Journal of Humanistic Psychology
April 2, 2022
Mitch Earleywine, Fiona Low, Carmen Lau et al.
47 citations
Integration therapy, a key part of psychedelic-assisted treatment, helps people make sense of their psychedelic experiences after the drug's effects wear off. In interviews with 30 integration therapists, 19 themes emerged reliably. Therapists commonly defined integration as a bridge between the psychedelic experience and daily life, expressed concern about nonresponsive clients, and worried about the commercialization of psychedelic psychotherapy. They viewed integration as a process that starts before substance use, never ends, makes sense of the experience, creates behavioral change, is personalized, and makes the individual whole. Many also discussed client resistance, unrealistic expectations, power differentials, the need for connections to other providers, and self-care. The findings may help standardize integration therapy and inform future research.
Journal of Psychoactive Drugs
March 23, 2022
Mitch Earleywine, Fiona Low, Brianna R. Altman et al.
31 citations
People with depressive symptoms consider it somewhat important that guides in psilocybin-assisted therapy have personally used psilocybin. In a survey of over 800 MTurk respondents with depressive symptoms, ratings for the importance of a guide who had used psilocybin exceeded the "somewhat important" level (50 on a 0–100 scale) and were higher than ratings for other guide qualities and for a cognitive behavioral therapist who shared demographics, had depression experience, or received personal therapy. People of color and those with prior therapy gave even higher importance ratings. Participants listed similar desired qualities—proper training and empathy—for both psilocybin guides and CBT therapists. The findings suggest that guides who have used psilocybin and inform clients might enhance therapy's antidepressant effects for some clients.
American Journal of Psychiatry
January 1, 2024
Mitch Earleywine, Joseph A. de Leo, Dinesh Bhayana et al.
23 citations
No Summary
Journal of Psychoactive Drugs
January 1, 2023
Zachary Herrmann, Mitch Earleywine, Joseph A. de Leo et al.
19 citations
Subjective responses to psychedelic drugs, such as mystical experiences and oceanic boundlessness, often correlate with therapeutic improvements in conditions like treatment-resistant depression, end-of-life anxiety, and substance use disorders. Measuring these responses is challenging; several scales show good reliability and factor structure, but samples are often small and self-selected. This review examines the psychometric properties of widely used scales and their links to treatment outcomes. Challenging experiences, psychological insight, and emotional breakthroughs also show promise, though replication is needed. A collaborative approach to data collection on subjective reactions in therapeutic settings could help predict improvement across conditions.
Psychedelic medicine (New Rochelle, N.Y.)
June 1, 2024
Ryan Yermus, John Bottos, Nathan Bryson et al.
13 citations
Ketamine-assisted psychotherapy (KAP) produces sustained reductions in anxiety, depression, and PTSD symptoms lasting up to 5 months after the last session. In a retrospective study of adults with treatment-resistant major depressive disorder, generalized anxiety disorder, or PTSD who received KAP across 11 North American clinics, large treatment effects were detected at 3 months (Cohen's d = 0.75-0.86) and sustained at 6 months (d = 0.61-0.73). Case reductions ranged from 39% to 41% at 3 months and 29% to 37% at 6 months. However, high attrition rates (82% at 3 months, 95% at 6 months) may limit validity of the results.
Journal of Psychedelic Studies
June 1, 2020
Mitch Earleywine, Joseph A. de Leo
12 citations
Antidepressant medications alone help only one in four patients and rarely outperform placebos, while psychotherapies yield better outcomes and combining both helps only 65% of clients who complete treatment. Psychedelics may improve depression through mechanisms overlapping with psychotherapy and some novel ones, suggesting their combination could work very well. Subjective experiences during psychedelic sessions correlate with improvement, so guiding clients to focus on targeted thoughts and feelings could enhance outcomes. Clinical trials of psychedelic-assisted, empirically supported treatment with guided sessions are needed, including preparatory, administration, integration, and follow-up components for maximum impact.
Cannabis
July 11, 2022
Mitch Earleywine, Maha N. Mian, Brianna R. Altman et al.
11 citations
People who use cannabis expect that a cannabis-assisted psychotherapy session, modeled on psychedelic-assisted psychotherapy, would reduce depression. Over 500 participants in each of two studies imagined such a session and reported expected antidepressant effects. Expected reductions in depression were linked to anticipated psychedelic-like subjective experiences, such as mystical-type feelings, and also to expected changes in dysfunctional attitudes—a separate pathway that resembles how cognitive therapy works. These findings support calls for clinical trials of cannabis-assisted psychotherapy and indicate that users anticipate it would work through mechanisms similar to both psychedelics and cognitive therapy.
