Anticipated Impacts on Veteran’s Healthcare: Insomnia is a critical obstacle to the rehabilitation and functional recovery of Veterans with psychotic disorders. The Veterans Health Administration (VHA) has made treatment of insomnia a high priority; and has initiated a nationwide dissemination of Cognitive Behavioral Therapy for Insomnia (CBT-I)–an evidence-based psychotherapy and the first-line standard of care for insomnia–across the VHA system. However, there are many challenges to treating insomnia in people with psychosis; and as a result, they are rarely treated with CBT-I. As part of my CDA-2, I developed guidelines to tailor CBT-I to address each of these challenges. I have piloted CBT-I delivered with these guidelines and have found that it is feasible, acceptable, and shows preliminary efficacy. A larger, fully powered trial is needed to evaluate efficacy of CBT-I delivered with these guidelines on insomnia and functioning of Veterans with psychosis. If CBT-I tailored for psychosis is effective, these guidelines will be incorporated into the national VA CBT-I manual and training materials. Thereby, immediately translating research into clinical practice for maximal functional impact. This project will allow us to evaluate insomnia as a target for accelerating rehabilitation and provide clarity as to whether this population—one of the most severely impaired and costly groups of Veterans—can experience long-term functional benefits from bettersleep. Project Background: Insomnia affects an alarming number of Veterans with psychotic disorders; causes significant long-term negative impacts on physical, emotional, psychosocial, and cognitive recovery; aggravates psychotic symptoms; and confers a nearly 15-fold increase in lifetime risk for attempting suicide. Among people with other chronic medical and mental health conditions, randomized controlled trials (RCTs) demonstrate that successful insomnia treatment can lead to significantly: improved sleep, cognitive, social, and daily functioning, psychiatric symptoms, and health-related quality of life. However, Veterans with psychosis are rarely offered CBT-I, the current gold standard treatment for insomnia, due to a lack of empirically driven clinical guidelines that can assist providers in its delivery with this complex population. Veterans with psychosis deserve access to the same treatments that are available to other Veterans; this inequity in delivery of insomnia treatment must be addressed. Project Objectives: The proposed research will evaluate the efficacy of CBT-I delivered with guidelines for psychosis on improving sleep and associated functional outcomes in Veterans with psychosis and insomnia via a large-scale multi-site randomized control trial (RCT) comparing 10 weeks of CBT-I (n=78) to 10 weeks of an active control intervention (n=78) on insomnia symptoms and functioning. In addition, we will assess the durability of effects of CBT-I on insomnia symptoms and functioning at a 6-m...