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

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.

Study at a glance

Abstract

Abstract Background Currently, personal or familial histories of psychotic symptoms are exclusionary criteria for 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. Methods In-depth interviews with 12 experts in the fields of psychiatry, clinical psychology, medicine, and the effects of psychedelics and entheogens were conducted in an expert consultation format. Interviews were transcribed and themes were produced using an Interpretative Phenomenological Analysis (IPA) approach. Results We found that while the exclusion criteria may be justified for psychedelic protocols that provide insufficient psychological support for participants, there was agreement that psychedelic-assisted psychotherapy is not necessarily contraindicated for all individuals with psychotic symptoms. Results suggest that highly supportive psychedelic-assisted psychotherapy may be of benefit to individuals experiencing symptoms of psychosis. Potentially relevant factors for predicting treatment outcomes include specific symptom endorsement, illness duration, symptom severity, quality of the therapeutic alliance, role of trauma in symptom etiology and perpetuation, and the level of other supports in the life of the client.