Customer Reviews

Cognitive-Behavioral Treatment of Irritable Bowel Syndrome: The Brain-Gut Connection

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Written by Brenda Toner and her colleagues, who have worked extensively on psychosocial aspects of Irritable Bowel Syndrome (IBS), this manual provides a thorough, yet accessible, introduction to the current understanding of IBS and cognitive behavioural approaches to its treatment.

One of the particularly interesting aspects of the book is the attention paid to gender socialisation and social stigma as factors which may help to explain both the high proportion of female IBS outpatients and some of the central concerns of the patient group. After summarising current research into the biological, psychological and social factors that contribute to the disorder the second half of the book outlines the cognitive behavioural therapy program developed and implemented by the Toronto group. A detailed outline of session themes and session content is included. Case studies and sample scripts are used throughout making this book clear and interesting to read.

Beyond its use as a manual to guide health care professionals in the management and treatment of patients with IBS, this book provides a great insight into the nature of the disorder and the impact it has on patient's psychological state and day to day lives.

While this book is written for practitioners, it provides information and insight which can be useful for the sufferer of irritable bowl syndrome (IBS) as well. This may be especially true for many of the over 20 million individuals in the US alone who suffer from social anxiety disorder - a fear of being negatively evaluated and humiliated in social situations - who suffer from this painful and embarrassing disorder as well.

Given that the diseased-based biomedical model can't adequately account for these gastrointestinal symptoms and their psychological effects, it is gratifying to see an empirically-supported cognitive-behavioral treatment for IBS which is effective.

In addition to its gender and social context issues, its comprehensive set of treatment recommendations includes emphasis on coping with shame, anger, assertiveness, self-efficacy, social approval, perfectionism, control, self-nuturance, and performance anxiety. To assist the therapist in facilitating the client's learning, the book also includes recommendations, troubleshooting guides, common problems and myths, case histories, scripts, and client-therapist dialogues.

This is an excellent volume on a condition which heretofore has received little attention.

Good book on using CBT for the treatment of IBS.

The Good: The book contains several chapters on IBS and the CBT conceptualisation of IBS. The IBS "patient themes" that Toner and her colleagues have identified as being personality characteristics that are typical of IBS patients are excellent and are necessary topics to cover/ work on in therapy. The chapters detailing the treatment sessions are informative and provide a brief guide on what to do during the particular session. Scripts for the therapist are also provided in some chapters, which help therapists grasp how to explain things to the client, such as the CBT explanation for IBS symptoms.

What Could Be Improved: Initially, I thought the book would contain detailed, step-by-step information pertaining to how to conduct each therapy session. This is not the case. Unfortunately, only a brief amount of information is provided and the session topics are only covered in point-form. A typical set of session instructions include things like "cover this topic in detail before moving on to the next topic"-- hence at times no real direction is provided. Also, Toner and her colleagues tend to refer to other resources for strategies that are central to their own treatment program. For example, although relaxation training is a central feature of the treatment, the authors refer to another source for the relaxation exercise, leaving the reader to try to locate that source as it is not contained in the book. The book is also quite short for a treatment manual. The authors say nothing about what to do should problems arise or if the treatment does not seem to be working.

I would recommend this book to all therapists who work with individuals with IBS or other psychosomatic/ health anxiety concerns as it does a good job at presenting the CBT conceptualisation of such problems.