Professional Roles in FND Care

A person may need help with diagnosis, movement, daily activities, communication, cognition, mental health, ordinary medical care, disability, access or another condition. Different professionals can contribute different parts of that care. The right combination depends on the person’s symptoms, goals, other health conditions and local access. [1][2]

This page answers a practical question for clinicians and other professionals:

“Where might my profession fit in this person’s care, and where on this site should I go next?”

Use this as a map of possible contributions. Professional titles, referral routes and legal scopes vary by country and service. Most cited evidence concerns adults; children need age-appropriate services. These role summaries mainly reflect clinical consensus, with treatment-trial findings identified separately. [1][3]

On this page: Specialty table · The person · Other professions · Working together · Sources

Specialty quick reference

Profession or specialty	Especially useful for	Start here
Neurology	Positive diagnosis, symptom phenotype, differential diagnosis, explaining findings, reassessment of important change	Understanding an FND Diagnosis · Diagnostic Signs
Primary care / family medicine	Continuity, general health, medication review, coexisting conditions, referrals and coordination	FND Alongside Other Conditions · Treatment Team
Physiotherapy	Functional movement, walking, balance, motor retraining, activity and mobility	Recovery Techniques · Functional Gait
Occupational therapy	Daily activities, routines, participation, equipment, environmental adaptation and independence	Daily Living and Equipment · Recovery Techniques
Speech-language therapy / pathology	Speech, voice, swallowing, globus, cough and upper-airway symptoms	Speech and Voice · Swallowing and Globus
Psychology / psychotherapy	Coping, adjustment, symptom-management approaches, distress, trauma when relevant, and coexisting mental-health needs	Psychological Treatment Without Blame
Psychiatry / neuropsychiatry	Complex psychiatric comorbidity, medication questions, diagnostic overlap and integrated neurological-psychiatric care	Treatment Team · Psychological Treatment
Neuropsychology	Functional cognitive disorder, cognitive assessment, memory/attention concerns and compensatory strategies	Functional Cognitive Disorder · FCD Recovery
Rehabilitation medicine / PM&R	Disability, rehabilitation planning, mobility, equipment and coordination across rehabilitation disciplines	Treatment and Rehabilitation · Daily Living and Equipment
Nursing	Ongoing observation, inpatient or community care, education, safety plans and communication across settings	Treatment Team · Functional Seizures
Emergency and acute care	New or changed neurological symptoms, injury, seizure-like events, urgent differentials and safe disposition	Tests and Investigations · Functional Seizures
Social work / case management	Disability systems, housing, transport, caregiving, benefits, work and access to services	Work, Disability and Participation · Healthcare Communication
Other medical and allied specialties	Treating coexisting or alternative conditions in their own field and contributing symptom-specific expertise	Co-occurring Conditions · Reference Library

On this page: Specialty table · The person · Other professions · Working together · Sources

The person with FND remains central

Professional roles should be organized around the person’s actual problems and goals rather than around a fixed “FND team.” A clinician may contribute one focused piece of care without becoming an FND specialist. Clear ownership matters: the person should know who is responsible for diagnosis, new-symptom assessment, medication, rehabilitation and follow-up. [1][2]

On this page: Specialty table · The person · Other professions · Working together · Sources

Neurology

How neurology may help and when it is especially useful: establish or review the diagnosis using the history, examination and appropriate positive signs; define the symptom phenotype; consider neurological alternatives and coexisting disease; explain diagnostic findings; and reassess major changes. Movement-disorder, epilepsy and neurophysiology expertise may be useful for particular presentations. [3][4]

Keep in mind: a positive FND diagnosis does not make future neurological symptoms automatically functional, and a brief examination finding does not measure the person’s everyday disability.

Search tags: epileptologist · EEG · EMG · movement disorder clinic

Useful pages: Understanding an FND Diagnosis · Diagnostic Signs · Functional Seizures

On this page: Specialty table · The person · Other professions · Working together · Sources

Primary care / family medicine

How primary care may help and when it is especially useful: provide continuity, review ordinary health problems and medicines, assess new concerns, manage or refer coexisting conditions, coordinate specialist recommendations and help prevent fragmented care. [1]

Keep in mind: FND should not become an explanation for every later symptom. General healthcare, prevention and proportionate investigation still matter.

