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Dosing and Therapeutic Conduct in Administration Sessions in Substance-Assisted Psychotherapy: A Systematized Review

Sascha Thal, Michelle Wieberneit, Jason M. Sharbanee, Petra Skeffington, Raimondo Bruno, Tobias Wenge, Stephen Bright

Journal of Humanistic Psychology May 3, 2023 Peer reviewed DOI: 10.1177/00221678231168516 via OpenAlex

Summary

The review highlights a lack of rigorous evidence on the best therapeutic practices during administration sessions of serotonergic psychedelics in substance-assisted psychotherapy. A total of 82 sources were synthesized, covering various aspects such as substances, dosages, and client experiences. However, most evidence is anecdotal, indicating that key components of these therapeutic interventions are still uncertain and require further systematic investigation.

Study at a glance

Design systematic review
Sample size 82
Population literature on serotonergic psychedelics and entactogens in psychotherapy
Key finding Most available evidence regarding therapeutic conduct during administration sessions is anecdotal and lacks rigorous research.

Abstract

While the potential of serotonergic psychedelics and related substances as adjuncts in substance-assisted psychotherapy (SAPT) has been investigated for the treatment of several disorders, evidence for the appropriate therapeutic conduct in administration sessions is sparse. In this article, we discuss the current evidence for best therapeutic practice during administration sessions with serotonergic psychedelics and entactogens as adjuncts to psychotherapy. We conducted a systematized review of the literature following PRISMA guidelines. PsycINFO, MEDLINE, and Cochrane Library databases were searched. Clinical trials, treatment manuals, study protocols, qualitative studies, case studies, descriptive studies, opinion papers, reviews, book chapters, and conference proceedings published until February 1, 2022 were retrieved. The final synthesis included k = 82 sources. Information about substances, dosages, number of administration sessions, issues that are common for clients, different types of experiences, music, and therapeutic conduct was summarized, compared, and critically discussed. The effects different therapeutic models, methods, techniques, and more complex interventions each have on the therapeutic outcome have not been investigated by means of rigorous research. Most of the available evidence we retrieved was anecdotal limiting any conclusive statements regarding appropriate therapeutic conduct during administration sessions. Consequently, essential components of therapeutic interventions remain largely tentative, necessitating systematic investigation.

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