The Effectiveness of Psychological Interventions for Children and Adolescents with Non-Epileptic Seizures

Abstract Background This article systematically reviews the literature on the effectiveness of psychological interventions for NES in children and adolescents. Methods Embase, Medline and PsycINFO were searched to December 2020, for articles published in English, which used an objective measure to evaluate the outcome of a psychological intervention for NES. Further studies were identified from reference lists and experts in the field were contacted for unpublished studies. Results Twelve studies met inclusion criteria. Of these, four were set up with the primary aim of evaluating an intervention (Flewelling, Koehler, & Shaffer, 2020; Fobian, Long, & Szaflarski, 2020; Kozlowska et al., 2018; Terry et al., 2020) of which two used a control group, two were prospective outcome studies and eight looked at retrospective clinical data. Two studies evaluated a single treatment modality, the others multiple treatment components. Overall, psychoeducation, and top-down psychotherapy, such as cognitive therapies, were the most frequent interventions, with recent studies describing body-oriented (bottom-up) approaches. Analysis across all studies identified a range of additional intervention components which included assessment and / or treatment for co-morbidities, liaison with school and support for parents, highlighting the importance of individualised treatment packages. Conclusions There is a paucity of studies specifically evaluating interventions for NES. Though a range of approaches have been described in managing this patient group, with generally positive outcomes, it is not possible to conclude from the available literature that one treatment approach is superior to another, though the information may be helpful in developing management guidelines.