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Best practice update: GI psychologists, GIs need collaboration
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Gastroenterologists should play an important role in the promotion of psycho-gastroenterology therapy, and research and clinical gaps need to be addressed to effectively incorporate psychological treatment into the management of digestive disorders, according to a best practices update published in Gastroenterology.
Laurie Keefer, PhD, AGAF, and colleagues reviewed existing literature to develop a list of five best practice recommendations to enhance cooperation and coordination between gastroenterologists and GI psychologists.
“My rationale for writing this article was to provide a more practical guide for gastroenterologists interested in working with a GI psychologist,” Keefer told Healio Gastroenterology and Liver Disease. “Each best practice update was based on frequently asked questions I get at conferences and workshops and barriers I have seen to effective integration in my almost 15 years as a GI psychologist.”
The researchers wrote that digestive diseases, including irritable bowel syndrome, GERD and inflammatory bowel disease, can be amplified when symptoms are severe or refractory, when psychiatric comorbidity is present, or when coping skills are impaired. Brain-gut psychotherapies are designed to address these problems.
Keefer and colleagues developed the following recommendations for gastroenterologists to address these issues and make effective referrals for brain-gut psychotherapy in routine practice:
- Routinely assess health-related quality of life, symptom-specific anxieties, early life adversity and functional impairment related to a patient’s digestive complaints.
- Master patient-friendly language to explain how the brain affects GI disorders, as well as how a GI psychologist can help.
- Know the structure and core features of the most effective brain-gut psychotherapies.
- Establish a relationship with one or two mental health providers and assure patients that they will still be part of their care team.
- Familiarize themselves with neuromodulators that can be used to augment behavioral therapies when needed.
“I feel that gastroenterology trainees often want to know how to convince a patient to seek out a brain-gut psychotherapy without implying that the patient has a mental illness,” Keefer said. “I wanted specifically to remind gastroenterologists that they do not need to know these therapies in order to refer their patients for a specific treatment, just to the GI psychologist who will make the right decision based on patient preference, psychological phenotype and GI symptoms.”
Disclosures: The authors reported no relevant financial disclosures.
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