“Why would you open someone’s brain up?” Lived experience insights inform a psilocybin-assisted psychotherapy treatment manual for body image disturbance
Claire Finkelstein, Olivia Soha, Alana Roy, Andrea Phillipou, Susan L. Rossell
Research Square (Research Square) July 27, 2023 preprint DOI: 10.21203/rs.3.rs-3189970/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study, co-design |
|---|---|
| Sample size | 6 |
| Population | Adult women with lived or living experience of anorexia nervosa and associated body image disturbance |
| Intervention | Psilocybin-assisted psychotherapy |
| Topics | Psilocybin Psychedelic-assisted therapy |
| Keywords | Thematic analysis Psychological intervention Psychotherapist Psychoeducation Ambivalence Clinical psychology Eating disorders Psychosocial Qualitative research |
| Citations | 2 |
| Key findings | A co-designed psilocybin-assisted psychotherapy treatment manual for body image disturbance in anorexia nervosa was developed, informed by lived-experience feedback identifying challenges with uncertainty, harm avoidance, alexithymia, and interoceptive impairment. |
Abstract
Abstract
Background: Body Image Disturbance (BID) is the distorted experience of one’s body. BID presents a risk for the onset, maintenance and relapse of body dysmorphic disorder and eating disorders, including anorexia nervosa (AN). Current treatments tend to focus on the cognitive and behavioural aspects while overlooking the perceptual symptoms and BID frequently persists beyond physical recovery. Psilocybin-assisted psychotherapy (PAP) may bridge the gap in current BID treatments by addressing perceptual and affective symptoms. This study sought to inform the development of a PAP treatment manual for BID in AN, through a co-design process informed by individuals with lived/living experience of AN.
Methods: A Lived Experience Panel (LEAP) comprising six adult women who had a lived or living experience of AN and associated BID were presented with the proposed treatment protocol, including therapeutic interventions, and invited to provide feedback. An experiential, relativist framework informed reflexive thematic analysis of the LEAP data.
Results: Reflexive thematic analysis of the LEAP data identified three central themes: enduring uncertainty; managing internal experience, and ambivalence in recovery. The LEAP also proposed strategies to address the challenges they identified and enhance the treatment manual more broadly.
Conclusions: The LEAP identified challenges associated with intolerance of uncertainty, harm avoidance, alexithymia, and interoceptive impairment. The LEAP provided feedback that directly informed adaptations to the PAP treatment manual, including graduated interventions, the inclusion of nominated supports, and comprehensive psychoeducation for participants and their supports. Accordingly, a PAP treatment manual to treat BID for individuals with AN has been developed through lived experience co-design.
Comparable studies
Other qualitative studies on psilocybin and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression enrolled in an open-label trial of psilocybin | 2017 | Qualitative study | n = 20 |
| Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis Adults aged 22 to 69 with clinically elevated anxiety associated with a cancer diagnosis | 2017 | Qualitative study | n = 13 |
| Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts Participants who completed a psilocybin-facilitated smoking cessation pilot study | 2018 | Qualitative follow-up study using semi-structured interviews and thematic analysis | n = 12 |
| Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress Adult participants with clinically elevated anxiety associated with a cancer diagnosis | 2017 | Qualitative study using interpretative phenomenological analysis | n = 13 |
| Reports of self-compassion and affect regulation in psilocybin-assisted therapy for alcohol use disorder: An interpretive phenomenological analysis. non-Hispanic White cisgender men and women with alcohol use disorder | 2023 | Qualitative study | n = 13 |