Importance of Integrating Spiritual, Existential, Religious, and Theological Components in Psychedelic-Assisted Therapies

JAMA Psychiatry, Год журнала: 2023, Номер 80(7), С. 743 - 743

Опубликована: Май 31, 2023

Importance Mounting evidence supports the role of spiritual, existential, religious, and theological components in mediating psychedelic-assisted therapy, yet integration these elements into clinical setting is lagging Observations Although therapy commonly produces spiritually, existentially, religiously, or theologically relevant experiences for patients, have not been systematically integrated psychotherapies that accompany therapeutic uses psychedelics. As a key feature potential mediator effects, evidence-based therapies should include topics treatment model. Research across multiple diagnostic targets contexts suggests spiritually are effective, feasible, produce add-on benefits outcomes, which particularly germane to Established standards psychotherapy may be fruitfully applied therapy. Objectives based on informed by considerations specific psychedelics recommended. Conclusions Relevance Spiritual, topics’ needed ensure culturally competent, aligned with highest care. Neglecting address can detract from cultural competence, contribute risks potentially undermine success.

Язык: Английский

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Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research

American Journal of Psychiatry, Год журнала: 2025, Номер 182(1), С. 21 - 32

Опубликована: Янв. 1, 2025

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain are effective safe treatment of major depressive disorder, treatment-resistant depression, posttraumatic stress disorder. Preliminary evidence also supports efficacy other disorders (e.g., tobacco alcohol use disorders). Notwithstanding promise psychedelics, concerns have arisen with respect to interpretability translatability study results. For example, aspects related short- long-term safety, abuse liability, essentiality psychedelic "trip" psychological support are, inter alia, insufficiently characterized agents. The overarching aims this overview 1) review methodological affect inferences interpretation extant studies disorders, 2) provide guidance future development psychiatry, critical clinical implementation.

Язык: Английский

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Psychedelics assisting therapy, or therapy assisting psychedelics? The importance of psychotherapy in psychedelic-assisted therapy

