The impact of psychology factors and cognitive processes on help seeking behaviour and attitudes towards therapy in individuals with ileostomies and ileal pouch anastomosis


Zeina Bushnaq, University of Roehampton, Second year PsychD Counselling Psychology Trainee

This study, to knowledge, is the first to examine the impact of psychological factors and cognitive processes on help seeking behaviours and attitudes towards therapy in individuals with ileostomies and ileal pouch anal anastomosis (IPPA) (also known as J-pouch). The majority of psychological studies, while attempting to examine individuals’ quality of life, have neglected other significant psychological areas (including cognitive functioning). To address this gap in literature, cognitive processes, such as one’s ability to maintain and shift attention, one’s awareness and understanding of their own thought processes, and their coping strategies, will also be examined. Individuals may experience high anxiety due to a combination of maladaptive cognitive processes. Understanding these cognitive processes and their impact on help seeking behaviours may be helpful in targeting maladaptive tendencies, which can help improve mental wellbeing.

There is a gap in literature addressing how psychological distress and cognitive processes impact help seeking behaviours, more specifically the utilisation of psychological support. Mental health services appear to be underused in the Inflammatory Bowel Disease (IBD) population, despite its positive impact on reducing disease course in some individuals. Research has shown that a majority of IBD patients believed they should have been offered access to a mental health provider before and after diagnosis. This implies that there are clear signs of unmet mental health needs in these populations, and this could be due to a lack of awareness of the high prevalence of psychological difficulties in the IBD communities, and more specifically for individuals with ileostomies and IPAAs. I believe this research could contribute and expand on previous IBD research, where more specific aspects of individuals’ experiences can be addressed.

Furthermore, while mental health services and psychological interventions have been developed to address individuals’ difficulties (such as psycho-gastroenterology and CBT interventions), there remains a lack of understanding of help seeking behaviours and attitudes towards therapy.

Understanding these aspects can help inform mental health services further and ensure that individuals with ileostomies and IPAAs who are facing difficulties have access to these services. Accessibility to mental health services has been shown to be helpful in improving mental health, thus helping individuals to adjust to their new life and live as normally as possible.

Finally, I am hoping to recruit participants who are 18 years or older, live in the UK, who have had a diagnosis of Ulcerative Colitis, and have either a permanent ileostomy, temporary (loop) ileostomy or a j-pouch. The reason for only recruiting participants with UC is because other IBD illnesses such as Crohn’s Disease, Cancer etc. may present with different psychological difficulties, which could risk the study’s validity.