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Monnica T. Williams

University of Ottawa

20 papers in the library · 1,147 citations · publishing 2018-2024

Papers

Inclusion of people of color in psychedelic-assisted psychotherapy: a review of the literature

BMC Psychiatry July 31, 2018 Timothy I. Michaels, Jennifer Purdon, Alexis Collins et al. 256 citations

Minorities are greatly underrepresented in psychedelic medicine studies, so reported treatment outcomes may not apply to all ethnic and cultural groups. Including minorities in future studies and improving recruitment strategies are necessary to understand how well psychedelic-assisted psychotherapy works for people of color and to ensure equal opportunities for all to participate in this potentially promising treatment.

The psychedelic renaissance and the limitations of a White-dominant medical framework: A call for indigenous and ethnic minority inclusion

Journal of Psychedelic Studies July 1, 2019 Jamilah R. George, Timothy I. Michaels, Jae Sevelius et al. 222 citations

The resurgence of psychedelic science for treating psychiatric conditions like depression, PTSD, and addiction owes much to indigenous healing practices, yet the contributions of indigenous people, ethnic and racial minorities, women, and other disenfranchised groups are often overlooked in the mainstream narrative. This review first highlights the traditional role of psychedelic plants and summarizes the history of psychedelic medicine, then explores historical and sociocultural factors that have led to unequal research participation and treatment. It recommends broadening the Western medical framework to include a cultural focus and inclusive approaches for future treatment development and dissemination.

Psilocybin-assisted therapy of major depressive disorder using Acceptance and Commitment Therapy as a therapeutic frame

Journal of Contextual Behavioral Science January 1, 2020 Jordan Sloshower, Jeffrey R. Guss, R. Krause et al. 168 citations

A group designing a psilocybin-assisted therapy protocol for major depressive disorder adopted Acceptance and Commitment Therapy (ACT) as the psychotherapeutic framework, citing strong overlap between ACT's proposed mechanisms of change and those of psilocybin therapy. The psilocybin experience may provide direct experiential contact with ACT processes that increase psychological flexibility, which can then be reinforced during ACT-informed follow-up sessions. The paper describes the rationale for selecting ACT, areas of synergism between ACT and psilocybin therapy, the treatment model's structure, and its limitations.

People of color in North America report improvements in racial trauma and mental health symptoms following psychedelic experiences

Drugs Education Prevention and Policy December 10, 2020 Monnica T. Williams, Alan K. Davis, Yitong Xin et al. 100 citations

Psychedelics such as psilocybin, LSD, and MDMA may reduce symptoms of racial trauma among Black, Indigenous, and other people of color (BIPOC) after a racist experience. In a cross-sectional survey of 313 diverse BIPOC in the US and Canada, participants retrospectively reported mental health symptoms 30 days before and 30 days after using a psychedelic. Analysis showed significant decreases in traumatic stress, depression, anxiety, and stress following the experience. A strong positive relationship emerged between acute psychedelic effects (mystical-type, insight, and challenging experiences) and reductions in psychopathology, even after controlling for prior discrimination and time since the experience. The findings suggest psychedelics could lessen the negative impact of racial trauma, though further research on psychedelic-assisted therapy for race-based trauma is needed.

Culturally informed research design issues in a study for MDMA-assisted psychotherapy for posttraumatic stress disorder

Journal of Psychedelic Studies July 30, 2019 Monnica T. Williams, Sara Reed, Ritika Aggarwal 87 citations

Psychedelic drugs combined with psychotherapy can help people change, and MDMA-assisted psychotherapy is being studied for posttraumatic stress disorder by reducing fear of traumatic memories and increasing trust and compassion without blocking access to difficult emotions. However, research has largely excluded people of color, leaving important questions unaddressed. At the University of Connecticut, a study site in a MAPS-sponsored, FDA-reviewed Phase 2 open-label multisite trial focused on providing culturally informed care to ethnic minority participants.

