Tailoring Cognitive Behavioral Therapy to PNES, Seizure-Related Disorders, Becky Tilahun, PhD

The clinical psychologist at Cleveland Clinic discussed the process for successfully changing and tailoring different cognitive behavioral therapy approaches to treat various forms of seizures. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"There’s a scarcity of providers for functional neurological disorders. We’re going to try different approaches and conduct more research to make these interventions more approachable and accessible for patients.”

Cognitive behavioral therapy (CBT) is a method of psychological treatment that has been shown to be effective to treat a range of conditions, including depression, anxiety disorders, alcohol and drug use problems, eating disorders, and severe mental illness. It has also had a positive impact on a number of neurological conditions, including the number of patients who suffer from insomnia-related depression.1

Most recently, the use of CBTip, a tailored form of CBT for patients with psychogenic nonepileptic seizures (PNES), seizures without a neurological abnormality caused by a psychological distress, showed the ability to improve seizure frequency, anxiety, and depression in these patients.

The study, presented at the American Epilepsy Society (AES) Annual Meeting, December 3-7, 2021, included 2 parts, where patients were treated with at least 7 sessions of CBTip for a 12-week period. The first analysis looked at change in outcomes in pretreatment and 90-day patient reported outcome scores, whereas the second analysis looked at those in a flexible treatment schedule by comparing pretreatment scores with 90-day to 1-year post initial visit scores.2

The improvements observed on seizure frequency, anxiety, and depression, were found to be significant only in the second analysis, indicating that a longer duration of treatment may be more beneficial. Lead author Becky Tilahun, PhD, clinical psychologist, Cleveland Clinic, sat down with NeurologyLive® to discuss the need for specifically designing CBT interventions to fit patients’ needs, as well as potential future research that may improve its overall efficacy.


1. Irwin MR, Carrillo C, Sadeghi N, Bjurstrom MF, Breen EC, Olmstead R. Prevention of incident and recurrent major depression in older adults with insomnia. JAMA Psychiat. Published online November 4, 2021. doi:10.1001/jamapsychiatry.2021.3422

2. Tilahun B, Thompson N, Sankary L, Laryea F, Trunick C. Outcomes in the treatment of psychogenic non-epileptic seizures (PNES) with CBTip: improvement in seizure frequency, mood, and quality of life. Presented at AES Annual Meeting; December 3-7, 2021. Abstract 3.256

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