Lesson 1Session 5: Mindfulness and interoceptive exposure — body scan, focused attention, tolerating visceral sensationsTeaches awareness skills to watch feelings without judging and cut reactions. Covers body check, focused watch, and inner body facing to GI feelings, stressing willingness, interest, and safe limits.
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 rationaleLists key plan choices for GI Strength Training, like suggested number, time per session, and way to give it. Explains changes for online, mixed, and group ways while keeping true and safe.
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 measuresCovers start steps, trust building, and risk check. Guides helpers in getting GI, health, and mind-social history, giving mind teaching, and making shared body-mind-social plan and care path together.
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 avoidanceDeals with rest, body work, and daily ways that change GI signs and strength. Covers rest care, step activity plans, speed ways, and cutting avoid-rest that keeps problems going.
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 surfingMixes feeling control and accept-based ways made for GI pain. Uses ACT-like tries, value clear, and urge riding to help patients act on values even with unease and wants.
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 experimentsCenters on finding worst views of GI feelings and linked safe actions. Teaches idea fixing, thought notes, and action tests to check guesses and cut sign-linked worry.
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 exposuresBrings in step facing of feared foods, places, and body feelings. Guides list making, session facing plans, and review to cut avoiding, safe actions, and worst hopes.
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 resourcesGuides fixing gains, back-slide stop, and end planning. Includes personal handle plans, early signs, extra help times, and links to health, mind, and community aids.
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 setupExplains stress-gut loop and how alert makes GI signs worse. Teaches belly breathing, short calm skills, and starts sign and food notes to track starts, ways, and early care wins.
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 avoidanceTells how to fit the plan for different sign strength, added worry or sad, and hard risks. Covers step changes, longer parts, and set safety plans for strong avoiding.
Stratifying patients by severity levelStepped-care and dose adjustmentsIntegrating anxiety and depression modulesCoordinating with prescribing cliniciansSafety planning for severe avoidanceMonitoring risk and escalation pathways
