Expert Opinion on Psychedelic-Assisted Psychotherapy for People with Psychopathological Psychotic Experiences and Psychotic Disorders
Joseph T. Torre, Mehdi Mahammadli, Sonya C. Faber, Kyle T. Greenway, Monnica T. Williams
International Journal of Mental Health and Addiction April 1, 2024 Peer reviewed DOI: 10.1007/s11469-023-01149-0 via Springer Nature
Summary
Experts agree that excluding people with personal or family histories of psychosis from psychedelic therapy may be justified when protocols offer minimal psychological support, but such treatments are not necessarily contraindicated for all. With high levels of support, psychedelic-, ketamine-, and MDMA-assisted psychotherapy may benefit some individuals experiencing psychotic conditions. Relevant factors for outcomes include specific symptoms, illness duration, severity, therapeutic alliance, trauma's role, and external support. More research is needed to determine risks and develop tailored protocols.
Study at a glance
| Design | qualitative study |
|---|---|
| Sample size | 12 |
| Population | experts in psychiatry, clinical psychology, medicine, and psychedelic effects |
| Key finding | Experts agreed that psychedelic-assisted psychotherapy with high support may benefit some individuals with psychotic conditions, but more research is needed. |
Abstract
Currently, individuals with personal or familial histories of psychopathological experiences of psychosis, psychotic spectrum disorders, bipolar disorder, and similar conditions are excluded from most psychedelic clinical trials, studies, and treatment programs. This study sought to determine why such an exclusion exists, what the implications of the exclusion criteria are, and if there was agreement in expert opinion. In-depth interviews with 12 experts in the fields of psychiatry, clinical psychology, medicine, and the effects of psychedelics were conducted in an expert consultation format. Interviews were transcribed, and themes were produced using an interpretative phenomenological analysis (IPA) approach. We found that while the exclusion criteria may be justified for psychedelic protocols that provide minimal psychological support for participants, experts agreed that psychedelic-, ketamine-, and MDMA-assisted psychotherapy are not necessarily contraindicated for all individuals within this group. Rather, results suggest that psychedelic-assisted psychotherapy as well as therapy with MDMA and ketamine, which include high levels of support, may be of benefit to some individuals experiencing said conditions and symptoms. Potentially relevant factors for predicting treatment outcomes include specific symptom endorsement, illness duration, symptom severity, quality of therapeutic alliance, role of trauma in symptom etiology and perpetuation, and the level of other supports in the client’s life. An analysis of expert opinions revealed that psychedelic-assisted psychotherapy can potentially benefit people with psychopathological psychosis and psychotic conditions under the right conditions. However, more research needs to be carried out to determine the risks and develop a protocol specific to this population.