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Vivian W. L. Tsang

11 papers in the library · 34 citations · publishing 2023-2026

Papers

Safety and tolerability of intramuscular and sublingual ketamine for psychiatric treatment in the Roots To Thrive ketamine-assisted therapy program: a retrospective chart review.

Therapeutic Advances in Psychopharmacology January 1, 2023 Vivian W. L. Tsang, Brendan Tao, Shannon Dames et al. 19 citations

A retrospective chart review of 128 participants in a 12-week ketamine-assisted group therapy program found that the treatment was well tolerated, with no dropouts. Across 448 sessions, elevated blood pressure occurred after 49.16% of sessions, while nausea affected 12.05% of participant-sessions, vomiting 2.52%, headache 3.35%, and dizziness in seven participant-sessions. Adverse events were transient and resolved with rest or medication. The findings suggest good safety and tolerability for intramuscular and sublingual ketamine dosing in a community group psychotherapy setting.

“The mushroom was more alive and vibrant”: Patient reports of synthetic versus organic forms of psilocybin

Journal of Psychedelic Studies October 29, 2024 Pamela Kryskow, Paul Stamets, Joseph T. la Torre et al. 4 citations

In a program offering psilocybin-assisted therapy for end-of-life distress, participants received synthetic psilocybin, whole Psilocybe cubensis mushrooms, and a mycological extract on separate occasions. Post-treatment interview transcripts revealed broad consensus that all three forms were helpful and similar, generating visual and perceptual distortions, emotional and cognitive insight, and mystical experiences. However, synthetic psilocybin was described as feeling less natural and its overall quality of experience was inferior to the organic forms. These preliminary findings suggest that research should include whole psychedelic mushrooms and extract alongside synthetic psilocybin, given that traditional medicine keepers have used whole mushrooms and plant material for millennia.

Psychedelic-Assisted Therapy Training: An Argument in Support of Firsthand Experience of Nonordinary States of Consciousness in the Development of Competence.

Psychedelic Med (New Rochelle) September 4, 2024 Shannon Dames, Crosbie Watler, Pamela Kryskow et al. 4 citations

Training programs for psychedelic-assisted therapy should include firsthand experience of nonordinary states of consciousness as a core component for developing therapist competence. The argument centers on how direct engagement with altered states provides practitioners with essential insights into the therapeutic process, enhances empathy and understanding of patients' experiences, and improves the effectiveness of therapeutic guidance. This experiential learning is presented as critical for achieving optimal healing outcomes and treatment efficacy, rather than relying solely on theoretical knowledge or observational training.

A clinical protocol for group-based ketamine-assisted therapy in a community of practice: the Roots To Thrive model

Frontiers in Psychiatry September 22, 2025 Shannon Dames, Pamela Kryskow, Vivian W. L. Tsang et al. 3 citations

RTT-KaT is a structured, scalable, evidence-informed, and culturally responsive model that bridges clinical safety with both Western and Indigenous knowledge systems. A longitudinal follow-up study is currently underway to evaluate its long-term impact and guide future implementations.

A systematic review to assess the use of psilocybin in the treatment of headaches

European Psychiatry March 1, 2023 Saundarai Bhanot, Michelle Cq Lin, S. Bains et al. 3 citations

Psilocybin, a naturally occurring psychedelic compound, shows promise for treating various headaches, including migraines and cluster headaches. A systematic review of eight studies found that psilocybin use was associated with improvements in headache frequency, intensity, duration, and remission periods, with clinically significant improvements reported in six studies and statistically significant results in three. Macrodosing provided greater pain relief than microdosing or conventional medications, with 12.3% more participants experiencing pain reduction three days after a macrodose. However, side effects included hallucinations in 18% of essential headache patients and temporary increases in anxiety and pain (5.3% with microdosing, 14.1% with macrodosing). Psilocybin remains illegal in many countries, limiting further research.

