Positive Health Online

Abstract

PAJAK and COLLEAGUES, (1)Research Department of Clinical, Educational and Health Psychology, University College London, London, UK reviewed the literature regarding minimal-contact psychological treatments for irritable bowel syndrome symptom management.

Background

Psychological treatments are effective in alleviating symptoms of IBS but are not widely available. The need for wider dissemination of treatments has encouraged the development of 'minimal-contact' therapies requiring fewer resources than existing psychological treatments which rely on face-to-face contact.

Methodology

Using comprehensive search terms, the Embase, Medline and PsychInfo databases (all years) were searched.

Results

Twelve studies - nine RCTs and three non-controlled preliminary studies - meeting inclusion criteria were reviewed and assessed for quality using objective criteria. Apart from one study of expressive writing, all interventions were based on cognitive (and/or) behavioural principles or hypnosis and tended to be adaptations of existing therapist-led interventions. Compared to control conditions, minimal-contact interventions were efficacious, the majority of studies showing statistically significant improvements by the end of treatment. For cognitive-behaviour-therapy-based interventions effects sizes were large. The two studies that compared minimal-contact with therapist-delivered interventions broadly suggest comparable outcomes between these modalities.

Conclusion

Minimal-contact cognitive-behavioural interventions show promise in the treatment of IBS. Because of the lower quality of studies of hypnosis and those involving interventions delivered entirely remotely, further support is needed before such approaches can be recommended for widespread use. More generally, future research should use representative samples, active control conditions, and intention to treat analysis. Nonetheless, existing high quality studies suggest that minimal-contact therapies may be a safe, effective means of achieving scaleability of psychological treatments for IBS.

References

Pajak R(1), Lackner J and Kamboj SK. A systematic review of minimal-contact psychological treatments for symptom management in irritable bowel syndrome. J Psychosom Res. 75(2):103-12. doi: 10.1016/j.jpsychores.2013.05.007. Aug 2013. Epub Jun 10 2013.