Psilocybin-assisted therapy of major depressive disorder using Acceptance and Commitment Therapy as a therapeutic frame

Sloshower, Jordan; Guss, Jeffrey; Krause, Robert; Wallace, Ryan M.; Williams, Monnica T.; Reed, Sara; Skinta, Matthew D.

doi:10.1016/j.jcbs.2019.11.002

Cited by 115 publications

(117 citation statements)

References 30 publications

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“…This suggests that there are large potential synergies between CBT and psychedelic therapy. In line with this, it has been proposed that psychedelics could be fruitfully integrated within acceptance-based CBTs, most notably ACT [ (13,42,(93)(94)(95)(96); for recent ACT-based protocols for psilocybin-assisted treatment of depression see (97,98)]. We agree with this view, but emphasize that the proposed model is suited as a theoretical framework for integrating psychedelic therapy with not only ACT and other acceptance-based approaches but CBT more generally 4 .…”

Section: Clinical Considerations Integrating Psychedelic Interventionsupporting

confidence: 72%

“…On this basis, it can be assumed that treatment outcomes could be optimized by including values work in treatment. Psychedelic therapy protocols that involve values-based interventions have been described [e.g., (97,103)]. To further improve treatment models, the impact of such interventions on treatment outcomes should be investigated systematically.…”

Section: Clinical Considerations Integrating Psychedelic Interventionmentioning

confidence: 99%

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Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

et al. 2020

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The efficacy of psychedelic-assisted therapies for mental disorders has been attributed to the lasting change from experiential avoidance to acceptance that these treatments appear to facilitate. This article presents a conceptual model that specifies potential psychological mechanisms underlying such change, and that shows substantial parallels between psychedelic therapy and cognitive behavioral therapy: We propose that in the carefully controlled context of psychedelic therapy as applied in contemporary clinical research, psychedelic-induced belief relaxation can increase motivation for acceptance via operant conditioning, thus engendering episodes of relatively avoidance-free exposure to greatly intensified private events. Under these unique learning conditions, relaxed avoidance-related beliefs can be exposed to corrective information and become revised accordingly, which may explain long-term increases in acceptance and corresponding reductions in psychopathology. Open research questions and implications for clinical practice are discussed.

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Section: Clinical Considerations Integrating Psychedelic Interventionsupporting

confidence: 72%

Section: Clinical Considerations Integrating Psychedelic Interventionmentioning

confidence: 99%

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

et al. 2020

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“…Experiential avoidance is a primary target of ACT ( 26 ), an evidence-based psychotherapeutic intervention for a range of mental health problems [for a meta-analysis, see ( 96 )]. Accordingly, we are currently conducting a trial (clinicaltrials.gov, NCT 03429075) in which we are integrating components of ACT with psilocybin for major depression [see ( 94 ); also, see ( 97 )].…”

Section: Discussionmentioning

confidence: 99%

Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation

Zeifman

Wagner²,

Watts

et al. 2020

Front. Psychiatry

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Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy's (ACT's) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.

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“…Part of the efficacy of psychedelics when utilised in a therapeutic context appears to be through their capacity to act as catalysts or amplifiers of psychotherapeutic practices and processes ( Grof, 1980 ; Sloshower et al, 2020 ; Watts et al, 2017 ; Watts and Luoma, 2020 ). Nature seems to also act as an amplifier of therapeutic effect: one study found that cognitive behaviour therapy (CBT)-based psychotherapy applied in a forest environment was helpful in achievement of remission of major depression among sufferers, with the forest setting enhancing the effect of the psychotherapeutic intervention when compared to a clinical hospital setting ( Kim et al, 2009 ).…”

Section: How To Maximise Nature Relatedness Using Psychedelicsmentioning

confidence: 99%

The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health

Gandy

Forstmann

Carhart‐Harris

et al. 2020

Health Psychology Open

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Therapeutic psychedelic administration and contact with nature have been associated with the same psychological mechanisms: decreased rumination and negative affect, enhanced psychological connectedness and mindfulness-related capacities, and heightened states of awe and transcendent experiences, all processes linked to improvements in mental health amongst clinical and healthy populations. Nature-based settings can have inherently psychologically soothing properties which may complement all stages of psychedelic therapy (mainly preparation and integration) whilst potentiating increases in nature relatedness, with associated psychological benefits. Maximising enhancement of nature relatedness through therapeutic psychedelic administration may constitute an independent and complementary pathway towards improvements in mental health that can be elicited by psychedelics.

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Psilocybin-assisted therapy of major depressive disorder using Acceptance and Commitment Therapy as a therapeutic frame

Cited by 115 publications

References 30 publications

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation

The potential synergistic effects between psychedelic administration and nature contact for the improvement of mental health

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