Search tags: GP · family doctor · general practice · PCP · community medicine · longitudinal care · care coordinator

Useful pages: Co-occurring Conditions · Treatment Team · Healthcare Communication

On this page: Specialty table · The person · Other professions · Working together · Sources

Physiotherapy

How physiotherapy may help and when it is especially useful: assess functional movement, gait, balance, transfers and physical activity; identify conditions in which movement becomes easier; and use individualized retraining that aims to restore more automatic and useful movement. [5][6]

Keep in mind: treatment should follow the person’s symptoms, safety and goals. Physio4FMD found no significant advantage over community neurological physiotherapy on its primary 12-month physical-function outcome, although some secondary outcomes favoured specialist treatment. Brief improvement during an examination is not a measure of sustained daily function. [2][6]

Search tags: PT · physical therapist · vestibular rehabilitation · falls prevention

Useful pages: Functional Limb Weakness · Functional Gait · Functional Tremor · Functional Dystonia

On this page: Specialty table · The person · Other professions · Working together · Sources

Occupational therapy

How occupational therapy may help and when it is especially useful: work with the activities that make up everyday life—personal care, household tasks, routines, work or study, fatigue and activity patterns, sensory/environmental barriers, equipment, access and participation. OT can also help translate rehabilitation into meaningful daily activity. [7]

Keep in mind: the OT consensus cautions against unnecessary aids during active retraining, while allowing equipment and adaptations for persistent disability. Decisions need individual assessment of safety, participation, treatment response and review plans. This is consensus guidance, not trial evidence that withdrawing an aid improves FND. [7]

Search tags: OT · ADL · IADL · assistive technology · ergonomics · sensory modulation · home assessment · vocational rehabilitation

Useful pages: Daily Living, Accessibility and Equipment · Fatigue · Functional Cognitive Disorder · Recovery Techniques

On this page: Specialty table · The person · Other professions · Working together · Sources

Speech-language therapy / pathology

How speech-language professionals may help and when it is especially useful: assess and treat functional speech, voice, swallowing, globus, cough and related upper-airway symptoms; distinguish the presenting problem from important structural or neurological alternatives; and support communication access when another symptom makes appointments difficult. [8]

Keep in mind: speech, swallowing and airway complaints are not interchangeable. New dysphagia, choking, respiratory danger or acute speech change requires the appropriate safety and differential assessment.

Search tags: SLP · SLT · dysphonia · aphonia · laryngeal retraining

Useful pages: Speech and Voice · Swallowing and Globus · Cough and Upper Airway

On this page: Specialty table · The person · Other professions · Working together · Sources

Psychology / psychotherapy

How psychological therapy may help and when it is especially useful: address coping, adjustment, fear, avoidance, distress, attention or behavioural patterns when these are relevant; treat trauma or another mental-health condition when present; and use evidence-informed therapies for particular FND presentations where appropriate.

Keep in mind: referral to psychology does not establish a psychological cause for FND. Treatment should match the person’s needs and goals, and trauma work should follow assessment, readiness and consent. [3][9]

Search tags: clinical psychologist · CBT · ACT · health psychology · behavioural medicine · counselling

Useful pages: Psychological Treatment Without Blame · Functional Seizure Recovery

On this page: Specialty table · The person · Other professions · Working together · Sources

Psychiatry / neuropsychiatry

How psychiatry may help and when it is especially useful: assess and treat coexisting psychiatric illness, help with complex neurological-psychiatric overlap, review psychotropic medication and participate in integrated care when psychiatric expertise is relevant. [1][3]

Keep in mind: psychiatric comorbidity can matter greatly without being the cause of every functional symptom. Absence of a psychiatric diagnosis does not rule out FND.

Search tags: psychiatrist · neuropsychiatrist · consultation-liaison psychiatry · liaison psychiatry · psychosomatic medicine · psychopharmacology

Useful pages: Treatment Team · Psychological Treatment Without Blame · Biopsychosocial Model

On this page: Specialty table · The person · Other professions · Working together · Sources

Neuropsychology

How neuropsychology may help and when it is especially useful: assess cognitive complaints in context, characterize strengths and difficulties, consider neurological and psychological differentials, identify internal inconsistency carefully and help develop practical cognitive strategies when appropriate. [1][12]

Keep in mind: one good test score or one unexpectedly successful task does not cancel real-life cognitive disability. Sleep, medication, pain, migraine, mood, neurological disease and other contributors may need separate assessment.

Search tags: neuropsychologist · memory clinic · FCD · executive function · cognitive rehabilitation

Useful pages: Functional Cognitive Disorder · FCD Diagnostic Page · FCD Recovery

On this page: Specialty table · The person · Other professions · Working together · Sources

Rehabilitation medicine / PM&R

How rehabilitation medicine may help and when it is especially useful: integrate disability, mobility, equipment, rehabilitation goals, coexisting musculoskeletal or neurological problems and the work of several rehabilitation disciplines. [1][2]

Keep in mind: rehabilitation plans should distinguish symptom change from function, participation, safety and assistance needs. Improvement in one clinic task does not automatically answer all four.

