Lesson 1Session 5: Mindfulness and interoceptive exposure — body scan, focused attention, tolerating visceral sensationsTeaches mindfulness skills to watch feelings without judging and lessen reactions. Includes body scan, focused attention, and facing gut sensations, stressing willingness, interest, and safety steps for local patients.
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 rationaleOutlines main format choices for GI Resilience Training, like suggested sessions, time per session, and group or one-on-one ways. Explains adapting for online, mixed, and group setups while keeping true to the plan 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 starting steps, building trust, and checking risks. Guides workers in collecting GI, health, and social history, giving education, and jointly making a whole-person plan and treatment outline for Namibian care.
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 movement, and daily patterns affecting GI symptoms and strength. Covers good sleep habits, planned activities step by step, pacing ways, and cutting rest from avoidance 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 acceptance ways made for GI stress. Uses ACT-based activities, value clearing, and riding urges to help patients act on values even with discomfort and strong wants in daily life.
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 experimentsFocuses on spotting worst-thinking about GI feelings and safety actions. Teaches rethinking thoughts, record keeping, and action tests to check ideas and lessen worry linked to symptoms in practical settings.
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 exposuresIntroduces step-by-step facing of scary foods, places, and body feelings. Guides making lists, planning facing in session, and reviewing to cut avoidance, safety actions, and worst expectations effectively.
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 locking in progress, stopping slips back, and ending care. Includes custom coping plans, early signs, extra sessions, and links to health, mental, and community help in Namibian contexts.
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 the stress-gut loop and how tension worsens GI signs. Teaches belly breathing, quick relaxation, and starts symptom and food logs to follow causes, patterns, and early wins in treatment.
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 avoidanceDetails tailoring the plan for different symptom levels, added worry or low mood, and tricky risks. Covers step changes, longer parts, and planned safety for strong avoidance in varied patient needs.
Stratifying patients by severity levelStepped-care and dose adjustmentsIntegrating anxiety and depression modulesCoordinating with prescribing cliniciansSafety planning for severe avoidanceMonitoring risk and escalation pathways
