For family physicians and nurse practitioners
Psychotherapy for Functional Neurological Disorder (FND)
Once FND is diagnosed, many patients struggle to find a therapist who understands it. I accept referrals for adults and mature adolescents across Ontario, online or in person.
Physician referral preferred, not required · No waitlist
How to refer
Referring starts with one call.
Call or leave a message. Your patient can also call directly.
Call
Phone to discuss a patient, or give the number to your patient to call directly.
Share the essentials
On the call, I'll ask for the diagnosis and who made it, relevant history, current medications and any risk concerns.
Consultation within 5 days
Your patient's free 20-minute consultation is booked within 5 business days. With consent, I confirm with you once treatment starts.
Why refer
After the diagnosis, patients need a next step.
FND is diagnosed on positive clinical signs. It is understood as a disorder of how the nervous system functions, with no structural damage, and it can be as disabling as other neurological conditions. The diagnostic presentation is directly related to treatment outcomes. A consultation with Todd can ensure best practice. 1,2 Current criteria no longer require a psychological trigger to make the diagnosis.3 A clear explanation matters, and so does what comes after it. Psychotherapy is one part of treatment, alongside physiotherapy and steady follow-up in primary care.1
What patients often bring to therapy
Fear of the next episode, which keeps attention fixed on the body and leads to avoidance.
Anxiety, panic, low mood or a history of trauma that makes symptoms harder to manage.
Doubt about the diagnosis, often after being told at some point that it was "all in their head".
Clinical approach
Therapy that builds on the explanation you gave.
Current models link FND to how the brain predicts and attends to signals from the body, how expectation shapes what a person experiences, and how stress and earlier adversity can raise vulnerability for some people.2,4–6 My work follows from that model.
Understand
We build a shared, plain-language account of how your patient's symptoms work, starting from the explanation given at diagnosis. Early, clear education helps patients engage with treatment.7
Personalize
I use an integrated, multi-modality approach, designed to resonate with your patient and to target what keeps symptoms going: attention, fear, avoidance, stress and arousal.
Practise
Patients practise skills for warning signs and episodes, and a graded return to activity. I coordinate with physiotherapy or neurology where that helps.
Weekly sessions, online or in person, beginning with a 12-week program.
Evidence
What the research shows
Psychotherapy for FND has been studied most in functional (dissociative) seizures. Two key sources:
Functional seizures
CODES trial, 368 adults
CBT plus standardised medical care was compared with standardised care alone. Seizure frequency fell in both groups, with no clear difference at 12 months. Patients who had CBT reported longer seizure-free periods, better daily functioning, less distress and higher satisfaction.8
Across FND presentations
Systematic review, 19 studies
Studies of CBT and psychodynamic therapy found moderate improvements in physical symptoms, mental health, wellbeing and function. Most studies were small, and most involved seizures.9
The evidence is still developing. I'm direct with patients and referring clinicians about what therapy can and can't be expected to do.
Who to refer
Is this a good fit for your patient?
Good fit
- Adults and mature adolescents with an FND diagnosis from a physician or neurologist
- Patients who accept the diagnosis, or are open to it
- Anxiety, panic, health anxiety or trauma symptoms alongside FND
- Able to attend weekly sessions, online or in person
Please check first
- Symptoms not yet assessed. I don't diagnose FND, so the medical workup comes first.
- Acute suicide risk, or a need for urgent psychiatric care
- A need for inpatient or intensive multidisciplinary rehabilitation
Questions from physicians
Is this covered by OHIP?
No. Psychotherapy from a Registered Psychotherapist isn't OHIP-insured. Many extended health plans cover it, and patients should check their own plan. Fees and policies
Does my patient need a referral?
A physician referral is preferred, but not required. Patients can also self-refer by phone or online booking. Either way, they need a formal FND diagnosis first, because I don't diagnose. If I need to consult with you, I'll reach out, with your patient's consent.
Do you diagnose FND?
No. Diagnosis rests with the patient's physician or neurologist. I treat after diagnosis, and I'll refer back if new or concerning symptoms come up.
Will you keep me updated?
With your patient's written consent, yes. You'll get a short note when treatment starts and when it ends, and sooner if there's a safety concern. I'll also reach out to consult when that would help your patient's care.
Do you prescribe or manage medication?
No. Medication stays with you or the prescribing physician.
About the clinician
Todd Kaufman, RP
Registered Psychotherapist, CRPO #3262. My practice focuses on adults whose anxiety has persisted despite real effort, and on functional symptoms where anxiety, attention and stress play a part.
Have a patient in mind?
A short call is enough to start.
Living with FND yourself but no formal diagnosis - let's talk. Book a free 20-minute call
If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and US), or go to your nearest emergency department.
References
- Aybek, S., & Perez, D. L. (2022). Diagnosis and management of functional neurological disorder. BMJ, 376, o64. https://doi.org/10.1136/bmj.o64
- Hallett, M., Aybek, S., Dworetzky, B. A., McWhirter, L., Staab, J. P., & Stone, J. (2022). Functional neurological disorder: New subtypes and shared mechanisms. The Lancet Neurology, 21(6), 537–550. https://doi.org/10.1016/S1474-4422(21)00422-1
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Jungilligens, J. (2023). A new science of emotion: Implications for functional neurological disorder [Conference abstract]. Journal of Neurology, Neurosurgery & Psychiatry, 94(12), e2.3. https://doi.org/10.1136/jnnp-2023-bnpa.11
- Terhune, D., & Edwards, M. (2023). Placebo, suggestion and FND: Interactions and clues to pathophysiology [Conference abstract]. Journal of Neurology, Neurosurgery & Psychiatry, 94(12), e2.2. https://doi.org/10.1136/jnnp-2023-bnpa.10
- Mavroudis, I., Petridis, F., Ciobica, A., Ionescu, C., Kamar, A. A. M., Cojocariu, R.-O., Kazis, D., Gheban, D., Morosan, C., Gurzu, B., Novac, O., & Novac, B. (2026). Stress-related neuroplasticity and developmental vulnerability in functional neurological disorder: From adverse experience to maladaptive overlearning. Frontiers in Molecular Neuroscience, 19, Article 1816644. https://doi.org/10.3389/fnmol.2026.1816644
- Dahir, T., Lapitan, S., Mohamud, A., Saxena, A., & Williams, V. (2024). Co-producing and quality assuring multi-modal psychoeducation to enable early engagement in guided self-help for people with functional neurological disorder. BJPsych Open, 10(S1), S132–S133. https://doi.org/10.1192/bjo.2024.357
- Goldstein, L. H., Robinson, E. J., Mellers, J. D. C., Stone, J., Carson, A., Reuber, M., Medford, N., McCrone, P., Murray, J., Richardson, M. P., Pilecka, I., Eastwood, C., Moore, M., Mosweu, I., Perdue, I., Landau, S., Chalder, T., & CODES Study Group. (2020). Cognitive behavioural therapy for adults with dissociative seizures (CODES): A pragmatic, multicentre, randomised controlled trial. The Lancet Psychiatry, 7(6), 491–505. https://doi.org/10.1016/S2215-0366(20)30128-0
- Gutkin, M., McLean, L., Brown, R., & Kanaan, R. A. (2021). Systematic review of psychotherapy for adults with functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry, 92(1), 36–44. https://doi.org/10.1136/jnnp-2019-321926