# Retraining and control therapy: sense of control and catastrophic symptom expectations as targets of a cognitive behavioral treatment for pediatric functional seizures

**Authors:** Caroline Watson, Badhma Valaiyapathi, Jerzy P. Szaflarski, Burel R. Goodin, Aaron D. Fobian

PMC · DOI: 10.3389/fpsyt.2025.1610446 · Frontiers in Psychiatry · 2026-02-12

## TL;DR

This study tests a cognitive behavioral therapy called ReACT to improve outcomes for children with functional seizures by targeting their sense of control and catastrophic symptom expectations.

## Contribution

The study introduces ReACT as a structured cognitive behavioral treatment targeting specific psychological factors in pediatric functional seizures.

## Key findings

- The study will evaluate whether ReACT modifies key treatment targets like sense of control and catastrophic expectations.
- Results will determine if ReACT improves patient outcomes compared to supportive therapy.
- Findings may lead to a refined, evidence-based approach for treating pediatric functional seizures.

## Abstract

This manuscript outlines the methodology of a randomized controlled trial (Clinical Registry #: NCT06007053) that aims to assess sense of control and catastrophic symptom expectations as targets of Retraining and Control Therapy (ReACT) a cognitive behavioral treatment for pediatric functional seizures (FS). Participants will complete baseline assessments of treatment targets and other outcome measures. The intervention will consist of either 12 sessions of ReACT or supportive therapy (i.e., unstructured, discussion-oriented therapy). Treatment targets and other outcome measures will be assessed again at one-week post-treatment and two-months post-treatment. The findings of the outlined study will contribute to the growing body of research on FS treatment by evaluating the effectiveness of ReACT in modifying key treatment targets and improving patient outcomes. If successful, ReACT may offer a structured, evidence-based approach for addressing FS in pediatric populations. Future directions include further refinement of the intervention and exploration of factors that may contribute to symptom persistence and remission.

https://clinicaltrials.gov/study/NCT05096273, identifier NCT05096273.

## Full-text entities

- **Diseases:** mental illness (MESH:D001523), psychosis (MESH:D011618), COVID-19 (MESH:D000086382), physical, sexual, and emotional abuse (MESH:D000082002), bullying (MESH:D000073397), Anxiety (MESH:D001007), trauma (MESH:D014947), Epilepsy (MESH:D004827), vision changing (MESH:D014786), Catastrophic symptom (MESH:D002388), hypertension (MESH:D006973), intellectual disability (MESH:D008607), C (OMIM:211750), Pain (MESH:D010146), tremor (MESH:D014202), gum bleeding (MESH:C537732), seizure (MESH:D012640), Tic (MESH:D020323), PSC (MESH:D015209), epileptiform activity (MESH:D014277), depressed (MESH:D003866), ReACT (MESH:C536209), paralysis (MESH:D010243), emotional neglect (MESH:D058069), FND (MESH:D003291), Dysfunctional (MESH:D006331)
- **Chemicals:** cortisol (MESH:D006854), sertraline (MESH:D020280), ARTIC A25 (-), water (MESH:D014867)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12936724/full.md

## References

68 references — full list in the complete paper: https://tomesphere.com/paper/PMC12936724/full.md

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Source: https://tomesphere.com/paper/PMC12936724