The need for another tool: Australian healthcare professionals on the use of psilocybin for existential distress in people with cancer

Healthcare professionals show interest in psychedelic-assisted therapy with psilocybin for existential distress in people with cancer, but face knowledge gaps, barriers, and a desire for more research. Interviews with 11 professionals from Australian cancer centers revealed four themes: varied knowledge about the therapy, conceptualizing its practical use, navigating complex provision and engagement, and envisioning future applications. Professionals preferred delivery by multidisciplinary teams that are culturally sensitive and ethically rigorous. Some saw it as a last resort, while others viewed it as another needed tool. The findings offer preliminary insights into implementation pathways for this therapy in oncology settings.

Study at a glance

Abstract

BACKGROUND: Existential distress is commonly experienced by people with cancer, yet there are limited treatment options. The therapeutic potential for psychedelic-assisted therapy (PAT) utilising psilocybin for this cohort is underexplored, with emerging literature showing clinical improvements in wellbeing. In Australia there is limited knowledge on healthcare professionals' (HCPs') attitudes, beliefs, and perceptions of the use of PAT for existential distress in people with cancer, and their opinions on components of delivery. METHODS: Qualitative semi-structured interviews were used to investigate the attitudes of 11 HCPs across specialties, largely from cancer treatment centres such as Chris O'Brien Lifehouse and Peter MacCallum Cancer Centre. The interviews were analysed using reflexive thematic analysis. RESULTS: Four key themes were identified: (1) A spectrum of knowing: The varied space of PAT knowledges, (2) Conceptualising and thinking through PAT in practice, (3) Navigating nuances territory: The complexity of providing and engaging with PAT, (4) Visualising potential future for PAT. Findings from the themes include that despite HCPs remaining interested in the potential of PAT, there are clear barriers being faced, knowledge gaps, and a desire for more research. HCPs also indicated a preference for PAT to be delivered in multidisciplinary teams, and for modes of delivery to be culturally sensitive and ethically rigorous. While some positioned this treatment as a last resort, others noted that there is a need for another 'tool' in the treatment of existential distress in cancer. CONCLUSIONS: As evidence for PAT grows, expanded clinical and qualitative research will be needed to develop delivery models that are ethically sound, culturally sensitive and informed by clinical evidence, as well as traditional knowledges While small in sample size, this present study offers preliminary insights into how HCPs perceive the potential role of PAT in cancer populations, specifically for existential distress. Thus, this study contributes to a growing qualitative evidence base to understand implementation pathways for PAT in oncology settings, and the complexity of managing the need for another tool with existing barriers, limitations, and knowledge bases.