Table 2 Intervention sessions

Session 1. Understanding your IBD symptoms

Factors that can contribute to fatigue, pain and urgency in IBD. Identifying specific factors and developing a personal vicious cycle of symptoms. Use of self-monitoring not symptom focusing. Setting aims for the programme.

Task: Symptom severity and stress level diary.

Session 2. Balancing your activity, eating and exercise

Importance of activity and exercise. How fear leads to avoidance. Eating patterns. Setting goals for activity and exercise.

Task: Reviewing and working toward goals for activity + sleep diary.

Session 3. Improving your sleep

Why is sleep important? Sleep patterns & habits. Improving sleep.

Setting goals for sleep.

Task: Reviewing and working toward goals for sleeping patterns and habits.

Session 4a. Changing your thoughts: Part 1

Why are thoughts important? Identifying unhelpful thinking.

Task: Thought record.

Session 4b. Changing your thoughts: Part 2

Developing alternative thoughts.

Task: Alternative thought record.

Session 5. Managing stress and coping with emotions

The effects of stress and finding ways to manage it. The role of emotions and determining how best to take care of oneself. Setting goals for managing stress and emotions.

Task: Reviewing and working toward goals for stress management + stress diary.

Session 6. Making the most of your social support and communication

Types of social support. Communication and disclosure. Setting goals for social support.

Task: Reviewing and working toward goals for social support.

Session 7. Managing and understanding fatigue in IBD

Types of fatigue. Factors related to IBD fatigue. Exploring a vicious cycle of IBD fatigue; the role of thoughts, emotions and behaviours.

Session 8. Managing and understanding pain in IBD

Difference between acute and chronic pain in IBD. Factors related to IBD pain. Exploring a vicious cycle of IBD pain; the role of thoughts, emotions and behaviours. Common questions around pain in IBD.

Session 9. Managing urgency and leakage

Bowel functioning and bowel control difficulties. Stress and anxiety in urgency. Exercises to help reduce accidents. Practical bowel management tips. Using social networks to help manage urgency.

Session 10. The role of acceptance and self-compassion in pain

What is acceptance and how can it help? The role of resilience. Practical exercises.

Session 11. Summary and maintaining improvement

Reviewing programme aims. Preparing for the future. Sustaining and building upon improvements.