Anxiety and stress are psychological concerns. We know that medical problems can create anxiety and stress. We also know that anxiety and stress can make medical problems worse. It’s been shown that psychological treatment techniques can help ease distress, sometimes change the course of disease and facilitate healing, or at least help a person cope with their digestive symptoms. The integrative approach of behavioral medicine can also lead to better outcomes.
Cleveland Clinic’s Behavioral Medicine program in its Digestive Disease & Surgical Institute is one of few nationally offering this unique service focused on the “gut-brain-body connection” as part of patients’ digestive treatment plan.
Behavioral medicine techniques have also been shown to help reduce post-operative pain and decrease the likelihood that any post-operative pain will persist and become chronic pain. These techniques can facilitate healing, speed recovery and help patients leave the hospital sooner. Our program teaches patients ways to cope with surgery (such as complex hernia repairs, colorectal surgery for IBD or colorectal cancer) including learning ways to manage of postoperative pain, to facilitate healing, adjust to ostomy, and more.
Behavioral Medicine Program Director
Am I A Candidate?
Patients with a wide array of conditions can benefit from seeing a Behavioral Medicine psychologist including:
- Patients with moderate to severe symptoms who have not responded fully to medical management
- Patients whose stress or emotional factors are worsening their symptoms
- Patients who are interested in alternative ways to manage their symptoms
- Patients newly diagnosed with chronic illnesses, such as Crohn's disease, ulcerative colitis, chronic pancreatitis, and gastroparesis
- Any patient needing assistance with coping with chronic, uncomfortable symptoms
- Any patients facing a surgery and interested in learning ways to facilitate their post-operative recovery
Patients who would not be a good candidate for referral would include:
- Patients who have significant psychological symptoms that are not related to their condition
- Patients who have current severe psychiatric symptoms (suicidal ideation, psychotic disorder, severe obsessive-compulsive disorder)
- Patients who have an active eating disorder
- Patients who are not accepting of the role of stress on their condition
- Patients who are not highly motivated to try behavioral medicine approaches
Several types of psychotherapies may help ease persistent gastrointestinal distress or at least help people learn to copy with such symptoms. These treatments include:
- Relaxation therapy: This approach uses several techniques to help people relax and reduce reactivity to stress. Techniques include progressive muscle realization, visualization, and restful music. Research suggests that these therapies are most effective when combined with cognitive behavioral therapy (CBT). Deep relaxation, in addition to being an endorphin releaser (the bodies’ natural pain killer), has also been shown to speed-up wound healing.
- Cognitive behavioral therapy (CBT): The goal of this approach is to help patients change their thoughts, behavior, and emotional response as well as learn coping skills to better manage anxiety and stress.
- Biofeedback: Biofeedback is a technique where, via visual or auditory feedback from a devise that measures a physiological marker- such as a thermometer measures temperature- the person can learn to modify that physiological response. For instance- when some people are stressed their hands get cold. Using a portable, digital thermometer with a sensor attached to the finger providing the patient feedback about their hand temperature, using relaxation, patients can learn to raise the temperate in their hands. (These devises can be found on line and are relatively inexpensive. Look under the term thermistor.) This technique can help with relaxation, and with healing, and a way to relieve stress and tension. One can also use phone apps such as heart rate variability apps to help learn relaxation and calm the body’s response to stress.
Most patients are seen in a Shared Medical Appointment (SMA). Topics covered in any given session are tailored to the needs of those in attendance. However, some core information and skills are covered in all sessions.
Frequently Asked Questions
Are there other benefits to these psychological treatments besides helping ease symptoms?
There is some evidence of improved mood and improved quality of life in patients who have undergone treatment. Also, although treatments may require greater time investment from patients initially, less frequent doctor visits may be needed (outpatient visits, medical procedures, medications).
Are visits with the Behavioral Medicine Psychologists covered under health insurance?
Always check with you insurance carrier before you receive care. However, it's important to note that behavioral medicine treatments provided by a health psychologist in the DDSI are billed using a medical diagnosis (as opposed to a psychological diagnosis) and are submitted to your medical insurance.
Appointments & Referrals
To make an appointment with the Behavioral Medicine Program, please call our office at 216.445.9552.
For Medical Professionals
To refer a patient to Dr. Scheman, please call 216.445.9552.
Listed below are helpful resources for patients interested in learning more about Behavioral Medicine.
- Podcast: Using Behavioral Medicine to Manage Psychological Issues Caused By GI Disorders - with Dr. Judith Scheman on Cleveland Clinic's Butts & Guts Podcast
- *Podcasts: Procedure Relaxation Exercises (See player)
- *Podcasts: Healing & Relaxation Exercises (See player)
*Do not listen to these recordings while driving or operating machinery or engaged in any other activity that demands your attention.
- Behavioral Medicine Education and Relaxation: Dr. Scheman - December 2020
This is an educational video that is designed to help patients get better, faster after their surgery. Your surgeon may have recommended that you view this video to help prepare for your upcoming surgery.
- Deep Relaxation Techniques: Dr. Scheman - December 2020
This video will introduce you to a deep relaxation technique. Deep relaxation has been shown to help speed healing after surgery, decrease inflammation, help your immune system and help regulate your gut. For additional details, please watch the Education Video.