Treatments for Functional Neurological Disorder: A Practical Guide for Program Development

Functional neurological disorder (FND) is an often-disabling condition with a complex path to diagnosis, further challenged by limited availability of evidence-based treatment resources. Providers hoping to offer treatment resources face the challenge of identifying effective and sustainable implementation of interventions. The existing literature provides limited guidance on the logistics of creating specialized programs for FND outside of tertiary care centers or high-resource medical settings. Members of a multidisciplinary treatment team may find it challenging to identify program development resources that provide a unified perspective on each member's role and how they function together. The authors' FND program at the Stanford University School of Medicine has recently fielded a high number of requests by clinicians, health care staff, and administrators across the United States for collaboration to start new programs. Frequently asked questions include the criteria for patient selection, what personnel to include, how to ensure prompt staff responses to FND symptoms, when to hospitalize patients, how to obtain funding for services, and more. The intended audience for this review includes seasoned and new clinicians, allied health professionals, and nonclinicians, including administrators. The authors discuss diagnosis and evidence-based treatment strategies and provide guidance on practical issues, including work, disability, and driving. The authors' program experience is highlighted as an example, and alternative working models are discussed. The aim of this article is to improve providers' knowledge and confidence and remove frequently encountered barriers to program development. The authors seek to provide a resource that may help connect those in need of care to FND services.