The ethical use of therapeutic touch in psychedelic-assisted therapy: a qualitative study of researcher perspectives and experiences.

Physical touch is often used as a supportive tool in psychedelic-assisted therapy, but participants under the influence of psychedelics have reduced capacity to consent and are more suggestible. Interviews with 16 researchers revealed three themes: flexible frameworks, therapeutic alliance, and boundary management. Researchers noted that consent to therapeutic touch should be established before dosing sessions and continually managed. Flexibility in consent protocols helped build therapeutic alliance but also created challenges in boundary management. Researchers emphasized the need for clearer ethical guidelines for handling changing preferences during dosing sessions and limits on expanding consent after drug administration.

Study at a glance

Abstract

Physical touch is often included as a supportive or therapeutic tool in psychedelic-assisted therapy (PAT), involving instrumental forms of physical contact, supportive touch and somatic techniques. However, participants under the influence of psychedelics have reduced capacity to provide consent, are more suggestible and may experience and interpret therapeutic touch in ways they did not expect prior to taking the drug. Yet little research has been conducted on the considerations and approaches to therapeutic touch in clinical trials of PAT. This study explored the experiences and perspectives of PAT researchers on the use and consent to therapeutic touch in clinical trials of PAT. A qualitative study using semi-structured interviews. Sixteen PAT researchers involved in clinical trials of PAT were interviewed. Reflexive thematic analysis was used to analyse the data. The reporting of this study conforms to the Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). Three themes were uncovered through reflexive thematic analysis: (1) flexible frameworks, (2) therapeutic alliance and (3) boundary management. Researchers discussed consent challenges across the broad spectrum of physical contact existing in PAT protocols at the time. Researchers indicated that consent to therapeutic touch should be established prior to the dosing sessions and continually managed throughout the course of treatment. Flexibility in consent protocols enabled researchers to interpret and approach consent through the development of a strong therapeutic alliance; however, flexibility could also lead to challenges in boundary management. Researchers emphasised the need for greater ethical guidance in instances where trial participants change their established preferences during dosing sessions, and limits on expanding consent after drug administration. Clear guidelines for obtaining consent, managing changing preferences and training on the management of boundary transgressions were viewed as essential for ethical research and practice of PAT.