TY - JOUR
T1 - Cognitive Behavioral Therapy for Foreign Accent Syndrome
T2 - A Single-Case Experimental Design
AU - Birdsey, Nicola
AU - Millar, Josie F. A.
N1 - Funding Information:
The author thanks Becky (pseudonym) for her consent to the publication of this article. Names used in the report have been changed to maintain confidentiality. The author(s) received no financial support for the research, authorship, and/or publication of this article.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Foreign accent syndrome (FAS) has historically been attributed to a neurological etiology. However, recent research has identified psychogenic causes of FAS, where patients present to health care services with medically unexplained FAS symptomology. Due to the rare nature of psychogenic FAS, there is currently no evidence-based psychological treatment for this syndrome. Although patients with psychogenic FAS do not meet the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) or the International Classification of Diseases (ICD)-10 diagnostic criteria for a diagnosis of somatization disorder, there are some similarities in presentation between psychogenic FAS and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for somatic symptom disorder (SSD). These include the presence of distressing and disruptive symptoms that result in increased health care utilization. Given the emerging evidence for cognitive behavioral therapy (CBT) for SSDs, it is arguable that CBT could help patients with psychogenic FAS to manage the psychological distress they experience. This paper aims to explore the use of CBT in reducing the psychological distress of a patient with no organic explanation for FAS using a single-case (A-B) experimental design. The results suggest that CBT was effective in reducing distress, as measured using the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM). This paper highlights the value in using an individualized formulation-driven CBT approach for presentations that do not yet have evidence-based guidelines. In this case, cognitive restructuring, activity scheduling, and stress management appear to be key mechanisms of change in reducing psychological distress associated with FAS.
AB - Foreign accent syndrome (FAS) has historically been attributed to a neurological etiology. However, recent research has identified psychogenic causes of FAS, where patients present to health care services with medically unexplained FAS symptomology. Due to the rare nature of psychogenic FAS, there is currently no evidence-based psychological treatment for this syndrome. Although patients with psychogenic FAS do not meet the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) or the International Classification of Diseases (ICD)-10 diagnostic criteria for a diagnosis of somatization disorder, there are some similarities in presentation between psychogenic FAS and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for somatic symptom disorder (SSD). These include the presence of distressing and disruptive symptoms that result in increased health care utilization. Given the emerging evidence for cognitive behavioral therapy (CBT) for SSDs, it is arguable that CBT could help patients with psychogenic FAS to manage the psychological distress they experience. This paper aims to explore the use of CBT in reducing the psychological distress of a patient with no organic explanation for FAS using a single-case (A-B) experimental design. The results suggest that CBT was effective in reducing distress, as measured using the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM). This paper highlights the value in using an individualized formulation-driven CBT approach for presentations that do not yet have evidence-based guidelines. In this case, cognitive restructuring, activity scheduling, and stress management appear to be key mechanisms of change in reducing psychological distress associated with FAS.
KW - aphonia
KW - cognitive behavioral therapy (CBT)
KW - Foreign accent syndrome (FAS)
KW - psychogenic
KW - single-case experimental design (SCED)
UR - http://www.scopus.com/inward/record.url?scp=85087436231&partnerID=8YFLogxK
U2 - 10.1177/1534650120936771
DO - 10.1177/1534650120936771
M3 - Article
AN - SCOPUS:85087436231
VL - 19
SP - 321
EP - 338
JO - Clinical Case Studies
JF - Clinical Case Studies
SN - 1534-6501
IS - 5
ER -