Lesson 1Session 5: Mindfulness and interoceptive exposure — body scan, focused attention, tolerating visceral sensationsThis lesson teaches mindfulness to notice body feelings without judging, reducing overreactions, including body scans, attention focus, and facing gut sensations with openness, curiosity, and safety measures.
Introducing mindfulness for GI symptomsGuided body scan for visceral awarenessBreath and anchor focused attentionPlanning interoceptive exposure exercisesManaging distress during exposure practiceIntegrating mindfulness into daily routinesLesson 2Overall format decisions: recommended number of sessions, session length, group vs individual delivery, mixed/online adaptations and rationaleThis lesson details format choices for GI Resilience Training, like session count, duration, group or one-on-one, and online mixes, explaining adaptations to keep quality and safety in varied Botswana settings.
Recommended total number of sessionsStandard session length and pacingCriteria for group versus individual formatHybrid and telehealth delivery adaptationsMaintaining treatment fidelity across formatsLesson 3Session 1: Assessment, psychoeducation, and collaborative formulation — goals, intake tasks, and baseline measuresThis lesson covers starting procedures, building trust, and checking risks, helping gather GI, health, and life history, provide education, and jointly create a mind-body plan and goals for treatment.
Pre-session screening and referral pathwaysStructured GI and medical history takingAssessing avoidance, disability, and riskPsychoeducation on gut–brain interactionDeveloping a shared case formulationSetting goals and initial home practiceLesson 4Session 7: Sleep, lifestyle, and behavioral activation — sleep hygiene, activity scheduling, pacing to reduce avoidanceThis lesson tackles sleep, activity, and routines affecting GI strength, teaching good sleep practices, planned movements, pacing, and cutting rest from fears to avoid ongoing limitations.
Assessing sleep patterns and fatigueTeaching core sleep hygiene practicesDesigning graded activity schedulesPacing strategies for symptom flaresReducing avoidance and safety restMonitoring lifestyle changes over timeLesson 5Session 6: Emotion regulation and acceptance strategies — ACT exercises, values clarification, urge surfingThis lesson combines feeling management and acceptance for GI stress, using ACT activities, value identification, and handling urges to act meaningfully despite unease and impulses.
Psychoeducation on emotions and urgesValues clarification and life domainsACT defusion and acceptance exercisesUrge surfing for symptom-driven behaviorsBuilding personalized coping menusAssigning values-based action tasksLesson 6Session 3: Cognitive patterns and cognitive restructuring — identifying catastrophic thoughts, thought records and behavioral experimentsThis lesson targets extreme views of GI feelings and safety actions, teaching thought changes, records, and tests to challenge fears and lessen anxiety tied to symptoms.
Mapping common GI-related thinking trapsLinking thoughts, emotions, and behaviorsUsing structured thought record worksheetsDesigning behavioral experiments safelyResponding to stuck or rigid cognitionsHomework review and refinementLesson 7Session 4: Exposure to feared foods and situations — graded exposure principles, hierarchy creation, in-session exposuresThis lesson introduces step-by-step facing of scary foods and places, building lists, planning during sessions, and reviewing to reduce avoidance and dire predictions.
Functional assessment of avoidance patternsBuilding individualized exposure hierarchiesPreparing patients for exposure rationaleConducting in-session food exposuresConducting situational and activity exposuresProcessing learning and updating beliefsLesson 8Session 8: Relapse prevention, maintenance plan, and discharge — personalized coping plan, booster scheduling, community resourcesThis lesson helps solidify progress, prevent slips, and plan endings, with custom coping, warning signs, follow-ups, and links to health, mental, and local supports.
Reviewing progress and remaining barriersIdentifying personal relapse triggersCreating written coping and action plansPlanning booster and follow-up contactsCoordinating with medical providersConnecting to peer and community resourcesLesson 9Session 2: Stress–gut cycle and short-term skills — diaphragmatic breathing protocol and symptom/food diary setupThis lesson explains the stress-gut loop and how tension worsens symptoms, teaching belly breathing, quick relaxations, and diaries to note triggers and early improvements.
Teaching the gut–brain interaction modelExplaining the stress–symptom feedback loopDiaphragmatic breathing teaching protocolIntroducing brief in-the-moment calm skillsDesigning symptom and food monitoring toolsAssigning home practice and troubleshootingLesson 10Adaptations for severity and comorbidity: stepped adjustments, extended modules for comorbid anxiety/depression, safety planning for severe avoidanceThis lesson shows tailoring the plan for symptom intensity, added anxiety or low mood, and risks, with step changes, extra parts, and safety steps for strong avoidance.
Stratifying patients by severity levelStepped-care and dose adjustmentsIntegrating anxiety and depression modulesCoordinating with prescribing cliniciansSafety planning for severe avoidanceMonitoring risk and escalation pathways
