Psychedelic-assisted therapy (PAT) is a promising treatment for conditions like treatment-resistant depression, substance use disorder, and PTSD. In palliative care, a single PAT session can produce lasting reductions in anxiety, depression, and demoralization—symptoms that harm quality of life for seriously ill and end-of-life patients. Although interest in psychedelics has revived, few resources exist for applying PAT in hospice and palliative care. This article provides 10 evidence-informed tips for palliative care clinicians, developed with international experts, to help familiarize teams with PAT, address legal and logistical barriers, discuss therapeutic competencies, and highlight approaches to maximize safety and benefits for patients and caregivers.
Researchers from palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapies identified seven key opportunities for advancing research on psychedelic-assisted therapy for people with serious illness. Four opportunities relate to science and design: clarifying which conditions the therapy is indicated for, developing and refining therapeutic protocols, investigating how set and setting affect outcomes, and understanding mechanisms of action. Three opportunities concern institutional and societal drivers: education and certification for therapists, regulations and funding, and diversity and inclusion. Participants also noted epistemological limitations of the medical model for understanding psychedelics' therapeutic value.
Meaning-centered psychotherapy (MCP) is a manualized, brief intervention that enhances meaning and purpose and appears to be a natural therapeutic partner for psilocybin-assisted therapy (PAT) in patients with cancer and major depressive disorder. In a phase 2 open-label trial, seven patients (ages 53-80) and six therapists (with 9-44 years of experience) participated in surveys and focus groups to adapt MCP for psilocybin. Focus groups highlighted the value of psilocybin experiences, group support, and MCP both separately and together. A 5-session model called MCP-PSIL was developed. The group format was emphasized, though individual MCP may be appropriate in some cases.