The Road to Becoming a GI Psychologist
"I didn't even know such a career existed!"
I often get that comment upon meeting new patients or in conversations about my career. Followed by:
“What is a GI psychologist?!”
“How did you become interested in GI psychology?”
Introduction to psychogastroenterology
The world of psychogastroenterology is a growing and rewarding field. Psychogastroenterology involves mental health providers applying evidence-based psychological interventions to aid in the management of digestive conditions. Historically, gastroenterologists who had “run out of options” considered a referral to a psychologist.
It isn’t uncommon for a patient with IBS to hear some variation of, “there isn’t anything wrong with you, it’s in your head”. Not surprisingly, that is an incredibly disheartening thing to hear from a medical provider. Thankfully, the field of gastroenterology has come a long way. Through significant research, clinical practice, and collaboration we now consider the use of GI psychology as first-line treatment for many patients with IBS. I highly recommend this article by Dr. Laurie Keefer and colleagues to better understand just how far psychogastroenterology has come.
I have a bachelor’s degree in clinical psychology, a master’s degree in counseling psychology, and my doctorate in clinical psychology. During my clinical training, I provided therapy services to diverse patient populations over a wide range of clinical settings (correction facilities, schools, medical settings, just to name some). My introduction to psychogastroenterology began after many years of school and training. Upon completion of my doctoral internship (yay, I was finally a psychologist!), I began a 2-year GI-specific health psychology fellowship at Northwestern University. I was immersed in all-things gastroenterology and behavioral health. I learned how to apply evidence-based psychological interventions to various gastrointestinal complaints. These interventions would include cognitive behavioral therapy (CBT) and gut-directed hypnosis.
I saw patients with irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and worked extensively with patients with upper GI complaints1 such as GERD, functional heartburn, dysphagia, and globus. I quickly became inspired by all of the opportunities that this career could offer in terms of shaping the growth of this field, while also offering valuable services to patients. The patients I saw were highly motivated because many had been suffering from their GI conditions for years.
As we worked together, applying treatment plans that focused on reducing health-specific anxiety, improving stress management, and regularly implementing relaxation interventions, patients got better. Some patients would have complete alleviation of their symptoms in a short period of time (3-7 sessions). Others would classify “getting better” as learning more adaptive skills and strategies to better manage their chronic GI condition. “I wish I had access to a GI psychologist years ago!” became frequent feedback.
An unfolding story
To be honest, when I first started my fellowship, I was not aware that there were psychologists dedicated to working with patients with gastrointestinal conditions. The reality was that there were not many doing this work. I felt motivated and compelled to continue to work in GI. While the community of mental health providers doing this work is small, it is extremely supportive. I was lucky to have mentorship from some of the psychologists who have paved the way for psychogastroenterology, literally writing the books and doing the research.
After fellowship, I was recruited to the University of Michigan and worked with physician champions to build our GI Behavioral Health Program. Over 5 years we have grown to two GI psychologists on faculty to support the clinical needs of our patient population. Additionally, we developed a GI Psychology training program for psychology fellows and mental health clinicians.
The field of psychogastroenterology is one that is growing and in need of trained mental health professionals. The Rome Foundation has a dedicated section to those in the field of GI psychology. There is also a therapist finder for patients looking for a GI psychologist. In conclusion, there are still limitations to accessing a GI psychologist. However, we hope clinicians become encouraged by the rewarding nature of this work and join our ranks!
Do you think there is enough awareness of IBS?