Frontiers in Psychology, Год журнала: 2025, Номер 16

Опубликована: Фев. 5, 2025

There is notable controversy about the role of psychotherapy in clinical trials psychedelic-assisted therapy (PAT). This heated and perpetually evolving debate informs questions such as how much should accompany a psychedelic intervention (Marseille et al., 2022), what type most effectively complements administration (Cavarra 2022;Yaden even whether always be included (Goodwin 2023;Earleywine 2024;Schenberg, 2024). Recent events, namely rejection by Food Drug Administration (FDA) Lykos Therapeutics' application to approve MDMA-assisted (MDMA-AT) treatment for PTSD, has brought forth some intricacies within this debate. That governing body's pharmacological agents, not psychotherapies. The FDA was likely unfamiliar with complication including MDMA-AT, rather than evaluating MDMA standalone intervention. highlights novelty PAT medicalized settings, underscores bona fide necessary component drug administration.From our perspective, unique psychiatric that it genuinely combined treatment, involving substance psilocybin or context psychotherapy. Thus, synergizes elements enhancement along psychological relational learning healing. psychedelics seems potentiate cognitive, emotional, behavioral change help more effective 2022;Grunder 2024;Nayak & Johnson, 2021). Additionally, like psychotherapies, emerging evidence, consistent body evidence literature, suggesting quality relationship between therapists patients critically important success (Levin 2024;Murphy 2022;Zeifman emotional impact real developed crucial patient's healing, perfunctory safety protocol nor peripheral afterthought.We champion essential arc helping attain meaningful relief from their distress, we encourage rigorous scientific examination which types doses may optimize delivery PAT.Commented [JZ1]: word erroneously title article, "auto-read" being part title. I am deleting here paper.While researchers support inclusion 2022;Deckel 2024;Earleywine 2024;Schenberg 2024), others have made case administration. Goodwin al. (2023) advance argument, stating there minimal confirm belief truly form enhanced catalyzed They suggest administration, safety, often all produce many suffering serious mental health conditions, configuration general study effects on psychosocial health.They first claim used been nondirective counseling, counseling an evidence-based conditions targeted PAT, treatment-resistant depression, use disorders. Our perspective la carte platter, "best" constructed extracting other non-psychedelic treatments (like psychotherapies) forcing them into framework PAT. Rather cobbling together specific ingredients package, advocate therapies are efficacious when delivered concert applied setting. If preliminary could treat condition, might further improve outcome pair thoughtfully-selected approaches, principles, techniques understood efficacious? We will know unless phenomenon. As stated Earleywine (2024), "only data can answer question. A trial compare groups without extensive preparation integration." same true regarding position well-trained facilitators ensure allow patient fully immersed experience, but no assumptions improving efficacy. Indeed, assumption made, only thoroughly studying issue able come complete understanding, preventing urge make assumptions.The authors assert complex interactions facilitators, kinds exemplify forms psychotherapy, impediment research; they complicate efforts determine therapeutic effect psychedelic, unregulated, lead ethical violations. It becomes difficult account placebo phenomenon expectancy, patient-therapist mutually unblind condition. But entire -the set setting, behavior therapists, interventions, relationships -is contributor outcome. cannot completely isolate Separating out us understand each aspect limits understanding interaction these distinct avenues, (Decker similar conventional aspects randomized dismantled, randomize two different modalities offer components unitary (e.g. randomizing receiving CBT receive cognitive restructuring activation only), therapist's empathy ability identify agree upon goals patients) so integral paradigm would unethical unfeasible remove trial. Process-oriented metaanalytic research assisted elements, absent randomizable condition (Norcross Lambert, 2011).PAT routinely include al.'s concerns addressed through methodologically and, appropriate protocols, training, regulation, adherence monitoring minimize risk violations harm patients.Further complicating discussion psychotherapy's type(s) employed. Current limited modality particular diagnoses populations patients, arguments put highlighting approaches (Brennan Belser, 2022;Sloshower 2020;Yaden 2022).Yaden ( 2022) argue cognitive-behavioral (CBT) default citing its robust base natural match interventions While understandable temptation clinicians provide orderly, structured can, problems argument. order prevent premature foreclosure exploration potentially usefully PAT.The high level congruence concepts Some concepts, sessions self-monitoring, indeed helpful demonstrate anything inherently sets apart any default. Other referenced authors, present moment awareness, mindfulness, reflective listening, CBT. roots humanistic-existential psychodynamic therapy, well Eastern wisdom traditions, employed varieties And yet suggestions, attempting utilize during session, actually conflict multidimensional non-ordinary states consciousness engender. Psychedelic predict, open process. Attempts "control" experience session difficult, hinder effectiveness (Luoma 2019). In typically follow process, largely self-determined sometimes openended. Flexibility therapist key. practice CBT, design, does open-endedness -rather, identifies focus clinician. Excessive open-ended process viewed focus, hijacking objective. rationale makes sense difficult-to-predict contours session.Most concerningly, authors' suggestion create self-fulfilling prophecy. Assuming approach prematurely forecloses inquiry develop best practices fails acknowledge potential those commonly historically paired humanistic, depthoriented, somatic, transpersonal Studies show benefits never conducted, far lower number studies pairing imbalance accrual sustain false narrative one school somehow innately superior another, replicated finding yield equivalent compared only, if helpful, whom helpful. unnecessarily trying disassemble known synergistic produced potentiation concurrent processing results high-quality therapy.In addition thorough synergize accomplished head-to-head corresponding differing theoretical orientations quantities Researchers also survey consumers who interested gleaning needs. especially minoritized harmed whose needs prioritized (Straus value strongly feel human element must preserved deeply examined.

Язык: Английский

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The Bright Side of Psychedelics: Latest Advances and Challenges in Neuropharmacology

International Journal of Molecular Sciences, Год журнала: 2023, Номер 24(2), С. 1329 - 1329

Опубликована: Янв. 10, 2023

The need to identify effective therapies for the treatment of psychiatric disorders is a particularly important issue in modern societies. In addition, difficulties finding new drugs have led pharmacologists review and re-evaluate some past molecules, including psychedelics. For several years there has been growing interest among psychotherapists psilocybin or lysergic acid diethylamide obsessive-compulsive disorder, depression, post-traumatic stress although results are not always clear definitive. fact, mechanisms action psychedelics yet fully understood molecular aspects be well defined. Thus, this aims summarize ethnobotanical uses best-known psychedelic plants pharmacological main active ingredients they contain. Furthermore, an up-to-date overview structural computational studies performed evaluate affinity binding modes biologically relevant receptors ibogaine, mescaline, N,N-dimethyltryptamine, psilocin, presented. Finally, most recent clinical evaluating efficacy molecules discussed compared with already used therapy.

