Behavioural science for gastroenterology, oncology, and chronic medical conditions
Advisory and methodological support for organisations designing, measuring, and evaluating the psychological and behavioural components of treatment: clinical trial methodology, patient-reported outcome measurement, intervention development, clinician-patient communication, and the preparation of clinical teams.
Areas of consultation
- Endpoint sensitivity and instrument fit
- Placebo response and expectancy in gastrointestinal trials
- Recruitment, retention and attrition
- Behavioural and digital intervention development
- Preparation of clinical teams for psychological factors
- Evidence base for patient support programmes
- Clinician-patient communication in the consultation
Who needs what, and when
Gastroenterology
Population-based work on shame and avoidance, condition-specific instrument development, randomised trials of internet-delivered Acceptance and Commitment Therapy, and contribution to the consensus methodology for behavioural trials in the field.
Oncology
Principal Investigator of a randomised trial of an acceptance, mindfulness and compassion-based programme in breast cancer, evaluating psychological, biological and cost-effectiveness outcomes in parallel. Published work on experiential avoidance, self-compassion, and fear of receiving compassion.
Other long-term conditions
Chronic pain, post-stroke pain, post-viral illness, and mixed samples. The core processes are largely shared, which is why an instrument such as the Cognitive Fusion Questionnaire – Chronic Illness validates across conditions, and why intervention logic transfers when the condition-specific content is rebuilt.
Segmentation and measurement
Establishing which psychological dimensions differentiate a population, and whether the instruments in use can detect them. Most endpoint problems originate here, and here they are least costly to resolve.
- Instrument selection and critique
- Construct definition and content validity, grounded in patient interviews
- Cross-cultural adaptation and validation
- De novo scale development
- Shame, avoidance, illness beliefs and psychological flexibility as covariates or targets
- Patient and public involvement in design and measurement
- Review of participant-facing materials and person-first language
- Secondary analysis of existing cohorts
Intervention and trial design
Specifying what the intervention is intended to modify, and building a study capable of detecting whether it did. Psychological interventions are not a supplement to medical treatment; they act upon determinants of the same outcomes.
- Behavioural trial design and protocol review
- Control condition, blinding and expectancy management
- Mechanism specification and mediation analysis
- Phased development under the ORBIT model
- Digital and internet-delivered intervention design
- Clinician-patient communication as a designed component
- Patient advisory panel design and facilitation
- ACT, mindfulness and compassion-based protocols
Timing, sequence and pathway
Placement is as consequential as content. A behavioural component offered only once every biomedical option is exhausted conveys something no degree of protocol fidelity will correct.
- Positioning within the care pathway
- The diagnostic consultation and what it sets in motion
- Sequencing relative to pharmacological treatment
- Adherence and persistence risk points
- Treatment transitions and survivorship
- Momentary assessment and adaptive intervention design
- Patient support programme architecture
Pharmaceutical and biotechnology
Endpoint and measurement strategy for gastrointestinal and oncology programmes; protocol review; placebo and expectancy management; recruitment and retention; support programme design; patient advisory panels; medical education and clinician communication; interpretation of psychological and quality-of-life findings.
Digital health and medical technology
Design and evidence strategy for digital therapeutics and behavioural applications in gastrointestinal and oncology populations; mechanism articulation; outcome selection; phased evaluation planning; scientific review of intervention content prior to investment or publication.
Professional societies and consortia
Consensus and working group contribution; methodological guidance for behavioural trials; curriculum design for continuing professional development, including communication training; conference programming; partnership design with patient organisations; academic-industry collaborations requiring a behavioural science lead.
Health services and clinical teams
Service design where psychological provision sits alongside gastroenterology, oncology or chronic pain; review and training of clinician-patient communication; supervision and implementation support for behavioural protocols; evaluation design for services required to demonstrate outcomes.
Inês A. Trindade, PhD
Dr Trindade is a clinical and health psychologist and behavioural intervention scientist: Associate Senior Lecturer and Principal Investigator of the EMBRACE Lab at Örebro University, and Invited Assistant Professor at the University of Coimbra. She holds specialist certification in Clinical and Health Psychology from the Portuguese Order of Psychologists.
The research programme, precision psychogastroenterology, asks which psychological processes are implicated, for which patients, and at which point in the illness course. It comprises population-based studies of transdiagnostic mechanisms in disorders of gut-brain interaction, the development and psychometric validation of patient-reported outcome measures, and randomised controlled trials of acceptance- and compassion-based interventions in gastrointestinal and breast cancer populations.
Alongside the research she has designed and delivered group interventions in inflammatory bowel disease, breast cancer, chronic pain, and obesity, and has taught clinical and health psychology at postgraduate level since 2019.
