Why Occupational Therapy should be included in your Functional Neurological Disorder (FND) treatment team

Functional Neurological Disorder (FND) affects how the brain sends and receives signals, disrupting movement, sensation, cognition, and autonomic function despite no observed structural damage to the nervous system. Because FND directly impacts daily functioning, occupational therapy plays a uniquely valuable and potentially central role in treatment and recovery.

Occupational therapy interventions are intentionally designed to feel safe, achievable, and success-oriented which are key ingredients for retraining and rewiring a dysregulated nervous system. At its core, occupational therapy focuses on a person's participation and consistent engagement in meaningful daily activities—the very areas most disrupted by FND. Rather than centering treatment solely on reducing symptom, occupational therapy emphasizes restoring the ability to engage in everyday life: walking, attending school or work, self-care, social participation, maintaining routines and more. This focus on a person's independent task engagement is essential, as improvement in real-world activity often drives nervous system regulation and symptom resolution in FND.

Occupational therapists focus on whole person recovery which is the foundation of FND treatment. Treatment that focuses on occupational engagement (any daily task that has meaning to an individual), physical skills, cognitive functioning, activity pacing, graded task engagement, fatigue management, sensory regulation and environmental awareness are integrated into training that all Occupational Therapists engage in during their education. By focusing on both physical and psychological recovery, treatment with an occupational therapist helps decrease excessive focus on symptoms, improve motor control and rebuild trust between the brain and body- key elements of recovery in FND.

Occupational therapists utilize routine engagement, task modification, sensory regulation and gradual re-engagement in activities of daily living (ADL) and instrumental activities of daily living to help improve overall independence and nervous system regulation. ADLs are all the self-care task you engage in on a daily basis including dressing, grooming, toileting, feeding, bathing and sleeping. IADLs refer to all other occupations that you engage in on a daily basis including work, socialization, money management, extracurricular engagement, raising children, cooking and much more.

Another critical contribution occupational therapists provide is the ability to address the context and environment symptoms most often occur in. FND symptoms are often influenced by stress, fatigue, demand variability, routine changes, and environmental demands. Occupational therapists assess how home, school, work, and social settings impact nervous system dysregulation and overall functioning. Occupational therapists create personalized treatment plans, along with help from the patient, that improve awareness of these exacerbating factors and promote proactive symptom management. Through this, occupational therapy helps patients shift from a fear-based avoidance of tasks to a confidence-based engagement which helps progress patients back toward functional independence.

Additionally, occupational therapists play a key role in diagnostic education and treatment collaboration. Occupational therapists provide a clear, mind-body explanations of FND that validate symptoms while reinforcing recovery expectations. Therapists often collaborate closely with physical therapy, mental health providers, medical teams, families, and schools to ensure a consistent and unified treatment approach.

Ultimately, occupational therapy is invaluable in FND treatment because it bridges neuroscience, function, and lived experience. By targeting the nervous system through meaningful activity and real-life participation, OT helps individuals with FND move beyond symptom management toward lasting functional recovery and improved quality of life.