Frontiers in Psychiatry
November 3, 2022
Lauren Okano, Bri Deyo, Alida Brandenburg et al.
24 citations
Research on psychedelic-assisted therapies is growing, but few studies examine extra-pharmacological factors that may influence treatment efficacy. One critical factor is the therapeutic setting—the physical and socio-cultural environment where the drug session occurs. Despite consensus that setting matters, recommendations for reporting key setting variables remain sparse. This paper reviews what is known about setting's influence, focusing on MDMA-assisted therapy, and proposes reporting guidelines for clinical trials based on MDMA-for-PTSD research. The authors suggest expanding these to include the subject's mood, expectations, and psychological condition once that area matures. The guidelines aim to increase data for future empirical study while preserving practitioner and patient autonomy.
Frontiers in psychology
January 1, 2024
Kelley C O'Donnell, Lauren Okano, Michael Alpert et al.
A conceptual framework for MDMA-Assisted Therapy for PTSD centers on the participant's inner healing intelligence as the primary agent of change, with the therapeutic relationship as the core facilitative condition. This inner-directed, holistic, self-directed, relational, and trauma-informed approach includes a non-pathologizing stance toward embodied experiences, such as intense emotional expression, multiplicity, suicidal ideation, and transpersonal experiences. Therapists bring psychodynamic, somatic, and transpersonal awareness, empathic attunement, relational skillfulness, and cultural humility. MDMA with this psychotherapy outperformed placebo with psychotherapy in Phase 2 and 3 trials, though significant symptom reduction also occurred in the placebo group, supporting the psychotherapy model itself.
Kelley O'Donnell, Michael Alpert, Lauren Okano et al.
preprint
MDMA-Assisted Therapy for PTSD uses a short-term, intensive psychotherapy model that includes three sessions facilitated by MDMA along with non-drug therapy sessions. The MDMA helps recall and process traumatic memories and enhances learning in social contexts, integrating top-down and bottom-up trauma care. This paper describes the psychotherapeutic concepts and theories behind this approach, centering on the participant's inner healing intelligence as the main agent of change, with the therapeutic relationship as a core facilitative condition. Phase 2 and 3 trials showed MDMA with therapy outperformed placebo with therapy in reducing PTSD symptoms, though significant symptom reduction also occurred in participants who received only therapy.