Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder

[Lady4]

The bit that caught my attention:

Full resolution of FND symptoms occurs in 63%–95% of children if diagnosis and treatment are promptly delivered using a multidisciplinary, biopsychosocial, stepped-care approach. Despite this need, pediatric FND services are scarce worldwide.

The link to the article:

ncbi.nlm.nih.gov/pmc/articl...

STEP 1: THE MEDICAL/NEUROLOGICAL ASSESSMENT AND PROVISION OF A POSITIVE DIAGNOSIS

Summary

"During this first step of the therapeutic process, a good clinical encounter ensures that the child and family understand “what is going on” and that they have positive expectations regarding the healing process and a positive treatment outcome."

STEP 2: TRIAGING THE REFERRAL FOR A HOLISTIC (BIOPSYCHOSOCIAL) ASSESSMENT

STEP 3: CLINICAL (BIOPSYCHOSOCIAL) ASSESSMENT WITH THE CHILD AND FAMILY

Summarize of the key pieces of information to be generated by the initial assessment:

•

−

A three-generation genogram, or family tree, that helps the clinician obtain a gestalt view of the pattern of family relationships (e.g., marriages, separations, relational breakdowns).

This genogram should also include information about medical conditions (always asked about before any questions about mental health issues, to communicate that the clinician is interested in the body) and mental health histories and concerns.

•

The child’s developmental history, starting at conception. This aspect of the family story helps the clinician, child, and family to understand both the temporal order of the key events, positive and negative, that shaped the child’s development and the context in which the symptoms emerged.

•

−

The child’s response to key events in the family story. The clinician uses the information from the genogram to probe how the child managed key events in the family story. The clinician also inquires how the child’s body responded to any challenging events. Did sleep become disturbed? Did the child show any other physical symptoms of stress, such as disrupted eating, headaches, tummy pains? Did the child show any behavioral symptoms of stress, such as tearfulness, emotional withdrawal, not wanting to go to school?

−

Levels of stress and anxiety, and changes in mood, over time. The clinician may use simple Likert scales to get a sense of the levels of family stress or any changes in the child’s anxiety or mood over time (see Figures ​Figures11 and ​and2).2). The clinician also tracks the emergence of functional symptoms over time and the context in which the symptoms emerged.

STEP 4: CO-CONSTRUCTING THE MIND-BODY FORMULATION WITH THE CHILD AND FAMILY

[Shimmyaway]

It must be music to your ears to know that successful treatment does exist, , but as with the recent research of Lisette Guy et alia, and their successful trial of outpatient treatment for adults, do we know if anyone is listening to our sad tune?

[Lady4 in reply to Shimmyaway]

Thanks.

Bitter sweet as not offered on NHS, 3-9 mths for both mental health and Autism Pathway and wish I had been doing more neck and head massages using Ibro on neck for pain and tension in head (forever on screens). Hindsight is a wonderful think.

Think anyone caught early, may benefit. Think rehabilitation help is key too, because you get a dx, go down the medical route and end up at a brick wall.

[Shimmyaway in reply to Lady4]

Talking of head and neck, have you investigated cervical instability as being a possible cause of some of your son;'s symptoms? Chiropractors use the Perrin technique to help smooth out any disturbances in the flow of the cerebrospinal fluid .it's used for ME by some people...just another possibility, when you are hitting the brick wall...never tried it myself. Best wishes

[Lady4 in reply to Shimmyaway]

I am convinced its surpressed stress and anxiety resulting in tension headaches but will consider, if this doesn't work. Thanks.

[Shimmyaway in reply to Lady4]

So what sort of treatment is he getting right now (in which you are less than confident ) for the stress/anxiety you think is behind his symptoms?

[Lady4 in reply to Shimmyaway]

Nothing. Last GP appt yest re referrals suggested neck and shoulder massage to relieve tension and Ibro gel. Think he would have taken stronger pain meds if recommended as this was touched upon but luckily GP in favour of a more holistic approach.

[Shimmyaway]

Same treatment as me then except I have clonazepam (as/when) for the shaking. I hope your son gets the physio/massage he needs on the NHS.

[AvacadoPits in reply to Shimmyaway]

I've been on clonazepam for a long time. And my new Doctor tells me it's very bad to be on it for a long time. Evidently it has to do with the milligrams. And how long you've used it, but it takes a long time to get off it. You also can't just take it whenever you're shaking. It's not something you can go on and off. But I sure hope they don't take mine away!

[Lady4 in reply to Shimmyaway]

Can I ask whether the medication benefits outweigh any side effects. Its just I have the book "anti-depressed" on my reading list (after how our emotions are made) and have read other articles about other special categories of drugs being mis-prescribed, as they are for specific conditions.

You come across as being very savvy and intelligent though, so I hope I haven't over stepped the mark.

[Shimmyaway in reply to Lady4]

I find clonozepam very good for getting a shake free night's sleep but I use it not more than once a week for that purpose. and then during the day if I have to go into an environment where the noise or heat will trigger the shaking. It can make you drowsy, even at low doses, but at night, who cares? Dr's seem to vary in how often they advise you to take it... mine uses the word 'sparingly' a lot .. the stuff is addictive...an opioid., best friend of diazepam... not allowed on repeat prescrip tion..it's 'acute' medication.

[Lady4 in reply to Shimmyaway]

Two of my besties are on anti-depressants, one tried to come off but made her worse, not sure if any have managed to reduce or not. Seeing them next week so will ask if I remember.

[Shimmyaway]

I take clonazepam to reduce the body shaking, not for depression, but it does contain GABA which reduces anxiety. I am not familiar with meds for depression.