People living with Disorders of Gut-Brain Interaction (DGBIs) frequently keep their symptoms even after proper medical care and reassurance. Standard treatment concentrates on reducing symptoms, but many patients stay stuck in loops of avoidance, hypervigilance, fear and impaired functioning that prolong their suffering and disability. This course views DGBIs through the idea of protective adaptations, which are behaviors, beliefs and bodily responses that arise to cope with perceived threat yet can end up keeping symptoms going.
The course shows how the nervous system, earlier experiences, family reactions and the history of learning around symptoms shape protective adaptations like reassurance seeking, symptom monitoring, bathroom safety behaviors, restricting food, avoiding activity and caregiver accommodation. Drawing on DGBI research, pain science, attachment theory and trauma-informed frameworks, it explains why patients get “stuck” and how clinicians can recognize these patterns during treatment.
Case examples and interactive discussion help attendees build the skills to recognize protective adaptations, understand symptoms through a biopsychosocial lens, and apply interventions that encourage flexibility, resilience, restored function and participation in valued activities. The aim is to move patients beyond managing symptoms and toward meaningful engagement 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: 08/7/2026 - 08/6/2027. 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.
System Requirements: Firefox, Chrome, Brave, Safari, Edge on any modern operating system (Windows, MacOS, Linux, Android, iOS). A desktop browser is recommended. We do not provide support resources for issues encountered using a mobile device.
Request for Special Accommodations: Learners can request special accommodations by contacting the administrative team at admin@ceus-ondemand.com