title: A feasibility study of a brief psycho-educational intervention for psychogenic nonepileptic seizures.
abstract: OBJECTIVE
  We have previously reported that one in six patients stops experiencing psychogenic nonepileptic seizures (PNES) following our communication protocol. This prospective multicentre study describes a psycho-educational intervention for PNES building on the initial communication of the diagnosis and examines the feasibility of its delivery by healthcare professionals with minimal experience in psychological therapies.
  
  
  METHODS
  Three healthcare professionals with minimal training in psychological therapies took part in a one-day training course. 20 participants attended for a four-session manualised psycho-educational intervention delivered at three different clinical neuroscience centres. Participants completed self-report measures prior to the intervention at baseline (n=29) and seven months after diagnosis (n=13) measures included seizure frequency, health related quality of life, healthcare utilisation, activity levels, symptom attributions and levels of functioning. Therapy sessions were audiorecorded and manual adherence assessed.
  
  
  RESULTS
  Of 29 patients enrolled into the study, 20 started and 13 completed the intervention and provided follow-up information. At follow-up, 4/13 of patients had achieved complete seizure control and a further 3/13 reported a greater than 50% improvement in seizure frequency. After training, epilepsy nurses and assistant psychologists demonstrated sufficient adherence to the manualised psycho-educational intervention in 80% of sessions.
  
  
  CONCLUSIONS
  The delivery of our brief manualised psycho-educational intervention for PNES by health professionals with minimal training in psychological treatment was feasible. The intervention was associated with higher rates of PNES cessation than those observed in our previous studies describing the short-term outcome of the communication of the diagnosis alone. An RCT of the intervention is justified but a significant proportion of drop-outs will have to be anticipated.
authors.affiliation: Academic Neurology Unit, University of Sheffield, Sheffield, UK. Electronic address: r.j.mayor@sheffield.ac.uk.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Mayor
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Brown
authors.forename: Hannah
authors.initials: H
authors.lastname: Cock
authors.forename: Allan
authors.initials: A
authors.lastname: House
authors.forename: Stephanie
authors.initials: S
authors.lastname: Howlett
authors.forename: Phil
authors.initials: P
authors.lastname: Smith
authors.forename: Markus
authors.initials: M
authors.lastname: Reuber
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004827:Epilepsy / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D011602:Psychophysiologic Disorders / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D057566:Self Report; D012917:Social Adjustment
keywords: Dissociative seizures; Intervention; Non-epileptic attack disorder; Psychotherapy; Treatment