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Pati­ents often report exten­ded bedti­mes of more than 12 hours, espe­ci­al­ly in the inpa­ti­ent set­ting. This is par­ti­cu­lar­ly pro­no­un­ced in cer­tain dis­or­ders, such as depres­si­on or anxie­ty dis­or­ders. For the inter­ven­ti­on to be effec­ti­ve, it is very important that time befo­re and after the sleep win­dow is spent out­side of the bed. The “sur­fer image” from the kick-off ses­si­on can be used to illu­stra­te the mecha­nism of sleep pres­su­re and to dis­cuss indi­vi­du­al beha­vi­or. If pati­ents have dif­fi­cul­ty get­ting out of bed despi­te strong moti­va­ti­on, docu­ment this, dis­cuss it within the tre­at­ment team, and poten­ti­al­ly address it tog­e­ther with the pati­ent so that the enti­re tre­at­ment team can pro­vi­de fur­ther sup­port.