Management of Conversion Disorder

SUPERVISOR MA’AM ASIA MANZOOR

PRESENTED BY JAHAN ARA RANA
Management Goals

 Engagement in therapy
 Describe the symptoms of patient with the help of CBT model
 To Educate the patient and family to deal with physical symptoms
 Increase ability to handle emotions
 Teaching relaxation skills to reduce emotional distress and manage stress
 Relapse Prevention
Management of Conversion Disorder

The following can be used for managing conversion disorder

 Cognitive Behavior Therapy
 Behavioral Therapy
 Family Therapy
 Hypnosis
 Relaxation Training
 Assertive Skill Training.
 Problem Solving Skills
 Relapse Prevention
Cognitive Behavior Therapy

 Educate the client about symptoms

 Focus on changing client’s maladaptive thoughts by validating them with
rationale thoughts
 ABC model for understanding the role of cognitions in affecting the behavior
 Socratic questioning (eliciting information by recalling most recent episode of
fit)
 To modify the attribution of illness verbal challenging strategies
 Questioning the evidence (e.g. belief that tingling sensation in head and
numbness is a sign of serious illness)(Point counter point)
Behavior Therapy

 Extinction : The process of extinction was applied in order to reduce occurrence of

sick behaviors by eliminating all rein-forcers for it

 Extinction guidelines

 Planned ignoring

 Extinction burst by telling the caregivers that the symptoms may exacerbate to
their maximum when the technique is implemented but by the continuation of the
technique, they will eventually lead to diminishing of symptom
Emotional Processing/acceptance and experiencing

 Coping Statements

 Mindful detachment

 Assessing Emotion (Examining beliefs about duration, control and danger of

emotion)

 Acceptance of Emotion
Relaxation Training

 Dysfunctional pattern of breathing which could cause distress in patient

 A two way process of breathing retraining
 Meditational process
Slowly inhale and exhale via nose in such a way that while inhaling chest go
inward and stomach came out like a balloon and while exhaling the stomach should
contract. During whole process the client is instructed to keep his attention to the breathing
path. Client is also asked to say 1 mentally when inhaling and say Relax while exhaling
 Paced Breathing
Take a breath and hold it for some second and then exhale
Rating of stress level before and after exercise
Covert Extinction

Covert Extinction we used to help the patient to develop effective coping mechanism as she was being

sent to leave today. It was employed to help her deal with her symptoms without the attention of her

family members. Situation were identified with the patient during which experienced fits.one of the

situation was selected and was instructed to gradually imagine herself symptoms- free without

receiving the attention of family. During the imagery was also instructed to imagine that was coped

wall and recovered from the dizziness and termers through self-control.
Assertive Skill Training

 Communication Style on a Continua

 Broken Record
This technique is taught to politely refuse other person request i.e. to keep repeating the same message again and again
until the other person heard your message.
 Use of I statement
Conveying message to other person e.g. you are a nice person usually but I found your last day behavior a bit personal. I
want to keep our conversation in friendly way and afterward reinforce other person if they implement change as you desire.
Assertiveness training

 Distinguishing between different style

 STEP II & III

 Assertiveness self-assessment was done with the patient.

 STEP IV

 The further step in assertiveness training is written your script for change. A script is a working plan

for dealing with the problem scene assertively. There six elements in a script.
STEP V Assertive body language

 The following points were told in order to know how she can maintain her body
posture. (Alberti, R. E., & Emmons, M. L. (1990)
 Maintain eye contact
 Maintain an erect body posture.
 Speak clearly
 Don’t whine or have an apologetic tone to your voice.
 Make use of gesture and facial expression for emphasis.
 A role play was done with the patient as she was asked to shoe assertiveness body
language while talking to her husband which she performed well.
 STEP VI

 The six and final step becoming assertive person is learned how to

avoid manipulating and was taught to the patient.

 L- Look at your right and what you want and understand your feelings about
the situation.
 A-Arrange a meeting with the the person to discuss the situation.
 D-Define the problem specifically
 D-Describe your feeling so that the other person fully understands how you
feel about the situation.
 E-Express what you want clearly and concisely.
 R-Reinforce the other people by explaining the mutual benefits of adopting
the sits of action you are suggestion.
Problem Solving Skills
Relapse Prevention

 The patient was giving tips for relapse prevention. Patients was advised to relapse as a part
of recovery rather than to indulge in self- downing, blaming and guilt. Patients was told
that relapse ill proved you the chance to practice the skill learned in therapy. Patients was
encouraged to use assertiveness skills learned in the therapy.

 Therapy Blueprint

Therapy blue print was provide to the patient to provide her with the summary of the technique
used in therapy and help deal with the similar problems herself easily in the future.