Psilocybin‐assisted psychotherapy for treatment‐resistant depression: Which psychotherapy?
International Journal of Mental Health Nursing – August 17, 2023
Source: OpenAlex
Summary
For individuals with treatment-resistant depression, the hallucinogen psilocybin shows promise. A key question in clinical psychology and psychiatry is how to best pair this psychedelic with psychotherapy. Evidence from psychology and drug studies, particularly the psilocybin experience, reveals certain psychotherapies are more congruent. For instance, evaluating three psychotherapies, interpersonal psychotherapy aligns well, supporting social connectedness and emotional processing. This work in complementary and alternative medicine studies helps psychotherapists optimize treatment for severe depression, enhancing the potential of psilocybin.
Abstract
Abstract This perspective paper explores the choice of psychotherapy for psilocybin‐assisted psychotherapy for treatment‐resistant depression. There is evidence to support the use of some psychotherapies in treating ‘treatment‐resistant’ depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta‐synthesis of the experience of psilocybin. The paper will examine whether three one‐to‐one psychotherapies identified as effective in the treatment of treatment‐resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short‐term dynamic psychotherapy align with that experience, although others are currently being trialled.