Psychedelic Assisted Psychotherapy (PAP): the Geneva University Hospital model

Psychedelic Assisted Psychotherapy (PAP) with LSD and psilocybin has been legally available in Switzerland since 2014 under supervised exceptional medical use. At Geneva University Hospital, a PAP protocol for treatment-resistant patients with depression, anxiety, and addiction combines preparation, dosing, and integration sessions within a cognitive behavioral therapy framework. Preliminary data from pre-post validated questionnaires show symptom reduction. The authors conclude that PAP is safe and useful, applicable routinely in a hospital setting for various diagnoses with treatment-resistant patients.

Study at a glance

Abstract

Introduction Psychedelic Assisted Psychotherapy (PAP) has been legal in Switzerland since 2014 under supervised exceptional medical use with MDMA, LSD and Psilocybin with case by case authorisations delivered from the Federal Office of Public Health. In particular, since 2021, we have implemented a clinical activity at Geneva University Hospital (HUG) for treatment resistant patients using LSD and psilocybin. We hereby present the treatment model we developed and the first clinical results on the treated patients’ population. Methods Treatment resistant patients diagnosed with depression, anxiety and addiction followed a PAP protocol consisting in preparation, dosing and integration sessions. Cognitive behavioral therapy framework was used to guide these interventions, in order for the psychedelic personal experience session to be inscribed within a psychotherapeutic process involving psychoeducation, objective clarification, and behavioral activation. Results We present preliminary data on symptom reduction gathered systematically with pre-post validated questionnaires. We discuss cognitive behavioral models to explain the specific characteristics of PAP like: insight, metacognition and general psychotherapeutic factors. Conclusions PAP is a safe and useful form of psychotherapy which can be applied routinely in a hospital clinical setting. PAP can be used for a variety of diagnoses with treatment resistant patients.