Must Psilocybin Always “Assist Psychotherapy”?

Goodwin, Guy M.; Malievskaia, Ekaterina; Fonzo, Gregory; Nemeroff, Charles B.

doi:10.1176/appi.ajp.20221043

Cited by 49 publications

(33 citation statements)

References 35 publications

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“…The specific type of psychosocial support provided has been heterogeneous, including cognitive-behavioral, supportive, and motivational therapies. Although we acknowledge there can be debate about the precise nature of the psychological interventions offered in psychedelic trials, 2 we argue that these frequently share such factors common to all psychotherapies as the importance of the therapeutic relationship, the healing setting, and an overarching therapeutic rationale. 8 Thus, for the purposes of this paper, we refer to these psychological interventions as psychotherapy.…”

Section: Randomized Trials Of Psychedelicsmentioning

confidence: 92%

“…For this reason, preparatory psychotherapy beginning before the psychedelic session, one or two therapists accompanying the patient during the session, and integrative psychotherapy following the session is a common approach, with the total number of preand post-treatment visits ranging widely. 2 The combination of a psychedelic and time-limited psychotherapy to maximize treatment benefits must be distinguished from the combination of a psychedelic and the support required to reduce the risk of adverse events. 4 These two broad approaches to psychedelic treatment require different resources, and providing even time-limited psychotherapy is more costly and more difficult to scale than only providing support to minimize harms.…”

Section: Randomized Trials Of Psychedelicsmentioning

confidence: 99%

“…Psychedelics, such as psilocybin, have received increasing attention over the past 2 decades as potential treatments for a variety of medical conditions, including depression, anxiety disorders, chronic pain, and migraine and cluster headache. [1][2][3][4][5] This is undoubtedly a result of several factors, including promising results of early clinical trials, generally modest efficacy of existing treatments for these conditions, and provocative reports in the popular press. Despite this enthusiasm, critically important questions about psychedelics remain unanswered, especially confirmation of efficacy and safety in phase III trials as well as mechanisms of action, appropriate contexts of use, and methodologic challenges, including blinding integrity.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Psychedelics and Psychotherapy: Is the Whole Greater than the Sum of its Parts?

Dworkin,

McDermott,

Nayak

et al. 2023

Clin Pharma and Therapeutics

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Section: Randomized Trials Of Psychedelicsmentioning

confidence: 92%

Section: Randomized Trials Of Psychedelicsmentioning

confidence: 99%

mentioning

confidence: 99%

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Psychedelics and Psychotherapy: Is the Whole Greater than the Sum of its Parts?

Dworkin,

McDermott,

Nayak

et al. 2023

Clin Pharma and Therapeutics

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“…A recent commentary from the authors of a psilocybin dose-finding study (Goodwin et al, 2023) highlighted the absence of prospective studies of psychedelic drugs without psychotherapy. They suggest there is a knowledge gap that makes it difficult to separate out the relative contributions of the drug and the therapy.…”

Section: The Psilocybin Experiencementioning

confidence: 99%

Psilocybin‐assisted psychotherapy for treatment‐resistant depression: Which psychotherapy?

Crowe,

Manuel,

Carlyle

et al. 2023

Int J Mental Health Nurs

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This perspective paper explores the choice of psychotherapy for psilocybin‐assisted psychotherapy for treatment‐resistant depression. There is evidence to support the use of some psychotherapies in treating ‘treatment‐resistant’ depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta‐synthesis of the experience of psilocybin. The paper will examine whether three one‐to‐one psychotherapies identified as effective in the treatment of treatment‐resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short‐term dynamic psychotherapy align with that experience, although others are currently being trialled.

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“…At first, psilocybin (a drug acting through serotonin receptors) was presented as an agent whose function was to assist psychotherapy. However, a recent formulation has argued that the psychotherapeutic element might reasonably be limited to safety monitoring (Goodwin, Malievskaia, Fonzo, & Nemeroff, 2023). This is an interesting and important discussion of great relevance to people with refractory depression and might indeed be suitable for the 5E approach endorsed by Professor Rose.…”

mentioning

confidence: 99%