Culture and psychedelic psychotherapy: Ethnic and racial themes from three Black women therapists

Journal of Evolutionary Psychology September 21, 2020 Monnica T. Williams, Sara Reed, Jamilah R. George 62 citations

African American women have been largely absent from psychedelic research as both participants and researchers, and little attention has been paid to how psychedelics might address traumas caused by racialization. In an FDA-approved clinical trial and training exercise, three African American female therapists each used MDMA once. The primary themes that emerged from their varied experiences were strength, safety, connection, and managing oppression/racialization. These experiences were personally meaningful and instructive for how Western models of psychedelic-assisted psychotherapy could be more effective and accessible to the Black community. The paper discusses the importance of facilitator training that incorporates cultural, racial, and spiritual themes, and considers Functional Analytic Psychotherapy as an adjunct to current psychedelic-therapy approaches.

Ethnoracial health disparities and the ethnopsychopharmacology of psychedelic-assisted psychotherapies.

Experimental and Clinical Psychopharmacology June 7, 2021 Colleen Fogg, Timothy I. Michaels, Sara de la Salle et al. 53 citations

Psychedelic-assisted psychotherapy (PAP) shows promise for treating substance use disorders, PTSD, depression, and anxiety in randomized, double-blind, placebo-controlled trials, but research has almost exclusively involved White populations in North America and Western Europe, neglecting Black, Indigenous, and People of Color (BIPOC). Ethnoracial differences in the metabolism, safety, and efficacy of psychotropic drugs are known from previous research, yet no studies have directly examined such differences for psychedelic pharmacology. This article argues that failing to include BIPOC in trials limits generalizability and overlooks biological and social factors affecting responses to PAP. It discusses limitations of ethnopsychopharmacology and advocates for expanded funding to address cultural, clinical, and public health needs.

Racial/ethnic differences in prevalence of hallucinogen use by age cohort: Findings from the 2018 National Survey on Drug Use and Health

Journal of Psychedelic Studies July 15, 2021 Zoe W. Jahn, Joel Lopez, Sara de la Salle et al. 36 citations

About 15.9% of the U.S. population over age 12 had used a hallucinogen at least once, and 2.0% had used one in the past year. Lifetime use was most common among non-Hispanic White and multi-racial individuals, while Black/African Americans reported the lowest rates. Past-year use was highest among White and multi-racial groups aged 12–34 and among White individuals aged 35–49. Hispanic individuals showed higher past-year use in the 12–17 age group but lower use in the 26–49 range. Black/African Americans had the lowest past-year use among 12–25 year olds. Adults 50 and older reported the lowest past-year use overall.

Expert Opinion on Psychedelic-Assisted Psychotherapy for People with Psychopathological Psychotic Experiences and Psychotic Disorders

International Journal of Mental Health and Addiction April 1, 2024 Joseph T. Torre, Mehdi Mahammadli, Sonya C. Faber et al. 31 citations

Experts in psychiatry, clinical psychology, and psychedelic research agree that excluding people with personal or family histories of psychosis, bipolar disorder, or similar conditions from psychedelic clinical trials may be justified only when protocols offer minimal psychological support. In interviews with 12 experts, themes derived from interpretative phenomenological analysis indicated that psychedelic-, ketamine-, and MDMA-assisted psychotherapy with high levels of support are not necessarily contraindicated for all such individuals and may benefit some. Factors like specific symptoms, illness duration, severity, therapeutic alliance, trauma's role, and available supports could help predict outcomes. More research is needed to develop a safe protocol for this population.

MDMA-assisted therapy for posttraumatic stress disorder: A pooled analysis of ethnoracial differences in efficacy and safety from two Phase 2 open-label lead-in trials and a Phase 3 randomized, blinded placebo-controlled trial

Journal of Psychopharmacology June 21, 2022 T. Ching, Monnica T. Williams, Julie B. Wang et al. 29 citations

In a pooled analysis of two Phase 2 open-label trials and one Phase 3 randomized placebo-controlled trial of MDMA-assisted therapy for PTSD, no significant difference in symptom reduction was found between BIPOC and non-Hispanic White participants who received MDMA. Among those given placebo-assisted therapy, BIPOC participants showed a trend toward greater improvement than non-Hispanic Whites. Non-Hispanic Whites had significantly larger reductions in PTSD symptoms with MDMA than with placebo, but no such treatment difference emerged among BIPOC participants. Adverse events were mostly mild or moderate across all groups. The findings suggest MDMA-assisted therapy is effective and safe across ethnoracial groups, though subgroup sizes were imbalanced.

