Depressive DisordersAnxiety DisordersPalliative & End-of-Life DistressSet & SettingEquity and Ethics

Mapping an Agenda for Psychedelic-Assisted Therapy Research in Patients with Serious Illness

This paper (2021) represents the outcomes of several brainstorming sessions, interviews, etc. with many of the leading psychedelic researchers that maps out the direction that the field may take with regards to the use of psychedelics for those with serious illness (end-of-life care).

Authors

  • Yvan Beaussant

Published

Journal of Palliative Medicine
meta Study

Abstract

Background

With support from the Radcliffe Institute for Advanced Study at Harvard University, we convened researchers representing palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapies. We aimed to define priorities and envision an agenda for future research on psychedelic-assisted therapies in patients with serious illness. Over two days in January 2020, participants engaged in an iterative series of reflective exercises that elicited their attitude and perspectives on scientific opportunities for this research.

Objectives

The aim of the study is to identify themes that shape priorities and an agenda for research on psychedelic-assisted therapy for those affected by serious illness.

Methods

We collected data through preconference interviews, audio recordings, flip charts, and sticky notes. We applied thematic qualitative analysis to elucidate key themes.

Results

We identified seven key opportunities to advance the field of psychedelic-assisted therapies in serious illness care. Four opportunities were related to the science and design of psychedelic-assisted therapies: clarifying indications; developing and refining therapeutic protocols; investigating the impact of set and setting on therapeutic outcomes; and understanding the mechanisms of action. The other three pertained to institutional and societal drivers to support optimal and responsible research: education and certification for therapists; regulations and funding; and diversity and inclusion. Additionally, participants suggested epistemological limitations of the medical model to understand the potential value and therapeutic use of psychedelics.

Conclusions

Medicine and society are witnessing a resurgence of interest in the effects and applications of psychedelic-assisted therapies in a wide range of settings. This article suggests key opportunities for research in psychedelic-assisted therapies for those affected by serious illness.

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Research Summary of 'Mapping an Agenda for Psychedelic-Assisted Therapy Research in Patients with Serious Illness'

Introduction

Beaussant and colleagues frame the problem by noting that people with serious illness frequently experience psychological, existential, and spiritual distress that negatively affects quality of life and other health outcomes. The introduction summarises prior findings that more than 30% of patients with cancer meet criteria for mood disorders such as anxiety or depression, and 13%-18% present clinically relevant demoralization. It also notes that conventional pharmacological, psychological, and spiritual care interventions often produce only small to moderate effect sizes, while preliminary studies of psychedelic-assisted therapies suggest potentially large and persistent improvements in depression, anxiety, existential distress, spiritual well-being, and quality of life among seriously ill patients. At the same time, experts have raised concerns about adverse effects (for example, delirium or worsening psychological distress), ethical issues around consent and therapeutic boundaries, and the need for rigorous research as legal and regulatory landscapes evolve. The paper reports an exploratory effort to define research priorities for psychedelic-assisted therapies in serious illness. To that end, the authors convened an interdisciplinary seminar bringing together clinicians and researchers from palliative care, psychosocial oncology, spiritual care, oncology, and psychedelic-assisted therapy. The stated aim was to elicit participant perspectives and to map an agenda for future research, identifying key domains where empirical work and institutional change are required. The authors emphasise the study’s pragmatic purpose: to synthesise expert input to guide rigorous, ethically grounded research in this emerging field.

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Study Details

References (9)

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