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U of T professor wins grant to study how online psychotherapy can help children with inflammatory bowel disease

Dr. Sara Ahola Kohut is investigating the viability of acceptance and commitment therapy
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Dr. Sara Ahola Kohut, a researcher at the Hospital of Sick Kids and an assistant professor at U of T, received a $50,000 grant from Crohn’s and Colitis Canada to research the promise of online acceptance and commitment therapy (ACT) workshops in supporting children with inflammatory bowel disease (IBD) and their families.

What is inflammatory bowel disease?

IBD is an umbrella term for two conditions characterized by chronic inflammation of the gastro-intestinal tract: ulcerative colitis and Crohn’s disease. Symptoms of these diseases include abdominal cramps and pain, diarrhea, fever, and unintended weight loss.

In an interview with The Varsity, Kohut, who has been researching IBD since 2014, pointed out that the main challenge for patients with IBD and their families is dealing with uncertainty.

“Young people living with IBD don’t know when they may have a flare or be in pain, nor when that pain might end.” She noted that this makes planning day-to-day activities and for the future extremely difficult.

Constantly coping with this state of unpredictability may cause severe anxiety, and research has found that the risk of depression and anxiety disorders is much higher in young people with IBD than the general population, which Kohut hopes to change through her work.

Dealing with uncertainty and stress

ACT is a relatively new form of psychotherapy which encourages patients to accept things and events that are out of their control and commit to making changes that could improve their life.

Unlike most other therapies, ACT does not aim to change unpleasant thoughts, feelings, and sensations. Instead, it employs mindfulness-based strategies to help the patient reduce their feelings of stress and change their relationship with their pain by accepting their struggles as they are, rather than trying to avoid them.

People experiencing chronic pain often exhaust themselves fighting off everything that reminds them of it — not only the obvious unpleasant physical sensations, but also any related thoughts or emotions. However, their attempts to drive off the pain may be futile — this is where ACT comes to the rescue.

The skills one learns through ACT are transferable to a variety of situations, making them especially valuable for dealing with the unpredictability of IBD. Kohut explained that “in moments of [overwhelming] or intense frustration, ACT skills can help you pause and choose to act in ways that are aligned to who you most want to be as a person.”

Benefits of ACT

In Kohut’s clinical experience, ACT has been a popular and successful approach for young people with IBD. This finding led her to develop a new series of online ACT workshops, which focus on helping the participants recognize their values and “develop skills [that] allow them to incorporate their values into their everyday choices and behaviours.”

ACT also helps participants “to respond instead of react to what is happening around [them].” Through this, young patients’ relationships with their families may begin to feel more calm and relaxed, especially during unpleasant moments, such as when receiving injections or taking medication.

Kohut also aims to create a program that is accessible and enjoyable for parents of children with IBD. She moves to teach them to navigate parenting in a way that aligns with their values as a family, which may support them in dealing with the constant challenges of IBD, while also helping them to “model positive adaptation… to IBD so that their kids will be able to emulate that approach.”

There is currently no cure for IBD, yet Kohut’s novel approach may give the 7,000 Canadian children living with IBD and their families hope for a better future.