Retraining and Control Therapy (ReACT): Cognitive Behavioral Treatment Targeting Sense of Control and Catastrophic Symptom Expectations for Pediatric Psychogenic Non-Epileptic Seizures

What this Trial Is About

Researchers are evaluating Retraining and Control Therapy (ReACT) and supportive therapy for treating pediatric psychogenic non-epileptic seizures (PNES), which are seizure-like episodes without epileptic brain activity. This study focuses on improving sense of control and reducing catastrophic symptom expectations in children aged 11 to 18 diagnosed with PNES. The trial also includes healthy controls for comparison and is sponsored by the University of Alabama at Birmingham. Participants are randomly assigned to receive 12 therapy sessions: one group receives ReACT, a cognitive behavioral intervention teaching control over symptoms and behaviors, while the other group receives supportive therapy focused on discussing stress and daily difficulties. The first session is in-person, and the following 11 sessions are conducted weekly via telehealth. Healthy controls have baseline and follow-up visits similar to PNES participants. During the study, participants and their parents attend a baseline visit and multiple follow-up visits over a year. Assessments include questionnaires on mood, trauma, and symptoms, computerized tasks measuring sense of control, pain tolerance tests, cortisol levels from saliva samples, and monitoring of sleep and PNES episodes using wearable devices. PNES frequency is tracked through diaries from 30 days before treatment through 12 months after. Long-term follow-up visits occur at 6 and 12 months post-treatment, with additional booster therapy sessions offered as needed.

Retraining and Control Therapy (ReACT) R33 Phase