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Expert Opinion on Psychedelic-Assisted Psychotherapy for People with Psychotic Symptoms

Joseph T. la Torre, Mehdi Mahammadli, Kyle T. Greenway, Monnica T. Williams

Research Square (Research Square) January 25, 2022 preprint DOI: 10.21203/rs.3.rs-1241397/v1 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study
Sample size 12
Population Experts in psychiatry, clinical psychology, medicine, and psychedelics
Topics Psilocybin Psychedelic-assisted therapy
Keywords Psychotherapist Clinical psychology Alliance Expert opinion Hallucinogen
Citations 18
Key findings Psychedelic-assisted psychotherapy is not necessarily contraindicated for all individuals with psychotic symptoms, especially with highly supportive protocols.

Abstract

Abstract Background Currently, personal or familial histories of psychotic symptoms are exclusionary criteria for most psychedelic clinical trials, studies, and treatment programs. This study sought to determine why such an exclusion exists, what the implications of the exclusion criteria are, and if there was agreement in expert opinion.

Methods: In-depth interviews with 12 experts in the fields of psychiatry, clinical psychology, medicine, and the effects of psychedelics and entheogens were conducted in an expert consultation format. Interviews were transcribed and themes were produced using an Interpretative Phenomenological Analysis (IPA) approach.

Results: We found that while the exclusion criteria may be justified for psychedelic protocols that provide insufficient psychological support for participants, there was agreement that psychedelic-assisted psychotherapy is not necessarily contraindicated for all individuals with psychotic symptoms. Results suggest that highly supportive psychedelic-assisted psychotherapy may be of benefit to individuals experiencing symptoms of psychosis. Potentially relevant factors for predicting treatment outcomes include specific symptom endorsement, illness duration, symptom severity, quality of the therapeutic alliance, role of trauma in symptom etiology and perpetuation, and the level of other supports in the life of the client.

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

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