Group psychotherapy format guided self-help for patients with FNSD awaiting inpatient multidisciplinary treatment: A pilot study

Background: We describe our experience of developing Guided Self Help for patients with Functional Neurological Symptom Disorder as group therapy, delivered remotely, via Zoom. // Aims: The aims of the current study are (a) to describe how the original Queen Square Guided Self-Help (QGSH) was adapted for group therapy, and (b) to present a service evaluation of the first 8 months of running QGSH therapy groups remotely. // Methods: We carried out a review after 8 months, from 11 May 2021 until 31 January 2022. // Results: A total of 16 patients were treated in three groups. Assessing our outcomes in terms of Yalom's framework for group psychotherapy, we found that the group provided 10/11 of Yalom's therapeutic factors. Patient satisfaction was high. // Discussion: We outline for plans for further devaluation and development, including the development of a stand-alone group. // Conclusion: The group therapy format is a promising addition to our service

Occupational therapy consensus recommendations for functional neurological disorder

BACKGROUND: People with functional neurological disorder (FND) are commonly seen by occupational therapists; however, there are limited descriptions in the literature about the type of interventions that are likely to be helpful. This document aims to address this issue by providing consensus recommendations for occupational therapy assessment and intervention. METHODS: The recommendations were developed in four stages. Stage 1: an invitation was sent to occupational therapists with expertise in FND in different countries to complete two surveys exploring their opinions regarding best practice for assessment and interventions for FND. Stage 2: a face-to-face meeting of multidisciplinary clinical experts in FND discussed and debated the data from stage 1, aiming to achieve consensus on each issue. Stage 3: recommendations based on the meeting were drafted. Stage 4: successive drafts of recommendations were circulated among the multidisciplinary group until consensus was achieved. RESULTS: We recommend that occupational therapy treatment for FND is based on a biopsychosocial aetiological framework. Education, rehabilitation within functional activity and the use of taught self-management strategies are central to occupational therapy intervention for FND. Several aspects of occupational therapy for FND are distinct from therapy for other neurological conditions. Examples to illustrate the recommendations are included within this document. CONCLUSIONS: Occupational therapists have an integral role in the multidisciplinary management of people with FND. This document forms a starting point for research aiming to develop evidence-based occupational therapy interventions for people with FND