Palliative care provider attitudes toward existential distress and treatment with psychedelic-assisted therapies
Halsey F Niles, Colleen Fogg, Ben Kelmendi, Mark Lazenby
BMC Palliative Care December 26, 2021 DOI: 10.1186/s12904-021-00889-x (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 19 |
| Population | Palliative care clinicians (physicians, advanced practice nurses, chaplains, social workers, psychologist) from multiple US sites |
| Topics | End-of-life distress Psilocybin Psychedelic-assisted therapy |
| Keywords | Demoralization Psychedelic-assisted therapy psilocybin Powerful future tool Severe spiritual distress Refractory existential distress Palliative care physicians Nurses Spiritual/psychological staff |
| Key findings | Palliative care clinicians view PAT as a promising but not yet ready tool for treating existential distress, citing the need for a stronger evidence base and resolution of barriers related to stigma, education, and integration into existing care models. |
Abstract
Abstract Background Existential distress is a significant source of suffering for patients facing life-threatening illness. Psychedelic-Assisted Therapies (PAT) are novel treatments that have shown promise in treating existential distress, but openness to providing PAT may be limited by stigma surrounding psychedelics and the paucity of education regarding their medical use. How PAT might be integrated into existing treatments for existential distress within palliative care remains underexplored.
Methods: The present study aimed to elucidate the attitudes of palliative care clinicians regarding treatments for existential distress, including PAT. We recruited palliative care physicians, advanced practice nurses, and spiritual and psychological care providers from multiple US sites using purposive and snowball sampling methods. Attitudes toward PAT were unknown prior to study involvement. Semi-structured interviews targeted at current approaches to existential distress and attitudes toward PAT were analyzed for thematic content.
Results: Nineteen respondents (seven physicians, four advanced practice nurses, four chaplains, three social workers, and one psychologist) were interviewed. Identified themes were 1) Existential distress is a common experience that is frequently insufficiently treated within the current treatment framework; 2) Palliative care providers ultimately see existential distress as a psychosocial-spiritual problem that evades medicalized approaches; 3) Palliative care providers believe PAT hold promise for treating existential distress but that a stronger evidence base is needed; 4) Because PAT do not currently fit existing models of existential distress treatment, barriers remain.
Conclusions: PAT is seen as a potentially powerful tool to treat refractory existential distress. Larger clinical trials and educational outreach are needed to clarify treatment targets and address safety concerns. Further work to adapt PAT to palliative care settings should emphasize collaboration with spiritual care as well as mental health providers and seek to address unresolved concerns about equitable access.
Comparable studies
Other qualitative studies on psilocybin for end-of-life distress, most cited first.