REFERENCE · RECOVERY TECHNIQUE
Planning Individual Cognitive Rehabilitation
Home › Recovery Techniques › Functional Cognitive Disorder
Background: Everything We Know About FCD — the concepts behind this page.
When this may fit: When needs are complex, basic adaptations are insufficient or a person needs support applying strategies in daily life. [Clinical rehabilitation guidance and early intervention development; efficacy uncertain]
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
—
For the Person With FND
You may understand the advice and still struggle to make it work at home. Individual rehabilitation offers a chance to look at the actual task with someone who can help adapt it. The starting point can be a problem you want less of, not an exercise you are expected to master.
Match rehabilitation to the difficulty you actually have
Assessment can look beyond remembering words. If relevant, describe difficulty with visual or nonverbal memory, recognizing or placing people, finding a person’s name, judging layouts or routes, forming mental pictures, or following and organizing conversation. These are different functions. Face-recognition and imagery complaints are not established hallmark FCD signs and may need separate investigation.
Your team can combine practice aimed at improving ability, ways of compensating and changes that make the task accessible. A written description can replace visualization; introductions with names and context can support participation. These are examples to individualize, not a proven FCD face-recognition or imagery-restoration programme. Useful aids can remain, and rehabilitation does not require certainty about every mechanism. Benefit cannot establish the cause or diagnosis. [1][2]
A manageable way to begin
- Identify one priority with your team: following appointments, managing a household step, communicating or returning to an activity.
- Ask which professional fits the need. Neuropsychology can help formulate cognitive patterns; occupational therapy can work on everyday tasks and routines; speech and language therapy may help with cognitive communication.
- Practise a strategy in a relevant setting, with agreed supports and safety limits.
- Review what transfers to daily life, what remains difficult and whether you need a different approach or continuing assistance.
Keeping the approach helpful
“Metacognition” means understanding and responding to how your thinking works. Strategy training might involve a restart note, a cue or a different task sequence. These approaches can be combined, but no single package suits everyone. Rehabilitation should not require removing useful aids or repeatedly proving your symptoms. [1][2][3]
During a familiar flare
During a flare, return to a simpler agreed plan. If progress is limited, ask the team to revisit contributors, access barriers and the goal itself. Ongoing disability still deserves practical support and follow-up; treatment is not a test you can fail.
When to seek assessment
Sudden new confusion, altered consciousness, or cognitive difficulty with new weakness, speech change, severe headache, fever, a seizure or head injury needs urgent medical assessment. New difficulty recognizing highly familiar people, progressive loss of familiar knowledge, major visual-spatial change, progressive decline, getting lost in familiar places, unsafe medication or financial errors, or a marked change from your usual pattern also needs review. Pause safety-sensitive activities when you cannot manage them safely. Existing FCD does not explain every new symptom.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
—
For Family, Friends, and Other Supporters
Bring observations only with permission, and let the person’s priorities guide the work. Ask for clear instructions about any help you are expected to provide. The plan should also recognize supporter workload and the need for backup.
During a familiar flare, use one speaker and one idea at a time. Give processing time and offer the person’s usual aids. Preserve dignity and choice; ask before taking over. If the pattern is new or severe, follow the medical plan instead of continuing a recovery exercise.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
—
For Clinicians and the Care Team
Use an individualized interdisciplinary formulation and ecological goals; clarify the respective roles of restorative work, compensation and access. A therapist-guided FCD workbook has an early development report with feedback from only two people. It is not an efficacy trial and does not validate all cognitive rehabilitation. Agree review criteria, monitor adverse effects and coordinate ongoing medical assessment. [1][2][3]
Agree a written next step, accessible prompts and a review point. Assess symptom burden, daily function, support needs and adverse effects. FCD is a positive clinical diagnosis; normal tests alone, a good moment or the response to an exercise cannot establish it. Practical assistance should continue when symptom improvement is limited. See the paired diagnostic page.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
—
Research and Sources
This page expands original entry 13, Individual cognitive rehabilitation. Everyday examples are illustrations, not patient quotations. Practical steps are educational adaptations of the clinical approach; they are not a reproduced trial protocol or an individually validated treatment. Evidence for a whole programme must not be transferred to each component.
| Citation | Source | What it supports and its limits | Figure |
|---|---|---|---|
| 1 | FND-CIT-0011 — Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. JNNP. 2020;91(10):1037–1045. DOI. | Professional consensus for individualized rehabilitation, activity and support; not an FCD component efficacy trial. | — |
| 2 | FND-CIT-0026 — McWhirter L, Ritchie C, Stone J, Carson A. Identifying functional cognitive disorder: a proposed diagnostic risk model. CNS Spectrums. 2022;27(6):754–763. DOI. | Diagnostic/formulation evidence; does not test the effectiveness of this practice. | — |
| 3 | FND-CIT-0187 — Cotton E, Mordecai K, McWhirter L, et al. Taking Control of Your Functional Cognitive Symptoms: Workbook—A Novel Intervention. Journal of Neuropsychiatry and Clinical Neurosciences. 2026;38(2):153–162. Published online October 3, 2025. DOI. | Intervention development with initial feedback from two people; efficacy remains untested. Bibliographic record and abstract reviewed. | — |
Source review: September 21, 2026 · Cognitive-neurology, neuropsychology, lived-experience and accessibility review pending
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
—