Using Acceptance and Commitment Therapy to Improve Outcomes in Functional Movement Disorders: A Case Study

Christopher D. Graham*, Simon R. Stuart, Daniel J. O'Hara, Steven Kemp

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Although there are many theories of functional movement disorders (FMD), the causes and prognosis remain unclear, and there are no treatments with high-quality empirical support. Acceptance and commitment therapy (ACT) is an acceptance-based behavior therapy which, via altering a process called psychological flexibility, aims to support behaviors that are consistent with a person's overarching values - even in difficult, uncertain, or immutable contexts. It may, therefore, have pragmatic benefits in the context of FMD. We outline the theoretical basis for ACT and detail a case study of a brief (six session) intervention for increasing personally meaningful activity with FMD. The participant was in her early 20s and had been diagnosed with functional propriospinal myoclonus. ACT techniques including relational framing, defusion, and mindfulness exercises were used to increase psychological flexibility, with the goal of enabling effective functioning within the difficult context created by FMD. Following treatment, the participant showed a reliable change/clinical recovery in psychological flexibility (Acceptance and Action Questionnaire II [AAQ-II]), FMD symptom interference (Work and Social Adjustment Scale [WSAS]; primary outcome), and mood (Clinical Outcomes in Routine Evaluation 10-item scale [CORE-10]; secondary outcome). This case study demonstrates an approach that focuses first on improving functioning with FMD, as opposed to eliminating or controlling symptoms.

Original languageEnglish
Pages (from-to)401-416
Number of pages16
JournalClinical Case Studies
Issue number5
Early online date01 May 2017
Publication statusPublished - Oct 2017


  • acceptance and commitment therapy
  • cognitive behavioral therapy
  • conversion disorders
  • functional movement disorders
  • functional neurological disorders
  • functional propriospinal myoclonus
  • medically unexplained symptoms
  • mindfulness
  • neurology
  • relational frame theory

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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