Ketamine-Assisted Therapy Outcomes for First Responders With Comorbid Mental Health Diagnoses

Journal of Occupational and Environmental Medicine October 17, 2025 Vivian W. L. Tsang, Megan Kennedy, Tarun Walia et al. 1 citation

A qualitative case study of six firefighters with PTSD who completed a 12-week ketamine-assisted therapy program found that, beyond reducing PTSD symptoms, participants reported improvements in sleep problems, a changed relationship to music, better tolerance for sensory stimuli, and altered time perception. These themes suggest ketamine-assisted therapy may provide meaningful benefits that extend beyond symptom reduction.

Ketamine-assisted psychotherapy for posttraumatic stress disorder: a systematic review and individual participant data meta-analysis of predictors of treatment effects.

Psychotherapy and Psychosomatics June 19, 2026 Judith Rohde, Tyler M Moore, Kathryn Walker et al.

A systematic review and individual participant data meta-analysis of 12 studies (533 participants) found that higher baseline PTSD severity was the most robust predictor of symptom reduction after combined ketamine and psychotherapy. More psychotherapy sessions, more ketamine sessions, and shorter treatment duration were also associated with greater improvement, but these findings are tentative because most studies were of poor quality. The analysis showed that for each additional psychotherapy session, PTSD symptoms improved by an average of 1.03 points on the PCL-5, and for each additional ketamine session, improvement was 1.15 points. The results require confirmation in well-designed prospective trials.

Ritual in Psychedelic Therapy: A Principle-Based Framework

Human Arenas April 25, 2026 Shannon Dames, Grace Scharf, Vivian W. L. Tsang et al.

Ritual functions as a relational organizing container that stabilizes psychedelic therapy by regulating the nervous system, orienting attention, and anchoring meaning through predictable sequencing and symbolic framing. Without clear frameworks, ritual applications risk becoming prescriptive or ethically problematic, especially when borrowing from Indigenous traditions without relational accountability. A principle-informed framework translates these functions into consent-based, culturally humble, and autonomy-protective clinical practice, shifting from prescribed techniques to co-created processes across preparation, dosing, and integration. This approach supports flexible, relational care that honors cultural context, participant agency, and situated meaning-making.

Improving access to psilocybin-assisted therapy: barriers, challenges, and recommendations

Frontiers in Public Health January 29, 2026 Vivian W. L. Tsang, Camille Roney, Pamela Kryskow et al.

Psilocybin-assisted therapy (PAT) combines psilocybin with structured psychological support to address psychological, emotional, and existential distress, particularly at end of life. The therapy is relational in nature, recognizing that healing occurs through human connection. Roots to Thrive in Nanaimo, British Columbia, is the only multidisciplinary non-profit healthcare practice in Canada legally offering group PAT, primarily serving terminally ill patients. Between 2022 and late 2024, 471 Special Access Program (SAP) applications were submitted for psilocybin or MDMA in Canada, with about 318 approved.

Exploring patterns of concurrent substance use, psychedelic dosing and intentions, and childhood trauma in psychedelic use in college aged adults

Psychedelics January 18, 2026 Vivian W. L. Tsang, Tanner Jones, Sally Tsoi et al.

Among 1395 college-aged individuals (76% female), those who had ever used psychedelics reported lower rates of opioid use than those who had never used them, while rates of other substance use were similar between groups. Lifetime psychedelic use was not linked to reduced trauma symptoms, emotional dysregulation, or psychosocial difficulties after accounting for adverse childhood experiences, but it was associated with higher subjective spirituality. The findings suggest psychedelic use may be tied to lower opioid use without increasing other substance use, and may not improve trauma-related outcomes.

The effect of the Apollo Neuro device on anxiety among participants who underwent ketamine assisted therapy.

Journal of Psychiatric Research November 1, 2025 Vivian W. L. Tsang, Brendan Tao, Raimey Olthuis et al.

In a 12-week mental health treatment program combining ketamine-assisted therapy with group support, patients who used the Apollo Neuro wearable device, which provides silent vibration touch therapy, did not show significantly greater reductions in anxiety than those who did not use the device. Anxiety was measured with the GAD-7 questionnaire. After statistically matching participants for age, sex, and baseline anxiety levels, there was no significant difference between the groups (p = 0.63). Both groups showed a median reduction in anxiety symptoms, but the device did not provide an additional benefit beyond the treatment program alone.