In order for psychotherapy to have any chance of working, the psychologist needs to have targets to work on and goals for change. The most obvious goal for change in PNES is for the behavioral episodes (i.e. non-epileptic seizures) to stop. In reality, there are a number of other important goals in treating PNES but this is by far the most visible one.
Treatment targets on the other hand are many and will vary depending on the patient’s individual characteristics, personal history, and social environment. In my opinion, this is where important differences appear.
Over the years, our PNES program at the Northeast Regional Epilepsy Group has selected a battery of tests and surveys that help us better understand our patients. It is for this reason that our neuropsychologists administer a very select group of psychological measures. Results from these measures can then be introduced into the treatment design itself by our psychotherapists to establish target problems by priority and can also then be tracked through repeat testing to see if changes are taking place.
The main problem areas we measure include:
Anxiety and somatic (physical) complaints
Ability to read emotions accurately (alexithymia)
Strategies to cope with stress
Quality of life
In the past 10 years, we have fine-tuned the battery of tests and will most likely continue to make changes as new questions arise and new measures are published. I welcome other professionals working with PNES to contact me so we can go over the measures that we use at the Northeast Regional Epilepsy Group in more detail and to hear what else is being administered elsewhere. I also welcome comments from patients who have feedback to give on what might be other targets to look at that we have not identified yet.