A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome

Blanchard, Edward B.; Lackner, Jeffrey M.; Sanders, Kathryn A.; Krasner, Susan S.; Keefer, Laurie; Payne, Annette; Gudleski, Gregory D.; Katz, Leonard; Rowell, Dianna; Sykes, Mark A.; Kuhn, Eric; Gusmano, Rebecca; Carosella, Ann Marie; Firth, Rebecca; Dulgar-Tulloch, Lisa

doi:10.1016/j.brat.2006.07.003

Cited by 99 publications

(66 citation statements)

References 24 publications

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“…On the whole, IBS patients have been reported to have more psychological disturbance than control groups with organic gastrointestinal disease or general populations [24] . There is an increasing evidence for the effectiveness of CBT in alleviating the physical and psychological symptoms of IBS [2,25,34,35] and it has thus been recommended as a treatment option for the syndrome [17,19] . CBT has matured into a creative and rigorous synergy from empirical evidence and clinical innovation [36] .…”

Section: Cbt and Application To Ibsmentioning

confidence: 99%

Cognitive-behavioral therapy for the management of irritable bowel syndrome

Tang

Lin

Zhang

2013

WJG

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Irritable bowel syndrome (IBS) is a common disorder, reported to be found in 5%-20% of the general population. Its management accounts for up to 25% of a gastroenterologist's workload in the outpatient department, and the main symptoms are abdominal pain, bloating, and altered bowel habits. Despite a great amount of available pharmacological treatments aimed at a wide variety of gastrointestinal and brain targets, many patients have not shown adequate symptom relief. In recent years, there has been increasing evidence to suggest that psychological treatments, in particular cognitive-behavioral therapy (CBT), are effective for the management of IBS. This review discusses CBT for the management of IBS. CBT has proved to be effective in alleviating the physical and psychological symptoms of IBS and has thus been recommended as a treatment option for the syndrome. Core tip: There is increasing evidence to suggest that cognitive-behavioral therapy (CBT) is effective for the management of irritable bowel syndrome (IBS). CBT can alleviate the physical and psychological symptoms of IBS, and has thus been recommended as a treatment option for the syndrome.Tang QL, Lin GY, Zhang MQ. Cognitive-behavioral therapy for the management of irritable bowel syndrome.

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Section: Cbt and Application To Ibsmentioning

confidence: 99%

Cognitive-behavioral therapy for the management of irritable bowel syndrome

Tang

Lin

Zhang

2013

WJG

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“…Social learning contributions to FAP and IBD small (n = 10 to 12 per group). A larger study [66] failed to show any difference between CBT and the support group, although this might have been explained by the different modes of delivering CBT (group vs individual sessions). Taken together, these 7 studies provide suggestive but not compelling evidence for the efficacy of CBT.…”

Section: Cognitive-behavioral Studies On T H E T R E a T M E N T O F mentioning

confidence: 89%

“…Table 1 summarizes controlled trials of CBT in adults with IBS. The majority of studies which have compared CBT to standard medical care (SMT) [61][62][63] or SMT plus symptom self-monitoring while waiting to receive CBT treatment [64][65][66] , have found CBT to be superior, although the trials by Corney et al [62] and Boyce et al [61] are exceptions. However, caution should be exercised in interpreting this as strong evidence for the efficacy of CBT, since there is reason to believe that randomizing patients to receive SMT who have previously failed to respond to SMT, or assigning them to monitor symptoms while waiting to receive treatment, creates a negative expectation for benefit and tends to exaggerate differences between groups [67] .…”

Section: Cognitive-behavioral Interventions For Chronic Somatic Pain mentioning

confidence: 99%

“…Three adult studies compared CBT to an active control group: The Drossman study [68] showed CBT to be superior to an educational control when outcomes were evaluated at the end of treatment; however, no follow-up data have been reported. Two studies [65,66] , both from the same group, compared CBT to a self-help support group, which has a high degree of credibility for IBS patients. One of these studies showed CBT to be superior to the support group [65] , but the total sample size was relatively [62] (1991) CBT vs SMT.…”

Section: Cognitive-behavioral Interventions For Chronic Somatic Pain mentioning

confidence: 99%

“…No FU 431 CBT > education; desipramine: placebo Boyce et al [61] (2003) CBT vs relaxation training vs SMT. FU at 12 mo 105 CBT = Relaxation training = SMT Blanchard et al [66] (2007) Group CBT vs Self-help support group vs SMT. FU at 3 mo 210 CBT = Support group > SMT Kennedy et al [63] www.wjgnet.com…”

