Irritable Bowel Syndrome (IBS) is a chronic, intractable gastrointestinal syndrome for which few medical treatments are available. The lack of adequate medical interventions has led to interest in psychological treatments for IBS. Cognitive Behavioral Therapy (CBT), with its grounding in the biopsychosocial model of chronic illness, has shown some promise in treating IBS. However, costs and time constraints related to seeing a mental health provider become barriers to receipt of this type of treatment. Recent research has shown that CBT treatment for IBS can be delivered efficaciously in a minimal contact (MC; 4 sessions) format. Treatment of IBS is not well-researched in the Veteran population despite the relatively high prevalence of the syndrome and a concern of increasing rates among returning OEF/OIF Veterans. Research is needed to explore whether MC-CBT treatment is effective for Veterans and how it can be implemented in the VA setting to maximize accessibility and satisfaction. The main objective of this study is to test the feasibility of offering MC-CBT for IBS in a VA sample in terms of : 1) establishing the interest level of Veterans in MC-CBT for IBS; 2) documenting rates of subject participation and drop-out; 3) measuring Veterans' satisfaction with MC treatment for IBS; 4) measuring preliminary outcome in terms of changes in gastrointestinal symptoms and quality of life; and 5) collecting data on comorbidities (PTSD, anxiety disorders, mood disorders, physical health disorders, military sexual trauma) and health care utilization amongst Veterans with a diagnosis of IBS. This study will consist of three phases: 1) chart review of Veterans with IBS to collect data on comorbidities and health care utilization; 2) recruiting Veterans with IBS via mail to assess interest in and perceived credibility of MC-CBT; 3) recruiting a small sample of Veterans with IBS to participate in a MC-CBT intervention. Major variables will include: 1) mental and physical health diagnoses (i.e. PTSD, anxiety disorders, mood disorders, pain disorders), endorsement of military sexual trauma, demographics (age, gender, race, era- Vietnam, OEF/OIF, etc.), health care utilization (use of primary, specialty, and mental health care in the VA); 2) ratings of perception of treatment credibility; 3) gastrointestinal symptom, IBS-related quality of life, and treatment satisfaction. Study participants will be evaluated pre- (baseline) and post-treatment.
Cognitive-behavioral treatment (CBT) for Irritable Bowel Syndrome (IBS) has been shown to be effective in civilian populations, even in a minimal contact (MC) format. Given that the VA population is more physically and psychiatrically compromised than the civilian population, and prior studies have traditionally excluded patients with serious psychiatric comorbidities, we do not know if Veterans would be interested in or respond similarly to CBT for IBS. Providing MC-CBT for IBS would be particularly beneficial for Veterans who may have difficulty accessing care at the VA due to work schedules, transportation, or distance.