Treatment of Functional Seizures in Children and Adolescents: A Mind-Body Manual for Health Professionals

Blanche Savage · Catherine Chudleigh · Clare Hawkes · Stephen Scher · Kasia Kozlowska

Dec 2022 · Australian Academic Press

About this ebook

In this treatment manual for functional seizures in children, adolescents, and young adults — ‘young people’ — we present the program developed by the mind-body team at The Children’s Hospital at Westmead, a tertiary care paediatric hospital located in New South Wales, Australia. The team’s Mind-Body Program, organised as part of a consultation-liaison psychiatry service within the Department of Psychological Medicine, works with young people, up to the age of 18 years, who present with functional somatic symptoms, including functional seizures. This manual describes the treatment interventions we have developed over the last 20 years through clinical trial and error, by translating research findings into our clinical practice, and by evaluating our own treatment interventions through prospective cohort studies.

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About the author

Blanche Savage, a clinical psychologist, has been a core member of the mind-body, consultation-liaison team at The Children’s Hospital at Westmead for 13 years. On joining the team, her first patient was an adolescent girl presenting with functional seizures in the context of a difficult family situation. It marked the beginning of what has become a deep, long-standing interest in children and adolescents with functional somatic symptoms, including functional seizures, and how to help them return to health and wellbeing. The current manual is an effort to share what the team has learned with other clinicians around the world. One of the interventions that Blanche uses extensively in her own work is hypnosis. Along with Helene Helgeland and Kasia Kozlowska, she has contributed a chapter — ‘Hypnosis in the Treatment of Functional Somatic Symptoms in Children and Adolescents’ — to the Routledge International Handbook of Clinical Hypnosis, to be published early in 2023.

Catherine Chudleigh, a clinical psychologist, has been a core member of the mind-body, consultation-liaison team at The Children’s Hospital at Westmead for 12 years. Alongside other clinicians in the team, she has helped to develop a range of child-friendly interventions for children and adolescents with functional somatic symptoms (including functional seizures). She has a particular interest in helping her patients to become aware of body states and to manage states of high arousal. In this context she has used heart rate variability to support children’s awareness of their emotional and physiological state and also as a means of tracking their treatment response to calming interventions. This use of heart rate variability is highlighted in a forthcoming 2023 publication, Implementing Evidence-Based Mind-Body Interventions for Children and Adolescents with Functional Neurological Disorder (Kasia Kozlowska, Catherine Chudleigh, and other team members) with the Harvard Review of Psychiatry.

Clare Hawkes, a clinical psychologist, has been a core member of the mind-body, consultation-liaison team at The Children’s Hospital at Westmead for two years. Clare brings energy and initiative to the mind-body team. She particularly enjoys the interface between medicine and psychological work. Clare utilises a wide variety of sensory strategies as calming interventions. She also has a special interest in neuropsychology assessments, and she conducts these assessments for young people in the Mind-Body Program who have difficulties in learning or other neurodevelopment concerns. She has taken on important role in the mind-body team’s neuromodulation study (with the Safe and Sound protocol) and, in that context, was a co-author of a recent case study published in the Harvard Review of Psychiatry. She is currently completing a Masters in Clinical Neuropsychology to build upon and extend this skill set.

Stephen Scher taught clinical medical ethics in Harvard Medical School–affiliated hospitals in the 1980s, spent several years at Yale Law School and Yale School of Management (teaching professional ethics and organizational behavior) in the 1990s, and joined the editorial staff of the American Journal of International Law in 1999 and the editorial staff of the Harvard Review of Psychiatry in 2003. At the end of 2016, he stepped down as Senior Editor of the American Journal. He is now in his twentieth year as Senior Editor of the Harvard Review. His recent publications, both published open access with Palgrave Macmillan, include Rethinking Health Care Ethics (2018, with Kasia Kozlowska) and Functional Somatic Symptoms in Children and Adolescents: A Stress-System Approach to Assessment and Treatment (2020, with Kasia Kozlowska and Helene Helgeland). A Lecturer in Psychiatry at Harvard Medical School, he has been collaborating with Kasia Kozlowska and other members of the mind-body team for over a decade.

Kasia Kozlowska has gained worldwide prominence as a child and adolescent psychiatrist at The Children’s Hospital at Westmead, as Clinical Associate Professor at the University of Sydney Medical School, and as Associate Professor and Research Fellow at the Westmead Institute of Medical Research, University of Sydney. In her intertwined clinical and research roles, she heads a multidisciplinary consultation-liaison team, a research program for children with functional neurological disorder, and a program — the Mind-Body Program — for the treatment of children disabled by functional neurological symptoms. She and her team are committed to the close integration of research findings and clinical practice, and to making the products of their clinical work and research broadly available to other professionals. Her 2020 open access book, Functional Somatic Symptoms in Children and Adolescents: A Stress-System Approach to Assessment and Treatment, is a free resource available to clinicians, as are many of her clinical and research publications.