Section: Cognitive-behavioral Interventions For Chronic Somatic Pain mentioning

confidence: 99%

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Social learning contributions to the etiology and treatment of functional abdominal pain and inflammatory bowel disease in children and adults

Levy

Langer

Whitehead³

2007

WJG

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This paper reviews empirical work on cognitive and social learning contributions to the etiology and treatment of illness behavior associated with functional abdominal pain and inflammatory bowel disease. A particular emphasis is placed on randomized controlled trials, the majority of which are multi-modal in orientation, incorporating elements of cognitive behavioral therapy, social learning, and relaxation. Based on this review, we offer methodological and clinical suggestions: (1) Research investigations should include adequate sample sizes, long-term follow-up assessments, and a credible, active control group. (2) Standard gastrointestinal practice should include, when appropriate, learning opportunities for patients and family members, for example, instruction regarding the encouragement of wellness behavior.

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Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care

et al. 2022

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IMPORTANCE Successful treatment of opioid misuse among people with chronic pain has proven elusive. Guidelines recommend nonopioid therapies, but the efficacy of mindfulness-based interventions for opioid misuse is uncertain.OBJECTIVE To evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE) for the reduction of opioid misuse and chronic pain. DESIGN, SETTING, AND PARTICIPANTSThis interviewer-blinded randomized clinical trial enrolled patients from primary care clinics in Utah between January 4, 2016, and January 16, 2020. The study included 250 adults with chronic pain receiving long-term opioid therapy who were misusing opioid medications. INTERVENTIONS Treatment with MORE (comprising training in mindfulness, reappraisal, and savoring positive experiences) or supportive group psychotherapy (control condition) across 8 weekly 2-hour group sessions.MAIN OUTCOMES AND MEASURES Primary outcomes were (1) opioid misuse assessed by the Drug Misuse Index (self-report, interview, and urine screen) and ( 2) pain severity and pain-related functional interference, assessed by subscale scores on the Brief Pain Inventory through 9 months of follow-up. Secondary outcomes were opioid dose, emotional distress, and ecological momentary assessments of opioid craving. The minimum intervention dose was defined as 4 or more completed sessions of MORE or supportive group psychotherapy. RESULTS Among 250 participants (159 women [63.6%]; mean [SD] age, 51.8 [11.9] years), 129 were randomized to the MORE group and 121 to the supportive psychotherapy group. Overall, 17 participants (6.8%) were Hispanic or Latino, 218 (87.2%) were White, and 15 (6.0%) were of other races and/or ethnicities (2 American Indian, 3 Asian, 1 Black, 2 Pacific Islander, and 7 did not specify). Atbaseline,themeandurationofpainwas14.7years(range,1-60years),andthemean(SD)morphineequivalent opioid dose was 101.0 (266.3) mg (IQR, 16.0-90.0 mg). A total of 203 participants (81.2%) received the minimum intervention dose (mean [SD], 5.7 [2.2] sessions); at 9 months, 92 of 250 participants (36.8%) discontinued the study. The overall odds ratio for reduction in opioid misuse through the 9-month follow-up period in the MORE group compared with the supportive psychotherapygroupwas2.06(95%CI,1.17-3.61;P = .01).At9months,36of80participants(45.0%) in the MORE group were no longer misusing opioids compared with 19 of 78 participants (24.4%) in the supportive psychotherapy group. Mixed models demonstrated that MORE was superior to supportive psychotherapy through 9 months of follow-up for pain severity (between-group effect: 0.49; 95% CI, 0.17-0.81; P = .003) and pain-related functional interference (between-group effect: 1.07; 95% CI, 0.64-1.50; P < .001). Participants in the MORE group reduced their opioid dose to a greater extent than those in the supportive psychotherapy group. The MORE group also had lower emotional distress and opioid craving. CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, among adult participants in a primary care setting, t...

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A controlled evaluation of group cognitive therapy in the treatment of irritable bowel syndrome

Cited by 99 publications

References 24 publications

Cognitive-behavioral therapy for the management of irritable bowel syndrome

Cognitive-behavioral therapy for the management of irritable bowel syndrome

Social learning contributions to the etiology and treatment of functional abdominal pain and inflammatory bowel disease in children and adults

Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care

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