Cognitive Behavioral Therapy and Irritable

Bowel Syndrome

Amy Weiman

Objectives Understand irritable bowel syndrome Realize that cognitive behavioral

therapy (CBT) can be an effective counseling method

Observe techniques in brief counseling session

Review outcome of session using CBT

Introduction to IBS Irritable Bowel Syndrome (IBS) is a

GI disorder characterized by recurrent abdominal pain, discomfort and bloating, accompanied by alterations in bowel movements such as constipation and diarrhea.

10-15% of Americans have IBS There is a link between IBS and

stress and anxiety There is no cure – follow Low

Fodmaps diet Studies show that managing stress

and anxiety can be effective in controlling IBS

Cognitive Behavioral Therapy

Our thoughts cause behavior

We can change the way we think/feel

Learning how to think differently leads to change

CBT continued…

Counselor’s role: listen, teach and encourage

Client’s role: express concerns, learn and implement that learning

Focus on specific concepts/techniques

Help clients “unlearn” Change irrational thinking patterns

Techniques to implement

motivational interviewing goal setting problem solving behavior modification self-monitor Set behavior change goals Use stimulus control

CBT and IBS

aims to help patients change their habitual thoughts, feelings, and behaviors that magnify stress and negative moods by applying a series of self-exploration exercises and stress reducing strategies.

CBT and IBS Effective techniques:

› Diaphragmatic/abdominal breathing,

› Progressive muscle relaxation

› Visualization/positive imagery

› Hypnosis› Desensitization

(gradual exposure to something feared)

CBT in ActionSession # 2

Meet Julie: › 23 year old female › Current weight: 108lbs› Usual weight: 123lbs› Recent diagnosis of IBS› History of gastrointestinal problems › Suffers from anxiety › Full-time office job involving long phone calls and

in-person client meetings usually over mealtime (at a restaurant)

› Currently afraid to eat anything because of undesirable symptoms at unpredictable times

Conclusion Julie was under the impression that IBS is strictly

food related Counselor helped her realize on her own that

other factors might play a role Julie began to think about her diagnosis differently Julie is still skeptical but is willing to give some

relaxation techniques a try Counselor left it open-ended, allowing Julie to

decide if relaxation will help her or not Bringing this new idea to Julie’s attention will take

time for her to decide if it is true for her or not Julie is open to thinking about her diagnosis and

its treatment differently now

Sources

Craske, Michelle G., and Kate B. Wolitzky-Taylor. "A Cognitive-Behavioral Treatment for Irritable Bowel Syndrome Using Interoceptive Exposure to Visceral Sensations." NCBI. U.S. National Library of Medicine, June 2011. Web. 17 Nov. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100429/>.

"IBS Symptoms | IBSgroup.org." IBS Symptoms | IBSgroup.org. N.p., n.d. Web. 17 Nov. 2013. <http://www.ibsgroup.org/symptoms>.

Kennedy, Tom, and Roger Jones. "Cognitive Behaviour Therapy in Addition to Antispasmodic Treatment for Irritable Bowel Syndrome in Primary Care: Randomised Controlled Trial." BMJ. BMJ Publishing Group, n.d. Web. 17 Nov. 2013. <http://www.bmj.com/content/331/7514/435>.

Shepherd, Sue, and P. R. Gibson. The Complete Low-FODMAP Diet: A Revolutionary Plan for Managing IBS and Other Digestive Disorders. New York: Experiment LLC, 2013. Print.

"Stress, Psychological Factors, and IBS." - AboutIBS.org. N.p., n.d. Web. 17 Nov. 2013. <http://www.aboutibs.org/site/what-is-ibs/intro-to-ibs/stress-psychological-factors>.

"What Is Cognitive-Behavioral Therapy?" What Is Cognitive-Behavioral Therapy? N.p., n.d. Web. 17 Nov. 2013. <http://www.nacbt.org/whatiscbt.htm>.