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.
Keywords: Cognitive behavioral therapy; functional neurological
symptom disorder; multidisciplinary treatment; qualitative research.