Table 2 Positive aspects and difficulties of the intervention that were reported in both nominal groups or only in one nominal group

Positive aspects

 • PCPs provided valuable non-pharmacological treatment

 • There were opportunities to go deeper into the causes of insomnia

 • Other sociological and sleep hygiene problems were identified

 • The patient-therapist relationship improved

• There was positive support for treatment of insomnia

• The relaxation sessions had high value

• The “Manual of Interventions” was very helpful

Difficulties

 • Doctors considered the goals of the intervention as too ambitious

 • It required PCPs to change their roles, in that it they had to address emotional issues

 • The intervention did not permit deep examination of other problems that emerged during the sessions

 • There were too many sessions, and some patients withdrew for this reason

 • The sessions were too short

 • Some concepts were repeated in the different sessions

 • A reorganization of agendas is needed to continue the intervention

 • The tutorial material for PCPs was considered essential to structure the therapy, but was too dense. More simplified materials are needed

 • Written material for the patient about sleep hygiene, and control of stimuli and thoughts is needed

• More time and energy are required than a normal consultation. Therapy should be given when the therapist is less tired

• There was a need for preparations prior to the consultations

• There were many difficulties in the session on cognitive restructuring (Session 4)

• Simultaneous intervention and data collection was difficult

• The intervention was more feasible for nurses, because they have more time for consultation

• Patients were reluctant to work on a health problem if there is no immediate solution

• Patients who had little education had difficulties completing the sleep diary