Current Mental Health Treatment Practices for Functional Neurological Disorders (FND): A Provider Survey

Functional neurological disorder (FND) conceptualization and treatment have rapidly evolved with mental health treatment representing a primary intervention target. Specific mental health treatment consensus recommendations have yet to be established as a standard of care. Clarifying current mental health treatment trends assists in programmatic planning while providing practical direction for clinical providers and researchers.

A novel Qualtrics designed online survey was distributed to providers delivering FND mental health treatment services. Survey items addressed psychotherapeutic protocols, techniques, intervention strategies, and methods of determining treatment effectiveness and benefit. A total of 63 participants completed the survey from 12 countries, with the highest number being clinical psychologists/neuropsychologists in academic medical centers in the United States.

Variability was demonstrated in mental health treatment frameworks and modalities, though Cognitive Behavior Therapy (CBT) represented the most utilized, consistent with previous research. Specific therapeutic techniques included trigger chart/tracking of symptoms, symptom/episode response plan/health behavior monitoring and relaxation training. Daily functional status was the top post-treatment outcome, exceeding patient report of symptom frequent/severity. Numerous barriers to implementation of FND mental health treatment were also described.

This survey highlights the lack of consensus in mental health treatment for FND, including treatment implementation, outcome tracking, and defining successful outcomes. Future research is necessary to establish treatment guidelines via collaborative multi-site trials as well as determine treatment effectiveness.