Feasibility and acceptability of Body Signal Integration training for Functional Neurological Disorder (FND): A case series

Objectives: Functional neurological disorder (FND) is a common and often disabling condition, but existing treatments are limited and often do not target relevant underlying mechanisms. This study piloted a manualised intervention package—Body Signal Integration (BSI) training—designed to improve interoception and mind–body integration in individuals with FND. The primary aim was to determine feasibility and acceptability of delivering BSI. A secondary aim was to gather preliminary evidence regarding whether BSI is associated with reductions in FND symptoms and distress. Methods: A case series of BSI was conducted with eight individuals with FND. Baseline, weekly and one-month follow-up self-report measures were completed. Feasibility was assessed by attendance and protocol adherence. Acceptability was evaluated using a self-report measure. Weekly clinical outcome measures were completed. Results: Seven of eight participants completed therapy with a total attendance rate of 98%. There were no unanticipated side effects or adverse events during therapy. High ratings on all items on the satisfaction questionnaire indicated treatment acceptability. Improvements in somatic symptoms, interoceptive awareness and quality of life were observed in some, but not all, participants. Five participants reported clinically important improvements in interoceptive awareness. Discussion: This preliminary study suggests that BSI is feasible and acceptable for use in FND. Clinical outcomes indicate that BSI could improve interoceptive sensibility and reduce experiences of somatic symptoms for some people with FND, but variation in outcomes suggests that the treatment may be suitable for some people more than others. Qualitative process evaluation of the treatment is recommended.