Issues to consider in cognitive-behavioural therapy for irritable bowel syndrome.

[table: see text] Physical, psychological and social factors interact in IBS. Evidence for the efficacy of CBT in its management is available. The cognitive-behavioural model can also be used to inform medical care for IBS. In designing and evaluating a cognitive-behavioural intervention, it is important to consider the particular strategies included, the goals being worked towards, the selection of patients to whom the intervention is offered and how far it is tailored to their needs. Other important factors are the skills of the therapist, the setting in which therapy is delivered and whether it is offered together with medication.