TABLE 1.

Common interventions used in brain-gut psychotherapies

	Associated with:
	Many brain-gut psychotherapies	GI-CBT	GDH	Description and examples
Psychoeducation	✕			Provide information about the relationship between the brain and the gut Examples: Description of the brain-gut axis, role of stress in GI functioning
Relaxation training	✕			Muscle relaxation and modification of autonomic arousal Examples: Diaphragmatic breathing, passive or progressive muscle relaxation
Self-monitoring	✕			Identify and monitor GI symptom triggers and responses Examples: Foods, substances, activities, environments, emotional or physical states or the GI symptoms themselves, which precipitate responses and outcomes
Therapeutic suggestions			✕	Use of therapeutic suggestion related to symptom reduction is a key feature and proposed mechanism of GDH. Typical components of a GDH session include hypnotic induction (i.e., narrowing of attention), physical relaxation, and use of metaphors and imagery. Facilitation of hypnotic trance, a state of deep relaxation and focused attention, is thought to increase receptivity and openness to changes in symptoms. Example: “Over time, you will notice less and less discomfort in your gut until only comfortable sensations remain.”
Cognitive restructuring		✕		Challenge common cognitive errors (e.g., symptom catastrophizing, negative future prediction) to address GI-specific anxiety Example: “My abdominal pain is a sign that something really serious is wrong, like having cancer” → “this pain is a sign of my sensitive GI tract. It is unpleasant, but it does not mean that I am unsafe”
Flexible coping		✕		Emphasizes the use of emotion-focused (passive) coping strategies for uncontrollable stressors and problem-focused (active) coping strategies for controllable stressors Examples: Often, decreasing problem-focused coping strategies such as internet searching, avoiding foods/activities, and increasing emotion-focused coping strategies such as practicing acceptance, relaxation, engagement in pleasant activities that turn attention away from symptoms
Behavioral exposures		✕		Engage in feared behaviors to challenge negative thoughts and beliefs and reduce GI-specific anxiety Examples: Eating foods that have been associated with symptoms in the past, going for a long walk without access to a toilet

Abbreviations: GDH, gut-directed hypnotherapy; GI-CBT, cognitive behavioral therapy for gastrointestinal disorders.