GI Behavioral Therapy

What is GI Behavioral Therapy?

For patients with gastrointestinal (GI) conditions such as Irritable Bowel Syndrome (IBS), Crohn’s disease, ulcerative colitis (UC) or inflammatory bowel disease (IBD), everyday life brings many challenges. In addition to managing physical symptoms, the discomfort, uncertainty and inconvenience of living with a chronic GI condition can take an emotional toll, negatively impacting mental health and quality of life.

GI behavioral therapy (BT) includes a number of techniques designed to help patients deal with the uncontrollable and unpredictable aspects of GI conditions.

For example, patients with IBS may become anxious when worrying about finding a bathroom in a strange place, or dealing with symptom flare-ups before a big event, work presentation or school exam.

Patients learn relaxation and stress management techniques they can apply on their own to manage everyday stressors. Putting these self-management strategies into practice can create long term change, without the need to remain in treatment indefinitely.

Who Can Benefit from GI Behavioral Therapy?

Patients receiving behavioral therapy do not necessarily suffer from mental illnesses. Rather, they are looking to improve their emotional health while better managing their physical condition. You may be a good candidate for behavioral therapy if:

  • You find that life stressors make the symptoms of your GI condition worse
  • You are excessively worried about the impact of your symptoms
  • You have trouble understanding your condition or treatment plan
  • Your medication is not working
  • You have trouble relaxing
  • You are experiencing anxiety or depression because of your symptoms
  • You feel as though you do not have an adequate support system

Behavioral Therapy Options

Each patient is unique. That’s why Michigan Medicine offers a range of behavioral therapy options to patients suffering from chronic GI conditions, including:

Cognitive Behavioral Therapy (CBT): Cognitive behavioral therapy is the most thoroughly researched psychological treatment model available in health care settings. CBT has been proven effective in treating mental health conditions like depression, anxiety and panic attacks as well as providing relief for sufferers of many chronic illnesses, including chronic gastrointestinal conditions.

During CBT, a trained psychologist works with a patient to uncover how he or she thinks about his or herself, others, and the world and to identify which thoughts are helpful and which are not as helpful. The patient and therapist work together to interrupt and change unhelpful thinking patterns. As those patterns change, resulting feelings and actions also change, bringing about relief.

CBT is a structured process, focused on addressing specific problems. During sessions with a trained psychologist, the patient learns skills to take home and practice, reviewing and building on these “homework” assignments at each therapy session. CBT is designed to take place over a limited amount of time, with most people gaining the most benefit after about five to ten sessions. Learn more about CBT in our Health Library.

Gut-Directed Hypnotherapy: Hypnosis is a special mental state where a trained therapist guides a person into a focused state of awareness while feeling deeply relaxed. The technique utilizes suggestion, imagery and relaxation to produce a therapeutic effect.

Gut-directed hypnotherapy for digestive conditions like irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) uses suggestions aimed at calming the digestive tract and preventing unnecessary focus on physical discomfort. With an overall response rate of about 80 percent among IBS patients, gut-directed hypnotherapy has been proven to be highly successful. Its results have been shown to be long lasting, and in many cases it has been shown to help when other treatments do not. Additionally, esophageal-directed hypnotherapy has been utilized for patients with difficult to treat conditions such as functional heartburn, functional dysphagia and globus.

Stress Management Therapy: Through both talk therapy and instruction in simple techniques like diaphragmatic breathing and relaxation training, psychologists can work with GI patients help them identify tools they can rely on to keep stress in check.

About the Michigan Medicine GI Behavioral Health Program

At Michigan Medicine, we know that looking out for the mental wellbeing of our patients is every bit as important as caring for their physical health. Research conducted here and at other top institutions shows that when it comes to managing chronic GI conditions, actively addressing emotional concerns can have a direct, positive effect on symptom management and quality of life.

Members of the GI Behavioral Health Program work with the medical team to bring mind and body care together, complementing medical treatments with proven behavioral health interventions. To learn more about the GI Behavoral Health Team visit the GI Behavorial Appointments and Team page.

A patient is typically referred to the GI Behavioral Health Program by a gastroenterologist after medical treatment options have not been entirely successful and/or when it is thought that he or she would benefit from some form of behavioral therapy (BT) to manage stress and anxiety.

At the center of the GI Behavioral Health Program are clinical psychologists specially trained to care for the psychosocial needs of GI patients.  They deliver the most current, evidence-based treatments in the comfortable outpatient therapy environments of the Taubman Center and the West Ann Arbor Health Center.

Patient Resources


Michigan Medicine's Dr. Riehl was interviewed by the Crohn's and Colitis Foundation about a number of topics related to GI Behavorial Health. You can view the videos on YouTube as a playlist by clicking on the video window below or by clicking on the links below the window to view the individual videos.

  1. What you can expect during your first visit with a mental health professtional
  2. When to seek a mential health professional
  3. IBD and stress can affect sleep
  4. Taking medications for your IBD and anxiety
  5. Breaking the GI stress cycle in Crohn's disease or ulcerative colitis
  6. The GI stress cycle in Crohn's disease and ulcerative colitis
  7. Understanding stress and anxiety in IBD

PDF Documents

Contact the GI Behavioral Health Program

At this time, adult patients (18 years and older) must be under the care of a Michigan Medicine gastroenterologist who would be happy to place a referral to the GI Behavioral Health Program.  To schedule an appointment with a Michigan Medicine gastroenterologist call 1-800-229-7408.  If you are a current patient with the GI Behavioral Health Program and need to reschedule or cancel an appointment, call 1-800-229-7408.

To learn more about new patient appointments, insurance coverage, and the GI Behavioral Therapy Care Team, visit the GI Behavioral Appointments and Team page.