Psychedelics and Racial Justice

International Journal of Mental Health and Addiction April 1, 2024 Monnica T. Williams, Victor Cabral, Sonya Faber 22 citations

Psychedelic-assisted therapies show promise for treating mental health disorders, but people of color and other marginalized groups have been largely excluded from clinical trials, leaving fundamental clinical issues unaddressed. A narrative review of relevant research on racial trauma, ethnic minority mental health, and psychedelic therapies suggests these treatments can advance recovery for people of color, while also highlighting potential harms. As many psychedelic therapy trials near completion and access expands, the paper argues for equitable research practices—including community-based participatory research and culturally informed design—to foster inclusion and culturally competent care.

Race, Ethnic, and Sex Differences in Prevalence of and Trends in Hallucinogen Consumption Among Lifetime Users in the United States Between 2015 and 2019

Frontiers in Epidemiology March 23, 2022 Alan K. Davis, Brooke J. Arterberry, Yitong Xin et al. 20 citations

Asian females had the highest prevalence of past-year hallucinogen use (35.06%), two or more times that of White males and females and Native American males. More than half of White males and females, Multiracial males, and Hispanic males had ever used psilocybin or LSD, while less than a quarter of Black males and females reported lifetime psilocybin use. Native American males had the lowest lifetime MDMA use (17.62–33.30%) but the highest lifetime peyote use (40.37–53.24%). Pacific Islander males had the highest lifetime mescaline use (28.27%), and Pacific Islander males and females had the highest lifetime DMT use (15.68–38.58%).

Expert Opinion on Psychedelic-Assisted Psychotherapy for People with Psychotic Symptoms

Research Square (Research Square) January 25, 2022 Joseph T. la Torre, Mehdi Mahammadli, Kyle T. Greenway et al. 18 citations

Experts agree that excluding people with personal or familial histories of psychotic symptoms from psychedelic-assisted psychotherapy may be justified only when protocols provide insufficient psychological support. With highly supportive therapy, such treatment is not necessarily contraindicated and may benefit individuals experiencing psychotic symptoms. Key factors for predicting outcomes include specific symptoms, illness duration, severity, therapeutic alliance quality, trauma's role, and the client's social supports.

Expert recommendations for Germany’s integration of psychedelic-assisted therapy

BMC Medical Education October 24, 2024 Susanne Birnkammer, Olga Chernoloz, Sergio R Pérez Rosal et al. 10 citations

As psychedelic-assisted therapy (PAT) advances to phase III trials in the USA, Europe, particularly Germany, must develop professional education and regulatory frameworks to catch up. Australia has already approved MDMA and psilocybin for mental health, Ukraine is exploring MDMA for war-related PTSD, and Switzerland restarted restricted medical use of MDMA and LSD around 2014, establishing precedents for nations where these substances were illicit. Key challenges include practitioner training standards, accessibility, and oversight. The paper outlines ethical considerations, training protocols, and governmental roles for building infrastructure in Germany to support PAT rollout, aiming to influence broader European policy and help Europe reclaim its historical lead in psychiatric innovation.

MDMA-Assisted Therapy for Posttraumatic Stress Disorder: A Mixed-Methods Case Study of a Participant of Color From an Open-Label Trial

Journal of humanistic psychology February 10, 2022 Terence H. W. Ching, Monnica T. Williams, S. Reed et al. 10 citations

A mixed-methods case study examined whether a person of color with treatment-resistant PTSD would benefit from MDMA-assisted therapy (MDMA-AT) as much as participants in earlier, less diverse trials. The participant showed quantitative improvement in PTSD symptoms. An interpretative phenomenological analysis of therapy session transcripts revealed recurrent themes related to psychological mechanisms of symptom change, reduced PTSD symptoms, and additional positive and negative effects beyond symptom reduction. The authors discuss these themes and offer recommendations for addressing culturally relevant material during MDMA-AT.

