Journal
EPILEPSY & BEHAVIOR REPORTS
Volume 16, Issue -, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.ebr.2021.100486
Keywords
Functional neurological disorder (FND); Functional seizures; Stigma; Children and adolescents; Cultural change; Clinical ethics
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There is a pressing need to develop an FND-informed culture of care to improve understanding of patients. Clinical encounter stories highlight issues with the current culture of care, including a lack of empathy and compassion in clinician-patient relationships that need to be addressed.
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from around the world-told by children and adolescents with FND, their parents, and health professionals-portray an outdated culture of care characterized by iatrogenic stigma, erosion of empathy and compassion within the clinician-patient relationship, and a lack of understanding of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 After a brief exploration of the outdated culture, we share our counterstories: how we and our colleagues have worked, and continue to work, to create an FND-informed culture in the health systems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. (C) 2021 The Author(s). Published by Elsevier Inc.
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