Search tags: physiatry · physiatrist · rehab physician · seating clinic

Useful pages: Treatment and Rehabilitation · Daily Living, Accessibility and Equipment · Recovery Techniques

On this page: Specialty table · The person · Other professions · Working together · Sources

Nursing

How nursing may help and when it is especially useful: observe symptoms across longer periods and different activities, support safety plans, reinforce understandable explanations, identify practical care needs and communicate changes across inpatient, outpatient and community settings. [1][10]

Keep in mind: observations across a shift can describe assistance, recovery time and safety needs. Registered nurses and nurse practitioners have different scopes; appropriately qualified practitioners may also assess, diagnose or prescribe within local rules. Changed events need reassessment.

Search tags: RN · registered nurse · NP · nurse practitioner · seizure first aid · care plan

Useful pages: Functional Seizures · Treatment Team · Personal FND Handbook

On this page: Specialty table · The person · Other professions · Working together · Sources

Emergency and acute care

How emergency and acute-care professionals may help and when it is especially useful: assess new or substantially changed neurological symptoms, injuries, prolonged or unfamiliar seizure-like events and other acute presentations; identify time-sensitive alternatives; and use an existing FND diagnosis or event plan when it genuinely fits the current presentation. [10][13]

Keep in mind: an FND diagnosis can coexist with epilepsy, stroke, injury, medication reactions and other emergencies. Avoid both unnecessary escalation of a familiar established event and premature closure on a new one.

Search tags: ED · ER · A&E · acute medicine · urgent care · ambulance · paramedic · triage

Useful pages: Tests and Investigations · Functional Seizure Diagnosis · Functional Seizure Recovery and Safety

On this page: Specialty table · The person · Other professions · Working together · Sources

Social work / case management

How social work and case management may help and when it is especially useful: address the practical consequences of disability, including housing, transportation, caregiving, finances, benefits, work or school, service navigation and barriers that prevent a care plan from being usable. [1][7]

Keep in mind: a clinically sound recommendation may still fail if the person cannot physically, financially or practically access it. Social circumstances affect care without being treated as proof of the cause of FND.

Search tags: MSW · income support · workplace accommodation · discharge planning · welfare rights

Useful pages: Work, Disability and Community Participation · Healthcare Communication and Self-Advocacy

On this page: Specialty table · The person · Other professions · Working together · Sources

Other medical and allied specialties

How other specialists may help and when they are especially useful: evaluate and treat problems that fall within their own expertise, including conditions that coexist with FND or initially resemble it. Headache, pain, sleep, vestibular, ophthalmic, ENT, gastrointestinal, urological, autonomic and other specialty care may remain important. [1][3]

Keep in mind: not every symptom in a person with FND belongs to FND. A referral should answer a clinical question, treat a relevant condition or improve function rather than simply move responsibility elsewhere.

Search tags: migraine specialist · otolaryngology · audiology · neuro-ophthalmology · gastroenterology · neurourology · cardiology · orthotics

Useful pages: Co-occurring Conditions · Migraine · Persistent Pain · Sleep · Autonomic Symptoms

On this page: Specialty table · The person · Other professions · Working together · Sources

If your profession is not listed

The list above is a starting map, not a boundary around who can help.

Pharmacists, dietitians, orthotists, rehabilitation engineers, vocational specialists, counsellors, respiratory clinicians, dentists, optometrists and many other professionals may have an important role for a particular person. The useful question is not whether a profession is considered part of a standard FND team. It is whether that profession has skills that match a real need.

On this page: Specialty table · The person · Other professions · Working together · Sources

Working together without losing ownership

A multidisciplinary plan works best when responsibilities are explicit. Record who is responsible for diagnostic review, new-symptom assessment, medication, rehabilitation, equipment, mental-health treatment, coexisting conditions and follow-up. The person with FND should not have to infer these responsibilities from a referral list. [1][2]

Communication is part of care: offer an understandable explanation and agree on follow-up. A 2026 review examines diagnostic communication and outcomes. Its full methods were not available for this check, so this page does not claim a particular effect size or that accepting a diagnosis guarantees improvement. [11]

A practical handover

As an application of the guidance, a handover can name the clinical question, what has already been assessed, the person’s own goal, current help or equipment, and who will follow up. Record what the person can sustain at home, including recovery time and assistance, as well as what happened in an appointment. This is a suggested workflow, not a validated FND assessment tool. [1][2][7]

On this page: Specialty table · The person · Other professions · Working together · Sources

Research and Sources

Evidence scope: Profession summaries are a practical synthesis of consensus and clinical literature, not a ranking of professions or a proven staffing formula. Specific treatment evidence should be read separately from role descriptions. The table identifies source types and limits. Full-text access was uneven; multidisciplinary and lived-experience review remain pending.

