Engagement in psychological treatment for functional neurological symptoms--Barriers and solutions.

Abstract

This naturalistic study explores how many patients with functional neurological symptoms referred for specialist psychotherapy engage with and complete treatment, and whether routinely recorded demographic or clinical features predict engagement. Of 77 consecutive patients referred, 14.3% were considered unsuitable for therapy and excluded from between group comparisons, 23.4% did not attend any appointments, 20.8% unilaterally discontinued therapy, and 41.6% completed treatment. 66.6% of patients starting therapy completed. Older patients were more likely to engage in or complete therapy (p = .05). There were no significant differences between groups in terms of specific functional symptoms, comorbidity, predisposing, precipitating and perpetuating, or social factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

A multicenter evaluation of a brief manualized psychoeducation intervention for psychogenic nonepileptic seizures delivered by health professionals with limited experience in psychological treatment

“…Our This high rate of non-attendance for initial appointments is in line with other research looking at how patients with PNES and other functional symptoms engage in psychological treatment [11].…”

How do neurologists discuss functional symptoms with their patients: A conversation analytic study

“…Such adverse outcomes are all the more regrettable because these encounters can also have remarkably positive effects: successful communication of the diagnosis of NES, for instance, stops seizures without any further psychological intervention (at least in the short term) in 15-38% of patients [18,19]. Successful communication of the diagnosis is also a crucial step towards to the engagement of patients in psychological treatment, which can be helpful in many cases [20].…”

Offering patients choices: A pilot study of interactions in the seizure clinic

“…Within the UK"s National Health Service, increasing patient choice has become a policy objective [4], with chronic conditions -such as epilepsy and nonepileptic seizures (NES) -considered particularly suitable [5][6]. In clinical epileptology, information provision about treatment options is part of the evidence-based guidance for high quality care [7]; and patient engagement is critical for the negotiation of anti-epileptic drug (AED) adherence [8] or the referral of patients with nonepileptic seizures (NES) for psychotherapy [9]. However, observational studies have found low levels of patient participation in decision-making [10][11][12][13][14][15], and patients often report a lack of negotiation about treatment options [15][16].…”