Abstract
M.A. (Counseling Psychology)
The purpose of this study is to investigate the effects of a holistic intervention approach for the management of Irritable Bowel Syndrome (IBS), which is a common disorder of the gastrointestinal tract that leads to a change in bowel habits and is often accompanied by cramping, bloating and/or pain. The functional nature of the syndrome is evident in the subjective and often variable pattern of symptoms, which are carried by the body as the vehicle for expression in people's lives. A review of the history and development of IBS locates the study in the context of the age-old mind body dilemma as well as in the postmodern shift away from reductionist,
linear thought towards the complexities of process and subjective interpretation of multiple realities. IBS thus serves as a metaphor for the holistic nature of the mind-body link and the way in which the body tells the story of human life. The specific aim of the study was to compare the effects of different treatments for IBS. The sample consisted of 70 South African women who were diagnosed with IBS by a medical doctor and who presented with moderate to severe IBS symptoms. The IBS Client Questionnaire was used to verify a diagnosis of IBS which was based on a number of different criteria as specified by the current international diagnostic criteria for IBS. The sample was divided into four groups. Group 1 (n=13) received IBS medication and
holistic psychotherapy, Group 2 (n=23) received IBS medication only, Group 3 (n=13) received holistic psychotherapy, and Group 4 (n=21) received no treatment until after completion of the study. During the intervention phase, Group I (IBS medication and holistic psychotherapy) and Group 3 (holistic psychotherapy) were administered one hourly sessions of holistic psychotherapy once per week for a period of eight to twelve
weeks. Medication as a treatment continued uninterrupted depending on each client's unique pattern of symptoms. This was administered and monitored by the referring doctor and was targeted at the IBS symptoms. The psychotherapeutic intervention was tailor made to suit the needs of each client. Therapies utilized were related to the appropriate levels of functioning in the context of interacting biological, psychological, emotional and perceptual subsystems. Paired sample t-tests were used for within-group comparisons and one-way analyses of variance with post-hoc Scheffe tests were used for between-group comparisons. The comparisons were made in terms of improvement in symptoms, determined by the Functional Bowel Disorder Severity Index (FBDSI) which was administered as a pre- and post-test measure both before and three months after the intervention was completed.
The results of the study indicate that Group I who received IBS medication and holistic
psychotherapy and Group 3 who received only holistic psychotherapy presented with the most improvement in IBS symptom severity. Thus it is concluded that a holistic approach for the treatment of IBS is indicated, depending on the nature and severity of symptoms as well as each individual's contextual situation. This study facilitates a framework for psychologists who are working with clients with IBS or any other mind-body illness. In view of the high incidence of IBS in the general population it is recommended that further research into the treatment of IBS be conducted to assist clients in coping with their symptoms and ultimately their lives.