Transcript Cognitive Behavioral Therapy and Irritable Bowel Syndrome

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
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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
 Our
thoughts cause
behavior
 We can change the way
we think/feel
 Learning how to think
differently leads to change
 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
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motivational interviewing
goal setting
problem solving
behavior modification
self-monitor
Set behavior change goals
Use stimulus control
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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.
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Effective techniques:
› Diaphragmatic/ab
dominal breathing,
› Progressive muscle
relaxation
› Visualization/positiv
e imagery
› Hypnosis
› Desensitization
(gradual exposure
to something
feared)
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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
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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
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>.