly struggle to fall asleep, wake up often or very early and cannot get back to sleep, or wake unrefreshed, for several weeks, and it affects your mood, concentration, energy or safety during the day. Worrying about sleep itself often becomes part of the problem.
What helps: treatments and professionals
Cognitive-behavioural therapy for insomnia (CBT-I) is recommended as a first-line treatment for chronic insomnia. It includes sleep scheduling, stimulus control, work on unhelpful beliefs about sleep and relaxation techniques. Psychologists and clinical psychologists trained in CBT-I usually provide it, individually, in groups or through guided digital programmes. A doctor should rule out physical causes and other sleep disorders.
When to seek urgent help
Seek prompt medical attention if you stop breathing or gasp during sleep, fall asleep while driving or in dangerous situations, or go several nights with almost no sleep alongside unusual energy, racing thoughts or confusion. If lack of sleep comes with hopelessness or thoughts of harming yourself, contact your local emergency services or go to the nearest emergency department.
What you can do in the meantime
Keep a regular wake-up time every day, including weekends, and only go to bed when you feel sleepy. If you cannot sleep after a while, get up and do something calm in dim light until you feel drowsy. Limit caffeine after midday, alcohol and heavy meals at night. Reduce screens before bed and get daylight and movement during the day.
What does a psychotherapist do?
A psychotherapist helps people understand and change emotional, relational and behavioural patterns through a structured therapeutic relationship. Their work is shaped by one or more models, such as cognitive-behavioural, psychodynamic, systemic, humanistic or integrative therapy. They meet individuals, couples, families or groups, usually in regular sessions, and spend time outside sessions on notes, preparation and their own supervision.
When to see a psychotherapist
Psychotherapy suits people who want to work in depth on recurring difficulties: anxiety, low mood, relationship patterns, self-esteem, the effects of past experiences or major life transitions. It can also help when you feel stuck without a clear diagnosis. If you need a formal diagnosis, a specific psychological assessment or medication, a clinical psychologist or psychiatrist may need to be involved.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in the United States cover psychological care?
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator.
How do I check that a psychotherapist is licensed in the United States?
State boards of psychology (umbrella body: ASPPB): Psychologists are licensed by each state board; check the board of the state where you live. Use of the title psychologist generally requires a state license.
Can I have online therapy in the United States?
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.