Changing the culture of care for children and adolescents with functional neurological disorder, 2021, Kozlowska et al

Highlights
• There is a pressing need to create a holistic and respectful culture of care for children with FND and their families.
• An outdated culture of care for children with FND lingers across many health systems.
• The outdated culture imposes iatrogenic stigma on children and families.
• Structural, educational, and process interventions can be used to promote change.
• Essential changes include adoption of FND-informed beliefs, attitudes, and referral/treatment processes by professionals.
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from around the world—told by children and adolescents with FND, their parents, and health professionals—portray an outdated culture of care characterized by iatrogenic stigma, erosion of empathy and compassion within the clinician-patient relationship, and a lack of understanding of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 After a brief exploration of the outdated culture, we share our counterstories: how we and our colleagues have worked, and continue to work, to create an FND-informed culture in the health systems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.

Open access, https://www.sciencedirect.com/science/article/pii/S2589986421000605

 

If their treatments worked we would all be clamouring for them.