Dr. Valentina Wasson: Questioning what we think we know about the foundations of psychedelic science

Journal of Evolutionary Psychology September 21, 2020 Monnica T. Williams, Amy Bartlett, Tim Michaels et al. 7 citations

Equity and diversity are essential for inclusive psychedelic research, yet oversights and misattributions of key figures persist. Dr. Valentina Pavlovna Wasson, an important early contributor to Western psychedelic science, remains under-recognized. Researchers must critically examine the foundations of psychedelic studies with an intersectional lens to avoid replicating social and cultural inequalities in the field's research and history.

Experiences of psychedelic drug use among people with psychotic symptoms and disorders: Personal growth and mystical experiences

Journal of Psychedelic Studies July 31, 2024 Joseph T. la Torre, Jade Gallo, Mehdi Mahammadli et al. 6 citations

Most people with a history of psychotic experiences or diagnoses who used psychedelics reported personal growth, mystical-type experiences, improved insight, and feelings of love and appreciation. In an online retrospective survey of 100 such individuals, 88% said their psychedelic experience led to some degree of personal growth. However, 11% described overall negative experiences including symptom exacerbation, dysphoria, and terror, and a slightly larger portion reported mixed experiences. The findings suggest that while many individuals with psychotic histories may benefit from psychedelic experiences, a notable minority experience adverse effects, challenging assumptions that this group should be universally excluded from psychedelic research.

Exploring effects and experiences of ketamine in group couples therapy

Journal of Psychedelic Studies May 6, 2024 Mark Cornfield, S. Mcbride, Joseph T. la Torre et al. 6 citations

Ketamine-assisted therapy, when given to both partners during Imago Relationship Therapy, produces a wide range of effects including empathogenic, mystical, anxiolytic, and antidepressant experiences. Participants reported heightened awareness, vulnerability, and communication, along with lower defenses and novel somatic sensations. The drug's short duration, rapid onset, and cumulative effects were noted, alongside transient mild side-effects. Statistical tests indicated improved relationship satisfaction after treatment. The findings suggest ketamine may have therapeutic benefits in couples therapy under clinical supervision, but more research is needed.

“The mushroom was more alive and vibrant”: Patient reports of synthetic versus organic forms of psilocybin

Journal of Psychedelic Studies October 29, 2024 Pamela Kryskow, Paul Stamets, Joseph la Torre et al. 4 citations

In a program offering psilocybin-assisted therapy for end-of-life distress, participants received synthetic psilocybin, whole Psilocybe cubensis mushrooms, and a mycological extract on separate occasions. Post-treatment interview transcripts revealed broad consensus that all three forms were helpful and similar, generating visual and perceptual distortions, emotional and cognitive insight, and mystical experiences. However, synthetic psilocybin was described as feeling less natural and its overall quality of experience was inferior to the organic forms. These preliminary findings suggest that research should include whole psychedelic mushrooms and extract alongside synthetic psilocybin, given that traditional medicine keepers have used whole mushrooms and plant material for millennia.

The Ethic of Access: An AIDS Activist Won Public Access to Experimental Therapies, and This Must Now Extend to Psychedelics for Mental Illness

Frontiers in Psychiatry July 5, 2021 Morgan Campbell, Monnica T. Williams

Patients with mental illnesses should have the same access to promising experimental therapies, including psychedelics, as patients with other conditions. The principle of early access to experimental treatments, advanced by activist Larry Kramer during the AIDS pandemic, is now standard in medicine for diseases like cancer and infectious diseases. Psychiatry has failed to provide similar expanded access during public health emergencies, psychological crises, and pandemics, despite patient preferences and community needs. The field must align with the rest of medicine and let patient preferences guide policy and law on unapproved medications such as psychedelics.