FND is one of the most common causes of neurological symptoms seen in outpatient clinics, yet it remains poorly understood and frequently mistreated. The evidence-based approach combines specific neurological physiotherapy techniques designed for FND, integrated psychological support, and education about the diagnosis. Most patients improve significantly with the right approach — but the approach is specific and is not the same as generic physiotherapy or generic psychotherapy.
What FND rehabilitation involves
Diagnostic education — understanding what FND is and is not. Specific FND-physiotherapy techniques — distraction-based movement, automatic movement patterns, retraining of pathological movement patterns. Graded exposure to triggering activities. Psychological support — addressing anxiety, depression, trauma where present, and the impact of the condition on life. Coordination with neurology for ongoing diagnostic clarity and management of comorbid conditions.
Our combined approach
FND treatment requires both physical and psychological work — separating them does not work. We deliver them together. Our neurological physiotherapists and our neuropsychology team work jointly on FND cases, often with sessions back-to-back or with explicit joint sessions where appropriate. The combined approach has the strongest evidence base.
Outcome measures we use
- Patient Health Questionnaire-15 (PHQ-15)
- Hospital Anxiety and Depression Scale
- Modified Rankin Scale
- Specific Functional Measures Depending on FND Presentation
- Patient-reported Global Impression of Change
Who leads this work at Kent
FND care at Kent is delivered by Arun Ambat Bharathan.
Frequently asked questions
Is FND "all in my head"?
No. FND is a recognized neurological condition where the brain's function is disrupted, even though the brain's structure is normal on imaging. It is real, it has identifiable patterns, and it responds to specific treatment.
My doctor said I have FND but I'm not sure I believe it. Should I see you?
Yes — and we welcome those conversations. Understanding the diagnosis is the first step in treatment. If after assessment we have any concerns about the diagnosis, we refer back to neurology before proceeding.
What's the difference between FND treatment and normal physiotherapy?
FND-specific physiotherapy uses different techniques — particularly distraction-based and automatic-movement approaches — designed for the way FND produces symptoms. Generic strengthening or stretching is generally not what FND needs.
How long does FND rehabilitation take?
Recovery timelines vary depending on individual needs. Some patients experience significant improvement within 4 to 6 weeks, while others require 3 to 6 months of structured therapy. Long-standing FND with severe functional impact typically requires a longer, multidisciplinary approach.