Язык: Английский

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Therapeutic mechanisms of psychedelics and entactogens

Neuropsychopharmacology, Год журнала: 2023, Номер 49(1), С. 104 - 118

Опубликована: Июль 24, 2023

Язык: Английский

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The need for establishing best practices and gold standards in psychedelic medicine

Journal of Affective Disorders, Год журнала: 2023, Номер 332, С. 47 - 54

Опубликована: Март 30, 2023

Язык: Английский

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Development and psychometric validation of a novel scale for measuring ‘psychedelic preparedness’

Scientific Reports, Год журнала: 2024, Номер 14(1)

Опубликована: Фев. 8, 2024

Abstract Preparing participants for psychedelic experiences is crucial ensuring these are safe and, potentially beneficial. However, there currently no validated measure to assess the extent which well-prepared such experiences. Our study aimed address this gap by developing, validating, and testing Psychedelic Preparedness Scale (PPS). Using a novel iterative Delphi-focus group methodology (‘DelFo’), followed qualitative pre-test interviews, we incorporated perspectives of expert clinicians/researchers users generate items scale. Psychometric validation PPS was carried out in two large online samples (N = 516; N 716), scale also administered before after 5–7-day psilocybin retreat 46). Exploratory confirmatory factor analysis identified four factors from 20-item PPS: Knowledge-Expectations, Intention-Preparation, Psychophysical-Readiness, Support-Planning. The demonstrated excellent reliability (ω 0.954) evidence supporting convergent, divergent discriminant validity obtained. Significant differences between those scoring high low (on preparedness) experience were found on measures mental health/wellbeing outcomes assessed experience, suggesting that has predictive utility. By prospectively measuring modifiable pre-treatment preparatory behaviours attitudes using PPS, it may be possible determine whether participant generated appropriate ‘set’ therefore likely benefit or at least, less harmed.

Язык: Английский

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Psychedelic-assisted psychotherapy: where is the psychotherapy research?

Psychopharmacology, Год журнала: 2024, Номер 241(8), С. 1517 - 1526

Опубликована: Май 24, 2024

Язык: Английский

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Mitochondrial Metabolism in Major Depressive Disorder: From Early Diagnosis to Emerging Treatment Options

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(6), С. 1727 - 1727

Опубликована: Март 17, 2024

Major Depressive Disorder (MDD) is one of the most disabling diseases in world. MDD traditionally diagnosed based on a patient’s symptoms, which can lead to misdiagnosis. Although pathogenic mechanisms are unknown, several studies have identified mitochondrial dysfunction as central factor onset and progression MDD. In context MDD, alterations metabolism imbalances energy production oxidative stress, contributing disorder´s underlying pathophysiological mechanisms. Consequently, identification key biomarker for early accurate diagnosis represents significant challenge. Faced with limits traditional treatments antidepressants, new pharmacological therapeutic targets being investigated such ketamine/esketamine, psychedelics, or anti-inflammatories. All these drugs show potential antidepressant effects due their speed action ability modulate neuroplasticity and/or motor processing. parallel, non-pharmacological studied, like Transcranial Magnetic Stimulation (TMS) Deep Brain (DBS), recognized neuronal activity offer treatment alternatives. As cellular directly related respiration, aim this review examining link between assessing how biomarkers could provide more objective precise diagnostic tool, exploring other addition specific focus emerging targets. Finally, detailed analysis strengths, weaknesses, opportunities, threats approaches was carried out, highlighting challenges that must be addressed.

Язык: Английский

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Benefits and Challenges of Ultra-Fast, Short-Acting Psychedelics in the Treatment of Depression

American Journal of Psychiatry, Год журнала: 2025, Номер 182(1), С. 33 - 46

Опубликована: Янв. 1, 2025

Unlike classical antidepressants, psychedelics such as psilocybin have been shown to induce a rapid antidepressant response. In the wake of this development, interest has emerged in ultra-fast, short-acting 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) and N,N-dimethyltryptamine (DMT) with expectation that these can produce effects following an intense but brief psychedelic intervention. The current paper reviews clinical pharmacology 5-MeO-DMT DMT their potential benefits challenges treatment depression. Both compounds display affinities for variety monoamine receptors transporters, mostly so serotonergic (5HT) receptors, including 5HT

Язык: Английский

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