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What Does the Research Say?
The Diagnosis That Heals: How Communicating Functional Neurological Disorders Changes Outcomes
The way you deliver an FND diagnosis is itself a therapeutic intervention. Patients who understand and accept the diagnosis have consistently better outcomes.
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The 5 Key Messages Every Patient Needs to Hear
Research shows that diagnostic communication should include: (1) Name the diagnosis clearly. (2) Validate that symptoms are real and involuntary. (3) Explain the positive exam findings that support the diagnosis. (4) Emphasize the potential for improvement. (5) Provide a clear rationale for recommended treatment.
What to Say (and What Not to Say)
Say This
"I found specific signs that tell me this is a functional disorder."
References positive exam findings. Shows the diagnosis rests on evidence, not on failure to find disease.
Not This
"We've ruled everything out and there's nothing wrong."
Implies symptoms are imagined. Undermines trust. Patients hear "the doctors gave up looking."
Say This
"Think of it as a software problem in hardware that works perfectly."
Analogies help patients understand why rehabilitation (not medication) is the right treatment approach.
Not This
"It's stress-related. You should see a psychiatrist."
Implies the problem is psychological and dismisses the neurological basis. Damages engagement with treatment.
3 Takeaways for Your Practice
1
Communication Skill
Lead with What You Found, Not What You Excluded
"I found Hoover's sign during your exam" is more reassuring than "your MRI was normal." Patients need to know the diagnosis is based on positive evidence.
2
Family Engagement
Include Family Members in the Diagnostic Conversation
Family members share patients' confusion and may harbor misconceptions. Including them ensures consistent messaging and helps them support recovery rather than inadvertently reinforcing the sick role.
3
Ongoing Reinforcement
The Diagnostic Conversation Is Not a One-Time Event
Understanding develops over time. Periodically revisit the explanation as patients deepen their knowledge. Address new questions as they arise rather than assuming one conversation is enough.
This content is for informational purposes for licensed clinicians and does not constitute medical advice or a substitute for your own clinical research and judgment. Content may include AI-synthesized information; all clinical data, protocols, and dosages must be verified against official primary sources prior to patient care. Any reference to CE rules or regulations is provided as a guide and must be independently verified against current governing body requirements prior to completing credits. This article may contain links to external websites or third-party AI platforms. Ridley Learning has no control over the nature, content, and availability of those sites and does not necessarily endorse the views expressed within them. Ridley Learning is not liable for any injury, loss, clinical outcomes, or licensure issues resulting from the use of or reliance on this information. Your use of this site constitutes acceptance of these terms.
Meet the Author: Anne Osborn, PT, MPT
Anne Perry Osborn is a distinguished physical therapist and entrepreneur with over two decades of experience bridging clinical practice and healthcare education. She holds a Master of Physical Therapy from Texas Tech University Health Sciences Center and currently serves as the Owner and Director of Quality and Accreditation at Ridley Learning. With a background that includes clinical roles in outpatient rehabilitation and home health, Anne brings practical, hands-on insight to her leadership in continuing education, ensuring that learning opportunities remain relevant and impactful for today's practitioners.
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