- Positions
- Associate Senior Lecturer and Principal Investigator, EMBRACE Lab, Örebro University
- Invited Assistant Professor, University of Coimbra
- Editorial and boards
- Associate Editor, Journal of Contextual Behavioral Science
- Associate Editor, British Journal of Health Psychology (2023–2026)
- Rome Foundation Working Team on behavioural trials in disorders of gut-brain interaction (2023–2025)
- Portuguese Study Group for IBD (GEDII)
- Recognition
- Outstanding New Investigator Award, International Society of Behavioral Medicine, 2021
- Visiting positions, 2025
- Icahn School of Medicine at Mount Sinai; King's College London; KU Leuven
- Record
- 91 peer-reviewed papers; h-index 35 (Google Scholar, 2026)
- Principal Investigator, iACTforDGBI (Forte, Sweden) and the Mind programme trial in breast cancer (FCT, Portugal)
- Approximately SEK 12.5 million in competitive funding as principal applicant
- Profiles
- Google Scholar
- ResearchGate
Teaching clinicians and scientists already expert in their own field
Dr Trindade has taught psychological approaches to chronic illness for more than a decade: eighteen editions of a postgraduate module for practising psychologists and psychiatrists, an undergraduate course in health psychology at Örebro University, and invited teaching for gastroenterology audiences across Europe. Sessions assume existing expertise and aim at a usable model rather than an introduction.
Psychogastroenterology for gastrointestinal teams
The evidence linking psychological processes to symptom experience, healthcare use and treatment response in disorders of gut-brain interaction and inflammatory bowel disease, including why these conditions carry a distinctive burden of shame and what patients therefore conceal.
Clinician-patient communication as an active ingredient
Explaining a diagnosis so the person feels believed, stating uncertainty without abandoning them inside it, inviting disclosure of symptoms that attract shame, and recognising stigmatising shorthand in departmental vocabulary.
Involving patients in research and product design
What meaningful involvement requires, and how it differs from the version documented after the decisions are made: when to consult, who is missing from the panel assembled, and what to do when patient priorities and protocol constraints conflict.
Acceptance, compassion and adjustment in cancer care
Experiential avoidance, self-compassion and fear of receiving compassion as determinants of adjustment in cancer, and how acceptance, mindfulness and compassion-based programmes are built and delivered.
Designing and reporting behavioural clinical trials
Control conditions, blinding, mechanism specification, outcome selection and analysis of change, following current consensus recommendations.
Acceptance and Commitment Therapy in chronic medical conditions
Relational frame theory, the psychological flexibility model, functional analysis and case formulation, with experiential and role-play components; and why these processes recur across diagnoses with little else in common.
Measurement of psychological constructs in medical research
Instrument selection, psychometric evaluation, cross-cultural validity, and the errors that follow from treating a questionnaire score as a diagnosis.
The biopsychosocial model, examined rather than invoked
What the model claims, why it is so often applied as a dualism, and what a non-dualist version requires of research design and clinical reasoning.
- Formats
- Conference workshop, half or full day
- In-house training for clinical teams
- Multi-session programme with supervision
- Curriculum design for continuing education
- Online, in person, or blended
- Audiences
- Gastroenterologists, IBD nurses and dietitians
- Oncology and supportive care teams
- Psychologists and psychiatrists
- Clinical research and medical affairs
- Basis
- Fees quoted per engagement, according to scope, format and travel
From anonymous student evaluations at Örebro University, included because they describe the intended effect of the teaching more precisely than a list of topics permits.
“It is more of a framework and an understanding that is hard to convey in simple points. It is something I integrated into myself. Perhaps that was the point of the course.”
“She is so engaged in the subject she teaches … taught us in a deeper way, not superficial knowledge, but real deep understanding.”
“The interactive structure of the lectures and seminars, as well as encouragement to think outside the box in regards to theoretical frameworks, has deepened learning and understanding.”
“The teacher connected the meditations to the lectures and what she was trying to say. The change experienced in the body just with the power of our minds … was a very good example of the body-mind connection.”
Anonymous course evaluations, Health Psychology (PS201G), Örebro University, 2026.
- Teaching record
- Course responsible, Health Psychology, Örebro University
- Module responsible, Advanced Specialisation in Cognitive and Behavioural Therapies, Portuguese Institute for Psychology and Other Sciences, since 2019: eighteen editions of forty-eight hours
- Invited teaching at Gothenburg, Coimbra, Linköping and the Miguel Torga Institute
- Workshop facilitation, Association for Contextual Behavioral Science World Conference
- MSc supervision and doctoral mentoring
- Preparation
- Teaching and Learning in Higher Education, University of Gothenburg
- Supervising doctoral students, Örebro University
Keynotes and invited lectures
Lectures are prepared for the specific audience and occasion. Recent invited contributions include the following.
