Changing the culture of care for children and adolescents with functional neurological disorder

Kasia Kozlowska, Tyson Sawchuk, Jeff L. Waugh, Helene Helgeland, Janet Baker, Stephen Scher, Aaron D. Fobian

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

As members of a multidisciplinary team of professionals who treat children and adolescents with functional neurological (conversion) disorder (FND), we highlight the pressing need to develop an FND-informed culture of care that takes into account recent advances in our understanding of this group of patients. Stories of clinical encounters in health care settings from around the world—told by children and adolescents with FND, their parents, and health professionals—portray an outdated culture of care characterized by iatrogenic stigma, erosion of empathy and compassion within the clinician-patient relationship, and a lack of understanding of FND and its complex neurobiology. After a brief exploration of the outdated culture, we share our counterstories: how we and our colleagues have worked, and continue to work, to create an FND-informed culture in the health systems where we practice. We discuss the therapeutic use of child-friendly language. We also discuss a range of structural, educational, and process interventions that can be used to promote FND-informed beliefs and attitudes, FND-informed clinician-patient encounters, and FND-informed referral processes, treatment pathways, and therapeutic interventions.

Original languageEnglish (US)
Article number100486
JournalEpilepsy and Behavior Reports
Volume16
DOIs
StatePublished - Jan 2021

Keywords

  • Children and adolescents
  • Clinical ethics
  • Cultural change
  • Functional neurological disorder (FND)
  • Functional seizures
  • Stigma

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

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