Attitudes toward treating functional neurological disorders: psychological service provider perspectives

Functional neurological disorders (FND) are characterized by involuntary sensory, motor, and/or other seemingly neurological symptoms lacking expected medical explanation. Once diagnosed, patients often are referred to mental health providers for psychotherapy, which is effective in treating many FND symptom presentations either alone or as part of an integrative approach. Mental health providers may feel reluctant or unprepared to accept these referrals, however.

We conducted a U.S.-based online survey of 286 practicing psychological service providers (psychologists, psychiatrists, counselors, social workers in private practice, neuropsychologists) to examine knowledge of, attitudes toward, and preparedness to treat FND.

Findings revealed that most of our sample had limited exposure to FND in routine practice. Confidence in treating FND was modest, with neuropsychologists reporting more knowledge of and more confidence in treating FND than other psychologists/mental health providers. Greater perceived adequacy of psychotherapy training for, and more experience working with, FND each were associated with more positive FND attitudes, including greater confidence and enjoyment in treating FND and greater belief that symptoms would improve.

This study is novel in its examination of knowledge and attitudes among psychological service providers, who are pivotal in furnishing effective treatment for FND patients but may not be well-versed in their needs. In contrast to existing studies of medical providers that revealed stigma as a major barrier to providing adequate care for FND, our findings suggest lack of knowledge and lack of access to FND patients may limit the ability to gain more training and expertise. Targeted training and consultation for mental health providers may improve confidence and motivation and expand the workforce capable of delivering effective treatment for FND.