Retraining and Control Therapy (ReACT) for Adult Functional Seizures: Cognitive Behavioral Treatment Targeting Sense of Control and Symptom Expectations

What this Trial Is About

This research aims to evaluate Retraining and Control Therapy (ReACT), a cognitive behavioral treatment targeting sense of control and catastrophic symptom expectations in adults with psychogenic non-epileptic seizures (PNES), which are seizure-like episodes not caused by epileptic brain activity. The study involves adults aged 19 and older diagnosed with PNES and treated at the UAB FND clinic. It compares immediate treatment to waiting periods of 3 or 6 months to assess how these factors affect outcomes. Participants will be randomly assigned to one of three groups: no waiting period, a 3-month waiting period, or a 6-month waiting period before starting ReACT. The therapy consists of 12 sessions delivered weekly through telehealth, with the first session lasting up to two hours and the rest lasting one hour each. The study includes baseline and follow-up visits to measure treatment effects before, during, and after therapy, including long-term assessments up to 12 months post-treatment. During the study, participants complete questionnaires about mood, relationships, and PNES symptoms, along with cognitive tests and biological measures like cortisol response to a cold pressor test. They track seizure frequency with diaries and wear devices to monitor sleep and seizure severity. Outcome measures include sense of control, pain catastrophizing, pain tolerance, cortisol levels, and seizure frequency over time. Follow-up visits occur up to a year after treatment to evaluate lasting effects and safety.

Retraining and Control Therapy (ReACT)- Adults