chapter  16
9 Pages

Functional bowel disorders (IBS and non-IBS)

Cognitive behavioural therapy
ByLaurie Keefer

This chapter describes the structure, approach and efficacy for cognitive behavioural therapy (CBT) as it applies to irritable bowel syndrome (IBS) and other functional bowel disorders (FBDs). CBT is a group of psychotherapies that operate under the assumption that problems arise from skills deficits that are either initiated or maintained by one's current environment. Older versions of CBT for functional gastrointestinal disorders (FGIDs) were based on manuals for the treatment of generalized anxiety disorder and delivered over 12–16 sessions. They focused on stress management and worry control and operated under the assumption that FGIDs were a somatic manifestation of chronic worry. Behavioural experimentation is a component of many CBT programs for FGIDs and focuses on the maladaptive responses patients develop as a result of their symptoms or cognitions. Newer CBT trials emphasize gastrointestinal symptom-based outcomes, self-management and minimal-contact techniques to improve accessibility to what are traditionally time-intensive and potentially expensive interventions.