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Background IBD patients have a heightened risk for mental health illness, but general psychotherapy has shown mixed results. This psychotherapy protocol specialized for IBD patients uses recommended mental health therapies to treat specific chronic mental health illness. Therapy focuses on practicing CBT, clinical hypnosis, and emotion regulation healthy coping skills to self-manage chronic mental health symptoms. Standard therapies for acute mental illness, e.g. anxiety, depression, and suicidality, should be used as appropriate. Aims Aims of psychotherapy in IBD include improvement of mental health, symptoms management, quality of life (QOL), and adherence to medical treatments. Cognitive behavioural therapy (CBT) changes maladaptive coping behaviours and thinking. Clinical hypnosis improves somatic symptoms, e.g. chronic pain, nausea, and cramping. Emotion regulation improves ability to process stressful emotions, and has been shown to be affected by chronic diseases, including moderate to severe Crohn’s disease. Methods Patients learn to self-manage chronic mental health symptoms with healthy coping skills. CBT allows patients to identify maladaptive coping behaviours and thinking. Healthy coping behaviours and thinking patterns are chosen, supported, and adapted to. Clinical hypnosis uses relaxation techniques, e.g. progressive muscle relaxation, visualizations, and positive suggestions as a complimentary therapy for somatic symptoms. Emotion regulation develops tolerance and healthy processing of stressors. Results Therapy effectiveness is evaluated by improvements in patients’ mental health, symptoms management, QOL, and adherence to medical treatments. Mental health improvement, QOL, and emotion regulation are monitored by patient self-report, e.g. questionnaires. Maladaptive coping behaviours and thinking changed using CBT are individual to each patient. Somatic symptoms improved using clinical hypnosis are determined by monitoring or patient self-report. Adherence to medical treatments, as appropriate, is monitored. Conclusions This IBD psychotherapy protocol uses gut-directed CBT, clinical hypnosis, and emotion regulation therapies, designed to improve mental health, symptoms management, QOL, and adherence to medical treatments. Healthy coping skills treat maladaptive coping behaviours and thinking, somatic symptoms, and emotion dysregulation. Chronic mental health illness associated with IBD, is treated using this specialized psychotherapy. Funding Agencies None

journal of the canadian association of gastroenterology

A239 INFLAMMATORY BOWEL DISEASE PSYCHOTHERAPY PROTOCOL: GUT-DIRECTED COGNITIVE BEHAVIOURAL THERAPY, CLINICAL HYPNOSIS, AND EMOTION REGULATION COPING SKILLS DEVELOPMENT