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This article is the author's final published version in Crohn's and Colitis 360, Volume 2, Issue 4, 1 October 2020, Pages 1-9.

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Copyright © 2020 The Author(s). Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.


Background: Psychological comorbidities are common among people with inflammatory bowel disease (IBD) and are associated with worse disease outcomes. Evidence-based psychotherapy is an effective means to increase psychosocial support. This study aimed to identify the barriers to attending psychotherapy.

Methods: This electronic survey study included a demographic, quality of life, and barriers to psychotherapy questionnaire. Quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Barriers were assessed using the Perceived Barriers to Psychological Treatments scale (PBPT). Linear regression was used to identify participant characteristics associated with higher PBPT scores.

Results: One hundred eighty-seven participants completed the study. Fifty-eight percent of participants had ≥1 significant barrier. Time (28%), knowledge about the availability of services (25%), and cost (19%) were the most common barriers. Least common were stigma (14%), lack of motivation (12%), and emotional concerns (7%). Lower SIBDQ scores, being male, not being full-time employed, having Crohn disease, and being in disease remission were associated with higher PBPT scores.

Conclusions: Knowledge about the availability of services, time constraints, and cost are the leading barriers to psychotherapy among people with IBD. Care providers should develop a network of psychotherapists available to those with IBD. Being male and not being full-time employed may be risk factors for greater barriers. Further research is needed on barriers among groups underrepresented in this study and on novel psychotherapy solutions, like telehealth and low-cost options.

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