The influence of therapists’ first-hand experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training

Nielson, Elizabeth M.; Guss, Jeffrey

doi:10.1556/2054.2018.009

Cited by 72 publications

(58 citation statements)

References 32 publications

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“…The ability to gauge the individual patient's distress tolerance on a moment-tomoment basis and strike a sensible balance between encouraging acceptance and supporting avoidance can be considered a key requirement for psychedelic therapists, and should be trained accordingly. It can be argued that such perspective-taking requires first-hand experience with psychedelic states [see (104) for a discussion of this matter].…”

Section: Direct Implications Of the Model For Clinical Practicementioning

confidence: 99%

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: Direct Implications Of the Model For Clinical Practicementioning

confidence: 99%

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

et al. 2020

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“…Another salient question in the field of psychedelic therapy training is the need for, or relevance, of a therapist's personal experience of the study drug. Some advocate for the inclusion of such experiences in training programs (23), and others have cautioned that the decision to have and discuss such experiences requires careful forethought by clinicians (31). No research has yet demonstrated the impact of therapists' training, or other kinds of personal experience, with psychedelics on clinical outcomes, and the inclusion of such experiences may be a barrier to the inclusion of a diverse group of therapists, place trainers and trainees in dual roles, and even stigmatize those who choose to pursue psychedelic-assisted therapy as a professional.…”

Section: Discussionmentioning

confidence: 99%

Development and Evaluation of a Therapist Training Program for Psilocybin Therapy for Treatment-Resistant Depression in Clinical Research

Tai

Nielson²,

Lennard-Jones³

et al. 2021

Front. Psychiatry

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Introduction: Psychological support throughout psilocybin therapy is mandated by regulators as an essential part of ensuring participants' physical and psychological safety. There is an increased need for specially trained therapists who can provide high-quality care to participants in clinical studies. This paper describes the development and practical implementation of a therapist training program of psychological support within a current phase IIb international, multicenter, randomized controlled study of psilocybin therapy for people experiencing treatment-resistant depression.Description of Training Program: This new and manualized approach, based on current evidence-based psychotherapeutic approaches, was developed in partnership with different mental health researchers, practitioners, and experts; and has been approved by the FDA. Training consists of four components: an online learning platform; in-person training; applied clinical training; and ongoing individual mentoring and participation in webinars.This paper provides a brief overview of the method of support, the rationale and methodology of the training program, and describes each stage of training. The design and implementation of fidelity procedures are also outlined.Lessons Learned: As part of the phase IIb study of psilocybin therapy for treatment-resistant depression, 65 health care professionals have been fully trained as therapists and assisting therapists, across the US, Canada and Europe. Therapists provided informal feedback on the training program. Feedback indicates that the didactic and experiential interactive learning, delivered through a combination of online and in-person teaching, helped therapists build conceptual understanding and skill development in the therapeutic approach. Clinical training and engagement in participant care, under the guidance of experienced therapists, were considered the most beneficial and challenging aspects of the training.Conclusions: Clinical training for therapists is essential for ensuring consistently high-quality psilocybin therapy. Development of a rigorous, effective and scalable training methodology has been possible through a process of early, active and ongoing collaborations between mental health experts. To maximize impact and meet phase III and post-approval need, enhanced online learning and establishing pathways for clinical training are identified as critical points for quality assurance. This will require close public, academic and industry collaboration.

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“…For example, Forstmann and Sagioglou (2021) found that the perception of a reserachers' integrity and quality of their research by psychedelic naïve participants was reduced if the researcher self-admitted substance use (Forstmann and Sagioglou, 2021). While there will likely be a continuum amongst therapists engaged in SAPT clinical trails, ranging from those without any personal experiences to those with a vast amount of experience across substances and settings, open discussion of these experiences can be constrained for fear of personal, professional, and sometimes legal consequences (Nielson and Guss, 2018;Ross et al, 2020). Some practitioners in the field regard personal experiences with these substances as essential in order to emphasize with the client's experiences (Metzner, 1998;Bogenschutz, 2013;Bogenschutz and Forcehimes, 2017) and in certain countries, such as Switzerland, personal experience is required for therapists to work with clients in SAPT settings (Grof, 2000;Strassman, 2001).…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…However, personal experiences may lead some therapists to become less curious about the client if they believe that their clients' experience will be similar to their own (Bogenschutz, 2013;Bogenschutz and Forcehimes, 2017). Thus, personal experience is a double edged sword that may be a potential confound to research and SAPT, though has not yet been empirically investigated (Nielson and Guss, 2018). Also, in line with standard ethical guidelines, we believe that therapists should not take any mind-altering substances before or during therapy sessions, regardless of whether they are providing SAPT or regular psychotherapy.…”

Section: Ethical Considerationsmentioning

confidence: 99%

Current Perspective on the Therapeutic Preset for Substance-Assisted Psychotherapy

et al. 2021

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The present narrative review is the first in a series of reviews about the appropriate conduct in substance-assisted psychotherapy (SAPT). It outlines a current perspective onpreconditions and theoretical knowledge that have been identified as valuable in the literaturefor appropriate therapeutic conduct in SAPT. In this context, considerations regarding ethics and the spiritual emphasis of the therapeutic approaches are discussed. Further, current methods, models, and concepts of psychological mechanism of action and therapeutic effects of SAPT are summarized, and similarities between models, approaches, and potential mediators for therapeutic effects are outlined. It is argued that a critical assessment of the literature might indicate that the therapeutic effect of SAPT may be mediated by intra- and interpersonal variables within the therapeutic context rather than specific therapeutic models per se. The review provides a basis for the development and adaptation of future investigations, therapeutic models, training programs for therapists, and those interested in the therapeutic potential of SAPT. Limitations and future directions for research are discussed.

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The influence of therapists’ first-hand experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training

Cited by 72 publications

References 32 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

Development and Evaluation of a Therapist Training Program for Psilocybin Therapy for Treatment-Resistant Depression in Clinical Research

Current Perspective on the Therapeutic Preset for Substance-Assisted Psychotherapy

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