Inflammatory bowel disease (IBD) is a chronic digestive condition that causes disruption to gut function, often leading to debilitating pain, overwhelming tiredness and other physical symptoms.
But for people affected, the impacts extend beyond the physical.
Taryn Lores is a psychologist and a researcher at Central Adelaide Local Health Network (CALHN).
Her work addresses an aspect of care that has previously received little attention – the psychosocial burden of IBD.
“Traditionally, IBD has been treated predominantly in a biomedical way, with a focus on medication and surgery to treat the physical symptoms,” says Taryn.
“Looking at the person as a whole, we now know IBD has a much broader impact on quality of life and how people function day to day.”
Taryn is a senior health psychologist at the Royal Adelaide Hospital’s IBD service, and has recently completed her PhD focused on improving psychological care for people living with IBD.
More information about the Royal Adelaide Hospital’s IBD service can be found here.
Holistic care for IBD
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, is characterised by relapsing-remitting inflammation of the digestive tract.
For patients, the medical implications of IBD include symptoms such as diarrhea, fatigue, abdominal pain and cramping, blood in stools, reduced appetite and unintended weight loss.
“Along with these symptoms, we often see high rates of psychological distress and mental health implications such as anxiety and depression in people with IBD,” Taryn says.
“Other common concerns include poor body image, disordered eating, medical trauma and sexual health issues.”
“My role in the service is about recognising when people with IBD might need support with their mental and emotional health, and creating behavioural strategies to help them manage the challenges of living with IBD.”
Evolution of a care model
A model of integrated care for IBD patients has evolved over the eight years Taryn has worked at CALHN.
“For people new to our service, we now offer an introductory psychology appointment, alongside the gastroenterologist and IBD nurse appointments,” she says.
“This serves to introduce the person to what we offer, provide some education around IBD, as well as complete an initial screening and assessment of mental health and how they’re coping.”
From there, the service offers short to medium-term psychological supports as required, and can expand support further through more detailed assessments and care programs if needed.
“Some patients have around five to ten sessions with me to focus on specific concerns they have around their IBD and the implications of the condition on their life,” Taryn says.
“This can take the form of strategies to help them maintain activities such as getting back to work or study, ways to manage stress and anxiety, and even communication techniques to help people talk with family and friends about what they’re experiencing.”
Cognitive behavioural therapy and hypnotherapy are the main interventions used, with further supports offered if required.
Building capability for the whole sector
As well as working as a health psychologist, Taryn has just completed her PhD and published four peer-reviewed research papers.
“My studies focused on the gaps in research around psychological care for people with IBD, and improving access in the public health system,” she said.
“This included looking at the acceptability and feasibility of models of care we offer, and outcomes for patients and the system as a whole.”
“I also conducted a pilot trial of hypnotherapy for people with Crohn’s disease, and worked with patients to co-design preferred models of care for people with IBD.”
Together, Taryn’s research provides compelling evidence of the need and value of psychological input to provide care for people with IBD.
“IBD health care should adopt a biopsychosocial model and embrace psychological care as a standard care component,” she says.
Read the research
Already conferred, Taryn will graduate from her PhD at a ceremony in late 2024.
Her research papers are already published: click through on each heading below to read further.
- Integrated Psychological Care Reduces Health Care Costs at a Hospital-Based Inflammatory Bowel Disease Service
- Integrated Psychological Care is Needed, Welcomed and Effective in Ambulatory Inflammatory Bowel Disease Management: Evaluation of a New Initiative
- Virtual adjunctive gut-directed hypnotherapy for people with Crohn’s disease: A randomized controlled pilot and feasibility trial
- Psychological services for people with Inflammatory Bowel Diseases: Care co-designed by consumers
