Who is the "Therapist" in Digital Cognitive Behavioural Therapy for Insomnia (dCBTi)?

Abstract

Cognitive Behavioural Therapy for insomnia (CBTi) is a highly effective, evidence-based intervention, increasingly delivered through digital platforms. However, the human qualities embedded in traditional face-to-face CBTi (such as empathy, clinical judgement, and personalised encouragement) are difficult to replicate digitally. Digital CBTi is often treated as a single therapeutic modality, yet approaches vary significantly in the extent and nature of human support provided, raising important questions about the identity and role of the "therapist" in digital care. This perspectives paper explores the critical role of human support in digital CBTi and examines different models for integrating human input into digital care pathways. The authors argue that while digital CBTi offers scalable and accessible treatment for insomnia, that the inclusion of trained human support remains a vital component for maximising engagement, personalisation, and long-term clinical outcomes.