Citation	Figure	Full citation	What it supports and limits
[1]	—	Lehn A, Petrie D, Palmer D, et al. Managing functional neurological disorder: treatment recommendations for health professionals in Australia. BMJ Neurology Open. 2025;7(1):e000970. https://doi.org/10.1136/bmjno-2024-000970 FND-CIT-0076.	Multidisciplinary consensus; local roles and referral systems vary.
[2]	—	Rutten S, Bradley-Westguard A, Nicholson TR, et al. Outcome measurement in functional neurological disorder: a qualitative study on the views of patients, caregivers and healthcare professionals. Journal of Neurology. 2025;272:189. https://doi.org/10.1007/s00415-025-12912-9 FND-CIT-0012.	Qualitative patient, caregiver and professional priorities; not evidence that a fixed team improves outcomes.
[3]	—	Espay AJ, Aybek S, Carson A, et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurology. 2018;75(9):1132–1141. https://doi.org/10.1001/jamaneurol.2018.1264 FND-CIT-0002.	Clinical framework and coexisting conditions; review.
[4]	—	Edwards MJ, Koens LH, Liepert J, Nonnekes J, Schwingenschuh P, van de Stouwe AMM, Morgante F. Clinical neurophysiology of functional motor disorders: IFCN Handbook Chapter. Clinical Neurophysiology Practice. 2024;9:69–77. https://doi.org/10.1016/j.cnp.2023.12.006 FND-CIT-0022.	Specialist neurophysiology role for selected motor symptoms.
[5]	—	Nielsen G, Stone J, Matthews A, et al. Physiotherapy for functional motor disorders: a consensus recommendation. Journal of Neurology, Neurosurgery & Psychiatry. 2015;86(10):1113–1119. https://doi.org/10.1136/jnnp-2014-309255 FND-CIT-0028.	Physiotherapy consensus; individualized retraining.
[6]	—	Nielsen G, Stone J, Lee TC, et al.; Physio4FMD study group. Specialist physiotherapy for functional motor disorder in England and Scotland (Physio4FMD): a pragmatic, multicentre, phase 3 randomised controlled trial. The Lancet Neurology. 2024;23(7):675–686. https://doi.org/10.1016/S1474-4422(24)00135-2 FND-CIT-0029.	Randomized trial with mixed outcomes; not proof of specialist superiority on primary physical function.
[7]	—	Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(10):1037–1045. https://doi.org/10.1136/jnnp-2019-322281 FND-CIT-0011.	OT consensus; activity, access and conditional equipment advice. Author manuscript, Aids and Adaptations section checked.
[8]	—	Baker J, Barnett C, Cavalli L, et al. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. Journal of Neurology, Neurosurgery & Psychiatry. 2021;92(10):1112–1125. https://doi.org/10.1136/jnnp-2021-326767 FND-CIT-0025.	Speech-language consensus; assessment and symptom-specific treatment.
[9]	—	Gutkin M, McLean L, Brown R, Kanaan RA. Systematic review of psychotherapy for adults with functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry. 2021;92(1):36–44. https://doi.org/10.1136/jnnp-2019-321926 FND-CIT-0077.	Psychotherapy review; heterogeneous interventions and limited studies.
[10]	—	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.	Functional-seizure guideline; not a protocol for every acute presentation.
[11]	—	Silva AF, Silva B. Diagnostic communication in functional neurological disorder: a systematic review and meta-analysis of patient acceptance and clinical outcomes. Patient Education and Counseling. 2026;152:109826. https://doi.org/10.1016/j.pec.2026.109826 FND-CIT-0083.	2026 communication review; record/indexed scope checked, full methods pending.
[12]	—	Ball HA, McWhirter L, Ballard C, et al. Functional cognitive disorder: dementia’s blind spot. Brain. 2020;143(10):2895–2903. https://doi.org/10.1093/brain/awaa224 FND-CIT-0071.	FCD clinical framework and differential diagnosis; no single decisive cognitive test.
[13]	—	Anderson JR, Nakhate V, Stephen CD, Perez DL. Functional (psychogenic) neurological disorders: assessment and acute management in the emergency department. Seminars in Neurology. 2019;39(1):102–114. https://doi.org/10.1055/s-0038-1676844 FND-CIT-0070.	Acute-care review; proportionate investigation and management.

Source and editorial check: October 1, 2026 · Multidisciplinary professional and accessibility review pending