Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model
William Brennan, William Brennan, Alexander Belser
Frontiers in Psychology June 2, 2022 DOI: 10.3389/fpsyg.2022.866018 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Interventions | EMBARK model psychedelic-assisted psychotherapy |
| Topics | Psychedelic-assisted therapy |
| Keywords | Psychedelic assisted therapy Psychedelic drugs Psychedelic drug use Robust psychological support Existing psychotherapy models New framework Embark Transdiagnostic Trans-drug approach This model Comprehensive ethical guidance Standardized therapist training Addresses these gaps Improving research utilization |
| Citations | 86 |
| Key points | Proposes the EMBARK model as a transdiagnostic, trans-drug framework for supportive psychotherapy in PAP clinical trials, designed to overcome limitations of prior models in conceptualizing therapeutic change and standardizing therapist interventions. |
Abstract
The current standard of care in most uses of psychedelic medicines for the treatment of psychiatric indications includes the provision of a supportive therapeutic context before, during, and after drug administration. A diversity of psychedelic-assisted psychotherapy (PAP) models has been created to meet this need. The current article briefly reviews the strengths and limitations of these models, which are divided into basic support models and EBT-inclusive therapy models. It then discusses several shortcomings both types of models share, including a lack of adequate attention to embodied and relational elements of treatment, and insufficient attention to ethical concerns. The article then introduces the EMBARK model, a transdiagnostic, trans-drug framework for the provision of supportive psychotherapy in PAP clinical trials and the training of study therapists. EMBARK was designed to overcome challenges that prior models have had in conceptualizing therapeutic change in psychedelic treatment, incorporating elements of non-psychedelic evidence-based therapies, incorporating therapists’ prior skills and clinical orientations, delimiting therapist interventions for research standardization, and determining specific factors that contribute to treatment outcomes. The article explains EMBARK’s six clinical domains, which represent parallel conceptualizations of how therapists may support therapeutic benefit in PAP treatment, and its four care cornerstones, which reflect therapists’ broad ethical responsibility to participants. The article describes how these elements of the model come together to structure and inform therapeutic interventions during preparation, medicine, and integration sessions. Additionally, the article will discuss how EMBARK therapist training is organized and conducted. Finally, it will demonstrate the broad applicability of EMBARK by describing several current and upcoming PAP clinical trials that have adopted it as the therapeutic frame.
Comparable studies
Other theoretical and historical papers on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. | 2024 | Theoretical or philosophical paper | |
| Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance | 2020 | Theoretical or philosophical paper | |
| Awe: a putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy | 2018 | Theoretical or philosophical paper | |
| Ethical and legal issues in psychedelic harm reduction and integration therapy | 2021 | Theoretical or philosophical paper | |
| Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations. | 2022 | Theoretical or philosophical paper |
Citations in the library
Cited by 76
- Psychedelic-assisted psychotherapy: where is the psychotherapy research? Psychopharmacology August 1, 2024
- Navigating groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences. PLoS One 2025
- Compass Psychological Support Model for COMP360 Psilocybin Treatment of Serious Mental Health Conditions American Journal of Psychiatry 2025
- Is the Requirement for First-Person Experience of Psychedelic Drugs a Justified Component of a Psychedelic Therapist's Training? Cambridge Quarterly of Healthcare Ethics March 2, 2023
- A rapid narrative review of the clinical evolution of psychedelic treatment in clinical trials. npj Mental Health Research July 2, 2024
and 71 more in the library
Cites 94
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Psychopharmacology July 7, 2006
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
and 89 more in the library