Psychotherapy Experiences within Multidisciplinary Care for Functional Neurological Symptom Disorder: A Qualitative Study.

Abstract

Objective: Functional Neurological Symptom Disorder (FNSD) is a complex neuropsychiatric condition associated with significant disability and shaped by the interaction of biological, psychological, and social processes. Although clinical recognition of FNSD has increased, patients’ subjective experiences of psychotherapy within multidisciplinary treatment remain insufficiently examined. This study aimed to qualitatively explore psychotherapy experiences of individuals diagnosed with FNSD who received short-term cognitive behavioral therapy (CBT) as part of a multidisciplinary treatment program.

Method: Semi-structured online interviews were conducted with 12 patients diagnosed with functional movement disorders who had completed a multidisciplinary inpatient treatment program. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to identify recurrent patterns across the narratives.

Results: Patients described therapeutic change across four domains: reduced symptom burden, improved emotional regulation, shifts in illness-related perspectives, and increased behavioral engagement in daily functioning. Change was primarily attributed to three domains: (i) the therapeutic relationship and the psychologically safe treatment environment, (ii) individual readiness and active participation in therapy, and (iii) structured cognitive, behavioral, and experiential techniques. Nevertheless, variability in outcomes was evident, as some patients reported persistent symptoms and ongoing emotional challenges.

Conclusion: Psychotherapy experiences in FNSD are not limited to symptom reduction. Alongside improvement, multidimensional experiences such as increased self-awareness, changes in how they understand and interpret their experiences, and re-engagement in daily life were also reported. These findings provide clinically meaningful insights into how therapeutic change is experienced within psychotherapy for FNSD and the factors to which this change is attributed by patients.