Gastrointestinal Behavioral Health Treatments and Services

We offer several different therapies for gastrointestinal behavioral health. We work together with you to find the therapy that best fits your needs and lifestyle.

Appointments and referrals

Adult patients (18 years and older) must be under the care of one of our team of gastroenterologists who would be happy to place a referral to our Gastrointestinal (GI) Behavioral Health Program. We will call you within 1 to 2 weeks to schedule you for behavioral health services. Your provider may recommend that you:

  • Attend one or more of our group skills classes.
  • Have a comprehensive consultation with a member of the GI behavioral health team. During the consultation, they will ask about your medical history, GI symptoms, stress and coping skills and your goals for your treatment.

Our services

We offer individual and group visits for the treatment of GI-related behavioral health issues. For individual visits, you may be seen one-on-one through a Zoom video conference call, or in-person in our Lebanon, New Hampshire clinic, depending on your own preferences.

Group treatment visits take place using video conferencing applications (Webex or Zoom). For these visits you will:

  • Need to attend from a private location and have your video camera turned on
  • Be highly encouraged to complete assignments between each group visit to get the most out of your experience

Individual visits

We will spend time getting to know each other during the initial visit. This visit is a consultation, meaning it doesn’t guarantee starting treatment. Our job during this first visit is to assess what your needs are and if we can meet those needs through our GI Behavioral Health Program. We may recommend:

  • Individual therapy, group programs, or a combination depending on what you want and the problems you are having
  • Therapy through the community, psychiatry services, or that we talk with your primary care doctor.

Based on this initial visit, we will design a treatment plan together.

Group treatment visits

During group visits, you and typically 5 to 10 other patients will be in a Zoom room together. We ask that you keep your camera on during the visit. The group leader will provide education on specific GI behavioral health topics and teach skills to address a specific concern. We provide a manual for the group that explains a lot of the concepts. We highly encourage you to attend every visit and complete homework assignments between groups to make the most of the experience.

We offer the following classes:

  • Goals: To learn different cognitive-behavioral techniques targeting symptoms for pain, its relationship with GI conditions and how to integrate these techniques into your life. We will practice mindfulness techniques to change our relationships with pain and learn the difference between acute and chronic pain. We will learn about:
    • Increasing trust in one’s body through personalized pain skills.
    • Pain versus self-care cycles
    • Somatic tracking
  • Participants will receive handouts on techniques and will be asked to record their symptoms and practice between visits.
  • Length: Four (4) 45-minute visits that take place weekly
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

  • Goals: To understand the ways that GI symptoms, food avoidances and anxiety can make each other worse and to come up with a personal plan for successfully expanding your diet
  • Length: One (1) 90-minute visit
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

  • Goals: To decrease symptoms of GI conditions (abdominal pain, bloating, or sensitive or uncomfortable belly) and improve your ability to manage the symptoms. Hypnosis is a form of deep relaxation that is designed to improve sensitivity to GI symptoms and the communication between your gut and your brain.
  • Group length: Seven (7) 45-minute visits that take place every other week.
  • Important notes: This class requires a quiet environment and a chair or couch where you can comfortably lean your head back on something. You must complete a screening phone call prior to scheduling this class.
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

  • Goals: To understand the ways in which thought and behavior patterns can make sleep worse. You will leave this class with an understanding of how insomnia develops and some clear ways you can improve your own sleep routine.
  • Length: One (1) 90-minute visit
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

  • Goal: To learn different relaxation techniques, understand how relaxation can help GI conditions and how to integrate the techniques into your life. We will practice diaphragmatic breathing, mindfulness, imagery relaxation and progressive muscle relaxation during the classes. Participants will receive recordings of the in-session relaxation content and will be asked to practice with or without the recording on their own between visits.
  • Length: Four (4) 45-minute visits that take place weekly
  • Important notes: This class is best attended from a quiet environment.
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

  • Goal: To live a life according to what you really want rather than living a life dictated by your GI symptoms. We will discuss how to disengage from difficult or unhelpful thoughts, identify our values and ways to move towards them and learn the basics of mindfulness. Participants will receive a PDF with session-by-session content and will be asked to practice the concepts between each group.
  • Length: Five (5) 45-minute visits that take place weekly
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

  • Goal: To learn how worry and anxiety impact physical health, learn cognitive-behavioral techniques to understand worry, challenge negative thinking and make individualized plans to face previously avoided situations. Participants will complete homework exercises based on specific strategies between sessions to gain mastery over skill.
  • Length: Five (5) 45-minute visits that take place weekly
  • Important notes: This group is a good complement to the relaxation skills group.
  • Registration: To register for this class, please call Lebanon Gastroenterology and Hepatology and we will review your eligibility. You need to have a referral submitted by your GI provider to register.

Types of GI behavioral health treatment

Please refer to the following links for the different types of treatments we offer:

Acceptance and commitment therapy

Acceptance and commitment therapy (ACT) is a form of cognitive-behavioral therapy that focuses on:

  • Emphasizing acceptance as a strategy for effectively coping with your negative thoughts, feelings and bodily experiences
  • Engaging in behaviors that are consistent with what is most important to you.
  • Learning to approach situations and experiences with greater flexibility.

Cognitive-behavioral therapy

Cognitive-behavioral therapy (CBT) is a treatment that helps you identify and change negative or unhelpful thoughts and behaviors. During CBT we help you to see how your thoughts, feelings, behaviors and physical sensations are all connected. Your beliefs and feelings about a situation or experience can influence how your brain and body react to that situation or experience. CBT focuses on helping you reduce the use of unhelpful coping strategies that you learned in response to GI symptoms or stress. We will educate you about:

  • Brain-gut interactions
  • Efforts to change thinking and behavior patterns
  • Self-monitoring of symptoms
  • Unhelpful patterns of responding

We help you learn to:

  • Face difficult situations instead of avoiding them
  • Recognize how your thinking can worsen GI symptoms

Gut-directed hypnotherapy

Hypnosis is a type of brain-gut behavior therapy that can help people reach a special relaxed state. This state can feel “dream-like,” allowing you to be more focused, aware and open to therapeutic suggestions. Hypnosis is often shown in the media to create a state in which people can be controlled. This depiction is not accurate. One of the most important ingredients in successful hypnosis is a willingness to be hypnotized. The imagery and verbal descriptions we use during gut-directed hypnotherapy are:

  • Directly relevant to people with GI symptoms
  • Meant to be helpful in thinking about or dealing with symptoms

Mindfulness-based therapy

Mindfulness-based therapy is a treatment approach that involves:

  • Intentionally increasing awareness of your experience in the present moment
  • Learning to pay attention to your thoughts, feelings and body sensations without judging them
  • Reducing physical vulnerability to stress

Relaxation training

Relaxation training focuses on becoming aware of tension in your body and then learning to reduce that tension in different ways. Relaxation methods include:

  • Diaphragmatic breathing
  • Guided imagery
  • Progressive muscle relaxation

These strategies are used to reduce physical tension and stress and create feelings of calmness and relaxation. They can help with improving sleep and reducing pain, anxiety and stress.