Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services 2023 Staton et al

Objectives
Individuals with a diagnosis of FND report experiencing stigma in medical settings, however, there is a paucity of research exploring their experiences in psychological services. The aim of this research was to explore experiences of accessing UK psychological services, from the perspective of those with FND.

Methods
This study utilised a qualitative approach with data collected from semi-structured interviews (n = 15) and analysed using reflexive thematic analysis.

Results
One superordinate theme, ‘the stigmatised self within the therapeutic relationship’, and five interrelated subthemes were identified: ‘internalised stigma and self-doubt’, ‘selective disclosure to professionals’, ‘perceptions of psychological explanations’, ‘having to educate the professionals’ and ‘attunement and trust within the therapeutic relationship’. Positive therapeutic relationships were perceived to mitigate the impact of these perceived barriers. The conceptualisation of FND and the perception of how this was responded to by services and professionals was a central tenet throughout the related themes.

Conclusions
Intra-personal, interpersonal and organisational stigma impact access and engagement to psychological treatment. The findings of this study highlight the need for increased training provision for practitioners with a focus on actively challenging FND stigma within services at both an individual and systemic level.


Practitioner Points

• Internalised stigma and perceptions of stigma within the therapeutic encounter are barriers to accessing and engaging with psychological services.
• Some individuals with FND experience psychological explanations of their symptoms as blaming. Psychological formulations that bridge the gap between mind–body dualism may be helpful in reducing perceptions of blame.
• Positive therapeutic relationships in services may challenge individuals internalised stigma and increase perceived acceptability of psychological formulation and intervention.

Open access, https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/papt.12504

 

The stigma will continue until a questionnaire makes it appear as if morale improves, then... more stigma. Ridiculous. They reject the answer and keep making up the same one.