Queen Square Guided Self Help for Functional Neurological Symptom Disorder

Abstract

Objective: Functional Neurological Symptoms (FNS) are disabling symptoms without macro-structural cause. While inpatient treatment confers important benefits, it is resource intensive and hence it is important to optimize its efficiency. Methods: We developed a brief, internet-based preparatory therapy based on psychoeducation and CBT, termed the Queen Square Guided Self-help (QGSH) to maximize the efficacy of the inpatient FNS treatment at the National Hospital for Neurology and Neurosurgery. Results: The QGSH aims to ensure that prior to admission the patient understands 1) The diagnosis of FNS , 2) The five areas CBT model and 3) The use of Goal setting in rehabilitation. It has now run since 2017 and 191 patients have taken part in the inpatient FNS program, with 122 of these have participated in the QGSH. It runs for up to twelve weeks and includes original videos and patient worksheets, as well as signposting to existing published resources. Information is sent weekly by e-mail and content is delivered in the form of eleven modules built around online video sessions.Conclusion: We believe that the set of materials used in QGSH has the potential to benefit patients with FNS and can support clinicians wishing to develop their expertise. It could help with the development of new FNS services, and we are in the process of developing it into a standalone service. We hope that the experience of the Queen Square team can be used to help patients and clinicians to improve the provision of FNS services.

Developing a multidisciplinary pathway for functional neurological disorders in a UK National Health Service: The Exeter model

“…In this literature multidisciplinary team based interventions that include the role of physical therapy in addition to psychotherapy has increasingly been recognised [25,26,27,28]. There is preliminary evidence for the benefits of a multidisciplinary approach that utilises physiotherapy and psychological therapies such as; CBT, hypnosis and motor-retraining [27,29,30].…”