Patients with Disorders of Gut-Brain Interaction (DGBIs) frequently present with persistent symptoms despite appropriate medical treatment and reassurance. While traditional treatment approaches often focus on symptom reduction, many individuals remain caught in cycles of avoidance, hypervigilance, fear, and functional impairment that contribute to ongoing distress and disability. This course explores DGBIs through the lens of protective adaptations—behaviors, beliefs, and physiological responses that develop to help individuals manage perceived threat but may inadvertently maintain symptoms over time.
Participants will learn how the nervous system, prior experiences, family responses, and symptom-related learning histories influence the development and maintenance of protective adaptations such as symptom monitoring, activity avoidance, food restriction, reassurance seeking, bathroom safety behaviors, and caregiver accommodation. Drawing from current DGBI research, pain science, attachment theory, and trauma-informed frameworks, this training will provide a comprehensive understanding of why patients become “stuck” and how clinicians can identify these patterns within treatment.
Through case examples and interactive engagement, attendees will develop skills for recognizing protective adaptations, conceptualizing symptoms within a biopsychosocial framework, and implementing interventions that promote flexibility, resilience, functional restoration, and engagement in valued activities. Emphasis will be placed on helping patients move beyond symptom management toward meaningful participation in daily life.
Upon completion of this training, participants will be able to
- Describe the role of the gut-brain axis, nervous system processes, and threat detection mechanisms in the development and maintenance of DGBI symptoms.
- Identify common protective adaptations associated with DGBIs, including avoidance behaviors, symptom monitoring, reassurance seeking, food restriction, and caregiver accommodation.
- Explain how learning history, attachment experiences, and prior medical or stressful experiences can contribute to the persistence of gastrointestinal symptoms and functional impairment.
- Apply a biopsychosocial and protective adaptation framework to case conceptualization in patients with DGBIs.
- Utilize evidence-informed interventions that promote functional restoration, behavioral flexibility, and increased engagement in valued activities despite ongoing symptoms.
- Differentiate between interventions that inadvertently reinforce symptom-focused behaviors and those that support adaptive coping and recovery.
Syllabus:
Introduction
Objective 1: Describe the role of the gut-brain axis, nervous system processes, and threat detection mechanisms in the development and maintenance of DGBI symptoms.
- Overview of the gut-brain axis and bidirectional communication
- The role of threat detection and nervous system protection
- Interoception, hypervigilance, and predictive processing
- Understanding symptoms through the lens of nervous system learning
Objective 2: Identify common protective adaptations associated with DGBIs, including avoidance behaviors, symptom monitoring, reassurance seeking, food restriction, and caregiver accommodation.
- Defining protective adaptations
- Avoidance, symptom monitoring, and body checking
- Reassurance seeking and medical reassurance loops
- Food restriction and bathroom safety behaviors
- Activity restriction and caregiver accommodation
- Understanding the short-term benefits and long-term costs of protection
Objective 3: Explain how learning history, attachment experiences, and prior medical or stressful experiences contribute to the persistence of gastrointestinal symptoms and functional impairment.
- Classical and operant conditioning in DGBIs
- Fear-avoidance cycles and symptom spirals
- Medical trauma and invalidating healthcare experiences
- Symptom memory networks and nervous system learning
- Attachment influences on threat perception and coping
- Family responses and developmental learning
Objective 4: Apply a biopsychosocial and protective adaptation framework to case conceptualization in patients with DGBIs.
- Looking beneath symptoms to identify threat and protection
- The Protective Adaptation Framework
- Identifying reinforcement patterns and functional impairment
- Case conceptualization exercises
- Application to pediatric and adult DGBI presentations
Objective 5: Utilize evidence-informed interventions that promote functional restoration, behavioral flexibility, and increased engagement in valued activities despite ongoing symptoms.
- Psychoeducation as intervention
- Identifying and targeting feared outcomes
- Exposure-based interventions
- Behavioral experiments and confidence-building
- Interoceptive exposure
- Acceptance, willingness, and values-based action
- Promoting flexibility and functional restoration
Objective 6: Differentiate between interventions that inadvertently reinforce symptom-focused behaviors and those that support adaptive coping and recovery.
- Support versus accommodation
- Parent coaching and family-based interventions
- Responding to reassurance seeking
- Common therapist traps and treatment barriers
- Managing setbacks and non-linear progress
- Shifting from symptom elimination to confidence-building
Summary/Q&A
Social workers completing this course receive 3 Clinical asynchronous continuing education credits.
For other board approvals, this course qualifies for 3 Clinical continuing education training.
Instructor: Samantha Silverberg, Ph.D., LPC
Recording Date: June 27, 2026
CEUS On-Demand, LLC, provider #2274, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: 08/7/2025 - 08/6/2026. Social workers completing this course receive 3hrs Clinical continuing education credits.
CEUs On-Demand, LLC has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7091. Programs that do not qualify for NBCC credit are clearly identified. CEUs On-Demand, LLC is solely responsible for all aspects of the programs.
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Request for Special Accommodations: Learners can request special accommodations by contacting the administrative team at admin@ceus-ondemand.com