Cognitive Behavioral Assessment and Treatment Outcomes for Gastrointestinal Dysfunction: The Case of Alex

Abstract

Chapter 20 covered gastrointestinal problems as a major symptom category. It provided an overview of common chronic conditions that involve gastrointestinal symptoms and reviewed issues related to the etiology and prevalence of common gastrointestinal disorders. This chapter will illustrate the application of cognitive behavioral therapy to Alex, who was introduced in Chapter 1 and periodically discussed throughout the text. The first objective of this case example is to synthesize the earlier examples that focused on Alex, discussing the case as a whole and summarizing therapy outcomes. The second objective of this chapter is to illustrate unique intervention approaches that can be incorporated into cognitive behavioral therapy with clients that have gastrointestinal symptoms or disorders. The chapter will close with an overview of the unique considerations in treating individuals with gastrointestinal symptoms and disorders. As described in Chapter 1, Alex is a 23-year-old graduate student with Crohn's Disease. He was referred for cognitive behavioral therapy by his school advisor because he was having difficulty adjusting to a recent progression of his Crohn's disease and appeared unusually concerned about his academic performance. Initial Orientation, Approach to Assessment and Assessment Findings Alex completed the initial orientation and assessment within a single session. Medical records and verbal information from Alex's colorectal surgeon and school advisor were collected. In addition, the following assessments were completed during the first session: • Semistructured clinical interview • Problem list Findings from these assessments are presented in the sections that follow. 337