Psychedelic-assisted psychotherapy: Where is the psychotherapy research?
OpenAlex – November 06, 2023
Source: OpenAlex
Summary
Despite the widespread assumption that psychotherapeutic support is vital for psychedelic-assisted medicine, there's a striking absence of empirical data on its specific role. As clinical trials for these compounds, influencing neurotransmitter receptors, transition to evaluating efficacy for mental health, understanding the psychotherapist's role in this intervention becomes paramount. Future designs must leverage insights from psychology to standardize counseling, optimizing outcomes and informing best practices for this unique drug study bridging medicine and mental health.
Abstract
Rationale: Psychedelic-assisted psychotherapy (PAP) has emerged as a potential treatment for mental health conditions, such as substance use disorders and depression. The current model for PAP emphasizes the importance of psychotherapeutic support before, during, and after ingestion of a psychedelic to maximize safety and clinical benefit. Despite this ubiquitous assumption, there has been surprisingly little empirical study concerning the “psychotherapy” in PAP, leaving critical questions about the necessary and sufficient components of PAP unanswered. Objectives: As clinical trials for psychedelic compounds begin the transition from demonstrating safety and feasibility to evaluating efficacy, the role of the accompanying psychotherapy must be better understood to enhance scientific understanding of the mechanisms underlying therapeutic change, optimize clinical outcomes, and ensure safety.Results: The present paper first reviews the current status of psychotherapy in the PAP literature, overviewing both published clinical trial psychotherapy models and putative models informed by theory. We then delineate lessons that PAP researchers can leverage from traditional psychotherapy research regarding standardizing treatments, identifying mechanisms of change, and optimizing clinical trial designs. Throughout this review, we underscore the need for increased research on the psychotherapeutic component of treatment in PAP. Conclusions: PAP is a highly unique and transdisciplinary intervention, and future research designs should consider transdisciplinary research methodologies to identify best practices and inform federal guidelines for PAP administration.