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Understanding Psychedelic-Assisted Psychotherapy Providers' Perspective and Insights: A Qualitative Analysis.

Crystal Lederhos Smith, Nathan Sackett, Brian Connor Stark, Victoria Dinh, Ellen Wager Romesburg, John Roll

Psychedelic medicine (New Rochelle, N.Y.) September 1, 2024 DOI: 10.1089/psymed.2023.0074 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study Peer reviewed
Population Underground psychedelic-assisted psychotherapy providers
Intervention psychedelic-assisted psychotherapy
Topics LSD MDMA Psilocybin Psychedelic-assisted therapy
Keywords Psychedelic healing Empathogen Psychedelic facilitators Psychedelic medicine Trip sitters Underground therapists Treatment methods
Citations 4
Key findings Underground guides articulated consistent yet flexible processes and believed client benefit came from clients' own intrinsic ability to heal, while expressing dissonance about legalization.

Abstract

There is increasing interest in the use of psychedelics for therapeutic and recreational use. Research has been hindered by federal prohibition, put in place in 1970. Despite the regulatory difficulty, research has rapidly expanded in the past decade. Multiple states and cities have drafted their own policies regarding the use of psychedelics. Assuming interest in psychedelics continues to expand; every opportunity should be explored to better understand how psychedelics may be helping or harming people. This study examined underground psychedelic-assisted psychotherapy providers' protocols and perspectives, to better inform policy and public health, as psychedelics increasingly are used in the United States. Transcripts of interviews were examined through qualitative content analysis. The following four themes were identified: (1) personal experiences and self-healing motivated sharing and promotion of the positive effects of psychedelics as an expression of altruism, (2) guides articulated consistent, yet flexible processes, (3) guides believed that the client benefit was actualized through their own intrinsic ability to heal themselves, and (4) guides expressed an overwhelming sense of dissonance regarding psychedelic legalization, not only desiring increased access and decreased risk but also expressing concern about potential negative impacts on provider flexibility, and depersonalization that could come with standardizing this field of practice. In order for current research and policy to be best informed, information must be gathered from both clinical trials and observational studies of current practice. This study identified themes within the latter to provide perspectives, practices, and insights of current underground practice, so it can be used to inform research and policy moving forward.

Comparable studies

Other qualitative studies on 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
LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects Patients with anxiety associated with life-threatening diseases 2014 Prospective follow-up with qualitative content analysis n = 10
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
The hidden therapist: evidence for a central role of music in psychedelic therapy Patients undergoing psychedelic therapy with psilocybin for treatment-resistant depression 2018 Qualitative study n = 19

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