- 2026 Contextual Behavioural Science projects in the EMBRACE Lab ACBS Swedish Chapter meeting
- 2025 ACT and compassion-based interventions applied to health conditions ACBS Swedish Chapter meeting
- 2024 The role of psychological and behavioural therapies in disorders of gut-brain interaction: a roadmap for gastroenterologists Keynote · Portuguese Digestive Diseases Week, Vilamoura
- 2023 Body image and body awareness: implications for health psychology Keynote · Conference on Body Awareness, Interoception and Health, Örebro University
- 2023 Psychological processes in inflammatory bowel disease Keynote · Annual Meeting of the Portuguese Study Group for IBD (GEDII), Porto
- 2019 Acceptance and self-compassion in psychogastroenterology Workshop · ACBS World Conference 17, Dublin
- 2019 The Mind programme for cancer patients: an acceptance, mindfulness and compassion-based intervention Workshop · XVIII Psychology Meeting, University of the Algarve
Selected publications and trials
Consultancy is confined to questions on which Dr Trindade has led or published empirical work.
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Trindade IA, et al. Implications of shame for patient-reported outcomes in functional bowel disorders. Gastroenterology 2026;170(2):353. Cover article
doi.org/10.1053/j.gastro.2025.06.030 · view the issue -
Burton-Murray H, Guadagnoli L, Kamp K, Trindade IA, Powell LH, Simrén M, Ljótsson B, Keefer L. Rome Foundation Working Team Report: consensus statement on the design and conduct of behavioural clinical trials for disorders of gut-brain interaction. Alimentary Pharmacology & Therapeutics 2025;61(5):787-802.
doi.org/10.1111/apt.18482 - Trindade IA, Pereira A, Veloso B, van Gils T, Nybacka S. The GI-Specific Avoidance Scale (GIAS): development, psychometric validation, and incremental power of a new questionnaire. Preprint Digestive Disease Week 2025, Poster of Distinction
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Trindade IA, Ferreira C, Pinto-Gouveia J. The longitudinal effects of emotion regulation on physical and psychological health: a latent growth analysis exploring the role of cognitive fusion in inflammatory bowel disease. British Journal of Health Psychology 2018;23(1):171-185.
doi.org/10.1111/bjhp.12280 -
iACTforDGBI: development, feasibility, efficacy and cost-effectiveness of an internet-delivered ACT intervention for disorders of gut-brain interaction. Principal Investigator; funded by Forte, Sweden (SEK 4,997,000).
iactfordgbi.com
- Mind programme: a randomised controlled trial of an acceptance, mindfulness and compassion-based intervention for women with breast cancer, testing efficacy and cost-effectiveness across psychological and biological outcomes. Principal Investigator; funded by the Foundation for Science and Technology, Portugal (EUR 245,681). Protocol published in Trials.
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Trindade IA, Ferreira C, Pinto-Gouveia J. Acceptability and preliminary test of efficacy of the Mind programme in women with breast cancer: an acceptance, mindfulness, and compassion-based intervention. Journal of Contextual Behavioral Science 2020;15:162-171.
doi.org/10.1016/j.jcbs.2019.12.005 -
Trindade IA, Marta-Simões J, Mendes AL, Borrego M, Ponte A, Carvalho C, Pinto-Gouveia J. A longitudinal preliminary analysis on the role of experiential avoidance in breast cancer patients' reported health outcomes. Psycho-Oncology 2020;29:812-814.
doi.org/10.1002/pon.5330 - Gustafsson M, Ismail A, Støre SJ, Blomqvist-Storm M, Trindade IA. Fear of receiving compassion from others moderates the association between self-compassion and depressive symptoms in women with breast cancer. Journal of Psychosocial Oncology Research and Practice 2025;7(4):e185.
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Trindade IA, Barbosa R, Ferreira C, Pinto-Gouveia J. Further validation of the Cognitive Fusion Questionnaire – Chronic Illness (CFQ-CI) in different health condition samples. Journal of Contextual Behavioral Science 2020;16:45-48. Cross-condition
doi.org/10.1016/j.jcbs.2020.03.004
Complete publication list: Google Scholar · ResearchGate
Enquiries
To arrange an initial discussion, please provide:
- The population and indication
- The stage of the programme
- The decision you are facing
- Your timeline
- Any constraints on disclosure