FND Education Project

REFERENCE · RECOVERY TECHNIQUE

ReACT for Children and Adolescents for Functional Seizures

Page role: Additional age-specific treatment page. ReACT is a separately discussed paediatric programme within the psychological-treatment family. It was already mentioned in the CBT resource map, but was not a numbered entry in the original symptom list. See the collection index for the original technique groupings.

Most likely fit: A child or adolescent with assessed functional seizures whose family and clinical team are considering a structured symptom-focused programme. [Emerging paediatric programme evidence; do not generalize directly to adults]

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

What the name means

ReACT stands for Retraining and Control Therapy. It is a clinician-delivered treatment for young people. Its model addresses symptom expectations and a sense of control and includes individualized responses and a family plan. “Control” is a treatment aim, not a claim that the young person chose the seizures. [1][2][3]

Ask the service what training its clinician has, how it adapts sessions for the child’s needs and what happens if the treatment does not help. The plan should include school access, safety and ongoing care. An adult should not copy a paediatric programme and assume the evidence applies unchanged.

What to discuss before starting

The young person should have a voice in the goals. For example, the family may want fewer emergency disruptions while the child wants to join one valued school activity. Agree on support for both. The treating clinician selects any competing response; a generic exercise from the internet is not equivalent to ReACT.

At onset, follow the individualized programme only when the young person can safely use the taught response. If awareness or safety is impaired, use the event plan. Restraint, blame or withdrawal of care is not a treatment exercise.

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

Parents and school staff need compatible instructions. Ask which response is appropriate during an event, who remains nearby and how the child can return to an activity safely. Quiet, consistent support does not mean ignoring danger or emotional needs.

Do not make privileges, affection, medical care or access to school conditional on stopping symptoms. Tell the therapist if sessions or practice increase distress, injury risk or family conflict.

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

Referral and implementation boundaries

ReACT is a named treatment package. This overview is not its manual and deliberately does not invent a standardized competing movement for every child.

  1. Confirm event diagnosis and identify any coexisting epilepsy or other FND presentations.
  2. Assess developmental understanding, assent/consent, family context, learning needs and safeguarding concerns.
  3. Explain the evidence and the proposed treatment model as a model, not a proven cause of the individual’s episodes.
  4. Refer to an appropriately trained provider and coordinate neurological follow-up.
  5. Have that provider specify the individualized response, family actions, school plan and exceptions for medical concerns.
  6. Monitor child-reported experience alongside parent reports and seizure outcomes.
  7. Adjust intensity, access arrangements or treatment choice when burdens outweigh benefits.

Evidence and generalization

The 2020 pilot randomized 32 young people, with 29 completing the seven-day assessment. Results favoured ReACT, but longer-term comparison was limited because participants with continuing events were referred for additional treatment. A 2025 adolescent telehealth cohort reported improvements but lacked a randomized comparison and had follow-up attrition. An author disclosed an equity interest in ReACT FND Health.

These are programme-level findings. They do not establish an adult treatment dose, guarantee remission or isolate one response as the active ingredient.

Basis and evidence boundary

Use the paediatric pilot and observational telehealth cohort with their different designs stated. Current service availability and suitability require local verification; this page does not endorse a commercial provider. [1][2][3]

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

Research and Sources

Citation Full citation and source
[1] Fobian AD, Long DM, Szaflarski JP. Retraining and control therapy for pediatric psychogenic non-epileptic seizures. Annals of Clinical and Translational Neurology. 2020;7(8):1410–1419. doi:10.1002/acn3.51138 FND-CIT-0099.
[2] Watson C, Stager L, Valaiyapathi B, Goodin BR, Szaflarski JP, Fobian AD. Telehealth provision of Retraining and Control Therapy (ReACT) on cognitive and biopsychosocial functioning in pediatric functional neurological disorder. Journal of Psychosomatic Research. 2025;192:112112. doi:10.1016/j.jpsychores.2025.112112 FND-CIT-0100.
[3] 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.

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 —