chapter  19
Psychological treatment outcomes in IBD, methodological issues, and future directions
Pages 11

Psychotherapy, very broadly, is an intervention approach that uses a range of techniques, in the context of a relationship between the therapist and patient, in order to facilitate changes. These changes encompass improved health and mental health, and enhanced positive functioning (Prochaska and Norcross 2013). Psychological treatment describes those interventions applied in a healthcare context (Barlow 2006). There is a large body of evidence supporting the effi cacy and clinical utility of psychological treatments (Roth and Fonagy 2005), with many of these therapies established as fi rst-line interventions for common mental health problems (e.g., panic disorder, depression). In recent decades, these treatments have had wider application to chronic health conditions, such as heart disease and back pain, with positive outcomes on clinical indices (Hoffman et al. 2007). Psychophysiological research has identifi ed changes in autonomic nervous system functioning (Bonaz and Bernstein 2013) and brain blood fl ow (Karlsson 2011) as potential biological mechanisms for symptom improvements with these “talk therapies”. While psychological interventions are wellestablished as effi cacious in the functional gastrointestinal disorders (Ford et al. 2009), their clinical utility in infl ammatory bowel disease (IBD) is less clear (Timmer et al. 2011).