Many Mental Health Providers Lack Confidence in Treating FND

Recent research indicates that mental health providers in the U.S. feel inadequately prepared to handle functional neurological disorders (FND), a condition requiring appropriate psychological interventions. A survey conducted among 286 practitioners, as published in Frontiers in Psychiatry, reveals significant gaps in knowledge and confidence in treating these disorders.

Understanding Functional Neurological Disorders

Functional neurological disorders manifest through involuntary sensory, motor, or cognitive symptoms that cannot be attributed to medical or neurological conditions. According to the DSM-5-TR, these disorders are categorized under Functional Neurological Symptom Disorder, with Conversion Disorder included in parentheses. Common subtypes include functional movement disorder and functional seizures, each diagnosed through distinct clinical assessments.

Research estimates FND's incidence at approximately 10 to 22 per 100,000, with broader prevalence rates reaching as high as 1,600 per 100,000. Patients frequently appear in neurology clinics or emergency rooms, leading to challenging prognoses; however, early diagnosis and a younger age at onset can correlate with improved outcomes.

Survey Insights on Provider Preparedness

The University of Arizona and related institutions initiated an online survey to assess the awareness and confidence of psychologists, psychiatrists, counselors, and other mental health professionals in treating FND. Findings indicate that many providers possess limited familiarity with the condition, with seven percent unaware of what FND entails. Among those who could define FND, only 45 percent expressed a solid understanding, while a larger portion conveyed moderate to weak knowledge.

Interestingly, although 79.4 percent of respondents reported providing care to FND patients, they felt more equipped to conduct psychological assessments than to deliver therapy. Barriers such as low patient volume and lack of formal educational resources were frequently cited as obstacles to further training.

Provider Attitudes and Confidence Levels

The survey also aimed to shed light on provider attitudes toward FND patients. The data revealed an average belief that FND symptoms could improve, yet providers reported mixed feelings about the challenges of treating these patients. Confidence levels were modest, averaging around 2.9 on a scale of 1 to 5. Remarkably, neuropsychologists displayed significantly greater knowledge and confidence in their ability to manage FND than other types of providers.

Overall, the survey highlighted a positive belief among many providers that they could help improve patient symptoms, with a noted gap in practical treatment training. The correlation between the percentage of FND patients treated and the perceived adequacy of psychotherapy training suggests that increasing exposure to FND might enhance confidence and competence.

Recommendations for Improvement

In response to these concerning findings, the study's authors recommend several strategies to bolster mental health providers' understanding and treatment capabilities regarding FND. They emphasize the importance of targeted training initiatives, closer collaboration between neurologists and mental health clinicians, and better access to existing FND clinics.

Enhancing the training landscape might entail integrating FND education into graduate and postgraduate curricula. Furthermore, increasing the inclusion of FND patients in clinical training sessions could have a significant impact on clinicians' readiness to treat this population.

Despite challenges, there is optimism within the mental health community regarding FND treatment. Many providers expressed empathy for affected patients, signaling a willingness to learn and improve care. By expanding the educational framework for FND, the mental health field can cultivate a broader network of competent providers, ultimately improving treatment availability for those in need.