Systematized Review of Psychotherapeutic Components of Psilocybin-Assisted Psychotherapy

Horton, David; Morrison, Blaise; Schmidt, Judy A.

doi:10.1176/appi.psychotherapy.20200055

Cited by 57 publications

(57 citation statements)

References 37 publications

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“…As such, the stance taken by therapists within such an approach is typically limited to interventions that direct the participant’s focus inward. To date, this has been the approach taken by all clinical PAP trials during sessions that involve the administration of a psychedelic medicine ( Horton et al, 2021 ). The differences in therapeutic approach between basic support and EBT-inclusive therapy models, as discussed in this article, are thus found almost exclusively in the preparation and integration phases.…”

Section: Assessment Of Prior Psychedelic-assisted Psychotherapy Modelsmentioning

confidence: 99%

“…PAP models to date have primarily framed treatment benefit from within what Barnes and Briggs (2021) have called a “one-person psychology,” in that they view therapeutic change as emanating from an internal, subjective process that occurs during a medicine session. In most PAP clinical trials to date, particularly those with classic psychedelics, participants have been invited to don an eye mask and headphones for the duration of the medicine session and “go inward” to have an inner-directed experience with limited intervention from clinicians ( Horton et al, 2021 ). However, some participants have still opted to engage interpersonally with the clinicians from within the altered relational dynamics of a medicine session.…”

Section: Assessment Of Prior Psychedelic-assisted Psychotherapy Modelsmentioning

confidence: 99%

“…The EMBARK model adheres to the three-phase PAP treatment design that has been used in all clinical trials published to date ( Horton et al, 2021 ). It consists of non-drug preparation sessions prior to administration, medicine sessions in which the psychedelic medicine is administered, and non-drug integration sessions after the date of administration.…”

Section: Embark’s Structurementioning

confidence: 99%

“…A diversity of adjunctive psychotherapy models has arisen to provide such a context ( Horton et al, 2021 ). They have been developed by clinical research groups within academic, corporate, and non-profit entities to support their trials of various psychedelic medicines in the treatment of a range of indications.…”

Section: Introductionmentioning

confidence: 99%

“…They have been developed by clinical research groups within academic, corporate, and non-profit entities to support their trials of various psychedelic medicines in the treatment of a range of indications. The specific approaches of these models have drawn influence from the work of early PAP pioneers inside and outside of formal research contexts ( Eisner, 1967 ; Grof, 1980 ; Greer and Tolbert, 1986 ; Stolaroff, 2004 ), indigenous approaches to the use of psychedelic substances for healing ( Fotiou, 2020 ), and elements of non-psychedelic therapeutic approaches ( Walsh and Thiessen, 2018 ; Horton et al, 2021 ). Although these models share some similarities (e.g., attention to set and setting, a structure consisting of preparation, medicine, and integration sessions), they vary greatly in how much non-drug therapy time they offer; the extent to which they incorporate extrinsic, non-psychedelic psychotherapeutic knowledge and best practices; and whether they view the support they provide as therapy per se or a distinct form of non-psychotherapeutic support.…”

Section: Introductionmentioning

confidence: 99%

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Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model

Brennan

Belser²

2022

Front. Psychol.

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The current standard of care in most uses of psychedelic medicines for the treatment of psychiatric indications includes the provision of a supportive therapeutic context before, during, and after drug administration. A diversity of psychedelic-assisted psychotherapy (PAP) models has been created to meet this need. The current article briefly reviews the strengths and limitations of these models, which are divided into basic support models and EBT-inclusive therapy models. It then discusses several shortcomings both types of models share, including a lack of adequate attention to embodied and relational elements of treatment, and insufficient attention to ethical concerns. The article then introduces the EMBARK model, a transdiagnostic, trans-drug framework for the provision of supportive psychotherapy in PAP clinical trials and the training of study therapists. EMBARK was designed to overcome challenges that prior models have had in conceptualizing therapeutic change in psychedelic treatment, incorporating elements of non-psychedelic evidence-based therapies, incorporating therapists’ prior skills and clinical orientations, delimiting therapist interventions for research standardization, and determining specific factors that contribute to treatment outcomes. The article explains EMBARK’s six clinical domains, which represent parallel conceptualizations of how therapists may support therapeutic benefit in PAP treatment, and its four care cornerstones, which reflect therapists’ broad ethical responsibility to participants. The article describes how these elements of the model come together to structure and inform therapeutic interventions during preparation, medicine, and integration sessions. Additionally, the article will discuss how EMBARK therapist training is organized and conducted. Finally, it will demonstrate the broad applicability of EMBARK by describing several current and upcoming PAP clinical trials that have adopted it as the therapeutic frame.

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Section: Assessment Of Prior Psychedelic-assisted Psychotherapy Modelsmentioning

confidence: 99%

Section: Assessment Of Prior Psychedelic-assisted Psychotherapy Modelsmentioning

confidence: 99%

Section: Embark’s Structurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model

Brennan

Belser²

2022

Front. Psychol.

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Therapeutic frameworks in integration sessions in substance‐assisted psychotherapy: A systematised review

Thal,

Baker,

Marinis

et al. 2023

Clin Psychology and Psychoth

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Serotonergic psychedelics and related substances have been explored as potential adjuncts in substance‐assisted psychotherapy (SAPT) for treating various disorders. SAPT can be divided into three phases: preparation, administration and integration. Integration is commonly defined as the comprehension and effective application of insights from psychedelic experiences into everyday life. However, there is limited research regarding the most appropriate therapeutic approach during SAPT. In this article, we discuss the current evidence for different therapeutic frameworks for integration sessions when serotonergic psychedelics and entactogens are used as adjuncts to psychotherapy. We conducted a systematised review of the literature following PRISMA guidelines and searched PsycINFO, MEDLINE and Cochrane Library databases. The final synthesis included 75 clinical trials, mixed‐methods investigations, treatment manuals, study protocols, quasi‐experiments, qualitative investigations, descriptive studies, opinion papers, reviews, books and book chapters, published until 11 November 2022. The effects that various therapeutic approaches for integration sessions have on therapeutic outcomes have not been investigated by means of rigorous research. Most of the available evidence we retrieved was not supported by empirical data, thus limiting any conclusive statements regarding appropriate therapeutic frameworks for integration sessions for SAPT. Current clinical studies have used a range of therapeutic frameworks with the majority drawing from the humanistic–experiential tradition. While integration is regarded as crucial for the safe application of SAPT, there is currently an insufficient evidence base to suggest that any type of therapy is effective for guiding integration sessions. A systematic investigation of different therapeutic frameworks for integration and additional therapy‐related factors is needed.

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Great Expectations: recommendations for improving the methodological rigor of psychedelic clinical trials

et al. 2022

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Systematized Review of Psychotherapeutic Components of Psilocybin-Assisted Psychotherapy

Cited by 57 publications

References 37 publications

Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model

Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model

Therapeutic frameworks in integration sessions in substance‐assisted psychotherapy: A systematised review

Great Expectations: recommendations for improving the methodological rigor of psychedelic clinical trials

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