MDMA-assisted dialectical behavioral therapy for borderline personality disorder: A qualitative study of mental health clinicians

In 2021, phase 3 clinical trials of MDMA-assisted therapy for treatment-resistant PTSD found that 71.2% of full-dose participants no longer met PTSD criteria. Although MDMA-assisted therapy is not FDA-approved for borderline personality disorder, its beneficial effects might be applicable. An exploratory, qualitative, interview-based study examined clinicians' perspectives by interviewing two dialectical behavioral therapy clinicians and two MDMA-assisted therapy clinicians. The study assessed underlying therapeutic mechanisms, pharmacological factors, and treatment context to improve clinical responses. Participants' codes revealed a chronological narrative with three treatment phases.

Study at a glance

Abstract

Abstract In 2021, the final series of phase 3 clinical trials looking at MDMA-AT for treatment-resistant post-traumatic stress disorder (PTSD) found that 71.2% of 3,4-methylenedioxymethamphetamine (MDMA) full-dose participants no longer met criteria for PTSD. MDMA-assisted therapy is not US Food and Drug Administration (FDA) approved in treating borderline personality disorder (BPD), and while PTSD is quite different from BPD, it is possible that some of the beneficial effects of MDMA-assisted therapy may be applicable in treating BPD. Interviewing two clinicians utilizing dialectical behavioral therapy treatment and two MDMA-assisted therapy clinicians was one way to examine the phenomenology of MDMA-assisted therapy with BPD individuals in a thoughtful manner. An exploratory, qualitative, interview-based study assessed clinicians' perspectives of MDMA-assisted therapy and BPD and increased our understanding of underlying therapeutic mechanisms and processes and the role of pharmacological factors in these treatment modalities, optimizing treatment context, and leading to improved clinical responses and patient recovery. The codes generated unique perspectives of the participants revealing a chronological narrative which included three phases of treatment.