'A challenging but rewarding journey': qualitative study of participants' experiences of EMDR for functional neurological disorder within the MODIFI trial

Functional neurological disorder (FND) is a common neurological presentation and can be associated with high disability, high healthcare costs and difficulty accessing treatment. Effective treatments are still being established. A feasibility study evaluating eye movement desensitisation and reprocessing (EMDR) therapy as a treatment for FND (MODIFI) demonstrated positive outcomes. The experiences of EMDR for people with FND have not been previously reported.

We aimed to explore the experiences of participants who had completed EMDR therapy in the MODIFI trial.

Participants who completed EMDR therapy in MODIFI were invited to take part in semi-structured interviews on completion of the trial. Eleven participants consented to take part and were interviewed. Interviews were analysed with reflexive thematic analysis.

Analysis was organised into four main domains: (a) expectations before the trial; (b) preparedness for EMDR; (c) mysterious but unique journey and (d) it was hard, but worth it - 'a rewarding challenge'. Within these domains, we identified ten themes.

Participants reported limited understanding of why or how EMDR might be helpful, but were still motivated to take part. Participants expressed that they had felt anxious about focusing on memories of past experiences. However, they described feeling safe and in control in the therapy, despite it being difficult at times. Overall, participants reported positive effects, and that perceived costs were worthwhile. These results add further support that a full-scale trial evaluating FND-focused EMDR is justified.