Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services

IF 2.6 3区医学 Q2 PSYCHIATRY Psychology and Psychotherapy-Theory Research and Practice Pub Date : 2023-10-06 DOI:10.1111/papt.12504

Amelia Staton, David Dawson, Hannah Merdian, Anna Tickle, Tammy Walker

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Abstract

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.

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功能性神经障碍：一项探索个体心理服务体验的定性研究。

目的：被诊断为FND的个体报告称在医疗环境中经历了耻辱，然而，很少有研究探讨他们在心理服务中的经历。本研究的目的是从FND患者的角度探讨获得英国心理服务的经历。方法：本研究采用定性方法，从半结构化访谈（n = 15）并采用反身主位分析法进行分析。结果：确定了一个上级主题“治疗关系中被污名化的自我”和五个相互关联的子主题：“内化的污名和自我怀疑”、“向专业人员选择性披露”、“对心理解释的感知”、“必须教育专业人员”和“治疗关系内的协调和信任”。积极的治疗关系被认为可以减轻这些感知障碍的影响。FND的概念化以及服务和专业人员对此的反应是贯穿相关主题的核心原则。结论：个人、人际和组织内部的污名影响获得和参与心理治疗。这项研究的结果强调了增加从业者培训的必要性，重点是在个人和系统层面积极挑战服务中的FND污名。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychology and Psychotherapy-Theory Research and Practice 医学-精神病学

CiteScore

6.10

自引率

5.90%

发文量

审稿时长

6 months

期刊介绍： Psychology and Psychotherapy: Theory Research and Practice (formerly The British Journal of Medical Psychology) is an international scientific journal with a focus on the psychological and social processes that underlie the development and improvement of psychological problems and mental wellbeing, including: theoretical and research development in the understanding of cognitive and emotional factors in psychological problems; behaviour and relationships; vulnerability to, adjustment to, assessment of, and recovery (assisted or otherwise) from psychological distresses; psychological therapies with a focus on understanding the processes which affect outcomes where mental health is concerned.