Journal of Psychoactive Drugs
April 20, 2021
M. Earleywine, Brianna R. Altman, Joseph A. de Leo
8 citations
People with depressive symptoms find a combination of ketamine and cognitive behavioral therapy (CBT) as credible as CBT alone, and both are seen as more credible than ketamine alone. Those who have had psychotherapy before tend to view ketamine as less credible. Depression severity does not relate to credibility ratings. The findings suggest that potential clients are cautious about ketamine despite media attention, and that providing balanced treatment descriptions may reveal important credibility information.
Journal of Psychedelic Studies
March 5, 2024
Mitch Earleywine, Alyssa B. Oliva, Joseph A. de Leo et al.
6 citations
Internal Family Systems (IFS) therapy, which views the mind as composed of multiple subpersonalities or 'parts' shaped by trauma, has gained popularity, particularly in psychedelic-assisted treatments. However, outcome data for applying IFS to post-traumatic stress disorder are limited, and its theoretical assumptions are difficult to test. The model's appeal highlights a problem with how empirically supported treatments are perceived. Ethical recommendations for presenting IFS include providing detailed psychoeducation about evidence-based treatments, being candid about the experimental nature of alternatives, monitoring progress, and watching for harm. Drawing on IFS's appealing features to improve perceptions of validated treatments may attract more clients and reduce dropout while awaiting empirical evidence.
Journal of Humanistic Psychology
September 22, 2023
Mitch Earleywine, Maha N. Mian, Joseph A. de Leo
5 citations
Expectations about psychedelics are understudied despite their powerful subjective effects. In over 500 people who have used psilocybin, expectancies about antidepressant effects correlated with specific subjective experiences—mystical experiences, ego dissolution, and emotional breakthrough—that previous work linked to depression improvement. Current depressive symptoms, ego dissolution, and emotional breakthrough each predicted unique variance in expected antidepressant effects, but mystical experience expectancies did not. Demographic factors and general hallucinogen involvement showed only weak correlations. These findings suggest that psilocybin users hold relevant expectancies about subjective and antidepressant effects, which could influence treatment outcomes and deserve monitoring in clinical trials.
Journal of Psychoactive Drugs
January 3, 2022
Brianna R. Altman, Mitch Earleywine, Joseph A. de Leo
4 citations
People with depressive symptoms view cognitive-behavioral therapy (CBT) as more credible than psilocybin-assisted therapy (PAT). In a study of 803 adults recruited from Amazon's MTurk, participants read descriptions of each therapy and rated their credibility. Those with prior therapy experience rated CBT higher than those without. Men and individuals who had used hallucinogens rated PAT more favorably than women and non-users. Other demographic and clinical factors explained little of the variation in credibility ratings. The findings suggest that potential clients are cautious about PAT, and researchers and clinicians should consider patients' treatment beliefs as possible predictors of outcomes.
Journal of Psychedelic Studies
July 11, 2024
Alyssa B. Oliva, Mitch Earleywine, Fiona Low et al.
In a survey of 635 adults in the United States, the importance people place on having a therapist of the same gender or same race differs by the type of therapy and by the participant's own race and gender. For both cognitive behavioral therapy (CBT) and psychedelic-assisted therapy (PAT), racial and ethnic minority participants and female participants rated a same-gender practitioner as more important than did White or male participants. A same-gender CBT therapist was rated as more important than a same-gender PAT guide.
Cognitive and Behavioral Practice
April 1, 2025
M. Earleywine, Henry A MacConnel, Joseph A. de Leo
Metaphors used in psychedelic-assisted therapy (PAT) shape client expectations and outcomes, yet few publications address their deliberate use within a cognitive-behavioral framework. Common metaphors like journeys, brain rewiring, and medicines may not suit all clients or align with learning-focused interventions. This paper introduces baseball's "batting practice" as an alternative metaphor, emphasizing autonomy, agency, responsibility, and the incremental skill-building nature of PAT. Depicting the therapist as a coach reimagines therapy as active engagement, ongoing effort, gradual improvements, and periods of progress and stagnation, paralleling integration processes. The metaphor highlights process over outcomes, persistence, patience, mindfulness, and teamwork. Potential shortcomings are noted to encourage flexibility and collaborative metaphor selection for optimizing outcomes in psychedelic-assisted CBT.