FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Supporter Response Rehearsal for Functional Seizures

Page role: Additional supporter-planning guidance. Develops safety planning and supporter guidance; rehearsal is an implementation aid, not a separately proven seizure treatment. See the collection index for the original technique groupings.

Most likely fit: When family, friends, school or care staff need a consistent, consent-based response before an event occurs. [Clinical guideline and safety guidance; rehearsal is an implementation aid]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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For the Person With FND

Decide how you want help to sound and feel

Agree who should stay nearby, what they should say and which kinds of touch or sensory input are unwelcome. A simple plan can reduce the number of decisions needed during an episode. It should respect your preferences without asking a supporter to ignore a medical emergency. [1][2]

Rehearsal means talking through a situation when you are settled. You do not need to act out a seizure. For example: “If I stop responding at the table, move the hot drink away, stay nearby and use the written plan.” Choose a time limit for the discussion if talking about symptoms itself brings them on.

Include the recovery period

You may need quiet, simple orientation or practical help afterward. Decide which questions can wait. If you cannot speak, a previously agreed gesture or written choice may help once you can use it. No response should be interpreted as consent to new exercises.

If discussion triggers symptoms, pause and use the real safety plan. You can return to planning in smaller parts later.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
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For Family, Friends, and Other Supporters

Practise finding the plan and identifying the first safety action, not testing your ability to stop an attack. Agree who calls for help, who keeps the area clear and who supports other dependants if needed.

Use one speaker where practical. Do not restrain, shame, crowd, film without consent or announce that the person is doing it for attention. Calm presence does not mean leaving an unsafe person alone. Ask for training or another helper if the plan exceeds what you can safely do.

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

Explicit procedure

  1. Obtain consent for which supporters receive information; consider the young person’s involvement and safeguarding where relevant.
  2. Check the event and emergency plan before rehearsing its implementation.
  3. Assign realistic roles: environmental safety, timing, communication, medical escalation and recovery assistance.
  4. Use a verbal tabletop scenario. Do not deliberately trigger symptoms or simulate hazardous movements.
  5. Ask supporters to describe their response to a typical event and to one clear exception, such as abnormal breathing.
  6. Clarify any conflict between quiet reassurance and necessary escalation.
  7. Check physical handling limits, sensory accommodations, language, literacy and caregiver capacity.
  8. Review the plan after an event without blame and update all authorized copies.

Outcomes and limits

Assess whether people can find the plan, identify hazards and explain when to get help. Include burden and disagreement, not just whether instructions were followed. Rehearsal cannot certify clinical competence, replace first-aid training or authorize untrained transfers.

Ictal unresponsiveness means limited observable response during an event; it is not permission to make assumptions about hearing, awareness or intent. Use respectful language throughout.

Basis and evidence boundary

Guidance supports involving chosen supporters and consistent care. The verbal rehearsal is an original implementation example; no separate trial establishes its seizure-reduction effect. [1][2]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

General first-aid precautions are drawn from NHS guidance. Its emergency advice is adjacent safety guidance, not a functional-seizure treatment trial; an individualized event plan must address duration, uncertainty and coexisting epilepsy. [3]

Citation Full citation and source
[1] Tolchin B, Goldstein LH, Reuber M, Stone J, Perez DL, LaFrance WC Jr, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106(1):e214466. https://doi.org/10.1212/WNL.0000000000214466 FND-CIT-0010.
[2] Stone J. Treatment of Functional Seizures. Neurosymptoms. Specialist treatment overview. Accessed September 14, 2026. FND-CIT-0098.
[3] NHS. What to do if someone has a seizure (fit). General seizure first aid. Reviewed December 19, 2023; accessed September 14, 2026. FND-CIT-0101.

Created September 14, 2026 · Neurology, relevant therapy, lived-experience, caregiver and accessibility review pending

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —