Survey: No clear consensus on psychological support strategies in psychedelic treatment
Key takeaways:
- Practitioners had a slight preference toward an emotive approach to psychedelic treatment.
- There was strong overall opinion about unprofessional physical contact and the importance of building trust.
Opinions varied among practitioners regarding psychological support when treating with psychedelics, although an emotive approach was slightly preferred, according to results of a survey published in Journal of Clinical Psychiatry.
“As the field of psychiatric psychiatry matures, key questions remain about best practices for providing psychological support, David A. Bender, MD, a psychiatrist at Washington University School of Medicine in St. Louis, told Healio. “Our survey results will spur dialogue on important topics like the role of psychotherapy, the subjective drug experience and spirituality in psychedelic treatments.”
Bender and colleagues sought to examine the viewpoints of clinicians who specialize in psychedelic medicine regarding mental health support for psychedelic treatments.
Their analysis was based on responses to an anonymous email survey, developed by physician-researchers from Washington University and Johns Hopkins University, sent to physicians involved with clinical trials of psilocybin and LSD, personal contacts of study authors, as well as those found via snowball sampling.
The survey included 28 Likert scale-type queries and two multiple choice questions. It was subdivided into three sections for demographics, quantitative response and qualitative or free response. Responses were subsequently coded along emotive or neuromodulatory approaches to treatment, with the resulting summative, or “E-scores,” determining quantitative physician preference.
A total of 40 qualified individuals completed the survey, representing four countries, 11 U.S. states and 16 institutions. Survey respondents had overseen an average of 41.4 psychedelic research sessions each, amounting to a total of 1,656 sessions.
According to the results, concordance among the respondents was lacking for many Likert survey items, with roughly half yielding an average response ranging from “somewhat agree” to “somewhat disagree.” However, the researchers noted those items had a higher average response rate (4.5 vs. 3.93) compared with other survey items.
Bender and colleagues further reported that an exploratory analysis identified four latent factors: the importance of trust, the role of spirituality, creating an emotional setting and conceptualizing negative experiences.
Respondents reported a slight preference for an emotive approach to psychedelic treatment, the researchers said, while those who received training at the Multidisciplinary Association for Psychedelic Studies or the California Institute of Integral Studies had significantly greater emotive preference compared with respondents from other institutions.
Strong consensus was found regarding the unprofessional nature of full-body contact with recipients during therapy, as well as the development of trusting relationships for effective treatment outcomes.
“Clinicians interested in offering psychedelic treatments or referring their patients should be aware of the various psychosocial approaches to drug administration,” Bender told Healio. “Because the unique psychological effects of psychedelics are likely to be impacted by the setting of treatment.”