Insomnia Formulation (Spielman 3P Model)
A formulation based on Spielman's 3P model — mapping predisposing, precipitating, and perpetuating factors that maintain insomnia.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Insomnia Formulation (Spielman 3P Model)
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Predisposing Factors
Precipitating Factors
Perpetuating Factors
The Insomnia Maintenance Cycle
Protective Factors & Strengths
What resources, strengths, and supports might help in recovery?
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The Insomnia Formulation (Spielman 3P Model) is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for insomnia and sleep problems.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device — or download it as a print-ready PDF.
How it works
The Insomnia Formulation (Spielman 3P Model) is a guided formulation canvas: you map the factors that made the difficulty more likely to develop (predisposing), what set it off (precipitating), and what keeps it going now (perpetuating) — showing why a problem can persist after its original trigger has passed.
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, the Insomnia Formulation (Spielman 3P Model) works by mapping how the parts of a problem connect and keep it going (formulation). The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going — and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Spielman, A.J., Caruso, L.S., & Glovinsky, P.B. (1987). A behavioral perspective on insomnia treatment. Psychiatric Clinics of North America, 10(4), 541-553. doi:10.1016/S0193-953X(18)30532-X
- Morin, C.M. (2004). Cognitive-behavioral approaches to the treatment of insomnia. Journal of Clinical Psychiatry, 65(Suppl 16), 33-40.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- Samaritans: 116 123 — free, day or night, 365 days a year
- SANEline: 0800 689 5555 — 4:30pm–10:30pm, every day
More Insomnia / Sleep worksheets
View all Insomnia / Sleep worksheets →Insomnia / Sleep
Sleep Diary
The standard CBT-I sleep diary — record bed times, sleep times, wake times, and daytime functioning to track patterns and calculate sleep efficiency.
Insomnia / Sleep
Sleep Efficiency Tracker
Calculate and track sleep efficiency (time asleep ÷ time in bed × 100) — the key metric for CBT-I sleep restriction therapy.
Insomnia / Sleep
Sleep Window Prescription & Tracking
Set and track your prescribed sleep window as part of sleep restriction therapy — with weekly adjustments based on sleep efficiency.
Insomnia / Sleep
Stimulus Control Plan
The core stimulus control rules for CBT-I — rebuilding the association between bed and sleep.
Insomnia / Sleep
Sleep Hygiene Assessment
Assess current sleep hygiene practices and identify areas for improvement.
Insomnia / Sleep
Unhelpful Sleep Beliefs Worksheet
Identify and challenge dysfunctional beliefs about sleep that fuel insomnia-related anxiety and arousal.
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