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MDMA-assisted psychotherapy with adolescents suffering from PTSD: Do or don’t? a qualitative study with youth, parents, and clinicians

This focus group study (n=19) investigated the perspectives of adolescents, parents, and clinicians on MDMA-assisted psychotherapy for adolescents with PTSD. Initial attitudes towards MDMA were mainly unfavourable, but after an explanation of the therapy, all but one participant supported its potential use, emphasizing the importance of research.

Authors

  • Van Vugt, A. S.
  • Zijlmans, J.
  • Lindauer, R.

Published

Drug Science Policy and Law
individual Study

Abstract

Background

PTSD in adolescence causes much suffering and has substantial health-care costs. Many patients with severe PTSD do not respond to psychotherapy or continue to have symptoms despite trauma-focused psychotherapies and psychopharmacological treatment. A recent alternative in the search for cost-effective treatments for PTSD in adults is 3,4-methylenedioxymethamphetamine-assisted psychotherapy (MDMA-assisted psychotherapy). However, no research has yet been conducted on the therapeutic potential of MDMA for adolescents.Aims of the study The purpose of this study is to investigate the perspectives of adolescents, parents, and clinicians about the possible clinical application of MDMA-assisted psychotherapy for adolescents with PTSD.

Method

We performed focus groups in three samples: (a) 16-24-year-olds who had undergone trauma therapy (N = 9), (b) parents of traumatized children (N = 4), and (c) trauma clinicians (N = 6). Focus group topics included: perception of and associations with MDMA, opinions on MDMA-assisted psychotherapy, risks/benefits, and precautions to take prior to possible adolescent clinical trials with MDMA-assisted psychotherapy.

Results

In all groups, initial participant attitudes towards MDMA were predominantly unfavorable, except for several adolescents who had conducted preliminary research on the subject. After a standardized explanation of MDMA-assisted psychotherapy, provided in each group, all but one participant changed their minds and supported the idea of implementing MDMA-assisted psychotherapy for adolescents. They all emphasized the importance of conducting research first.

Conclusion

Our findings suggest that when provided with information on what MDMA-assisted psychotherapy entails, adolescents, parents, and clinicians are open to the idea of exploring this type of treatment for adolescents.

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Research Summary of 'MDMA-assisted psychotherapy with adolescents suffering from PTSD: Do or don’t? a qualitative study with youth, parents, and clinicians'

Introduction

Post-traumatic stress disorder (PTSD) in adolescents is a significant public health problem that can cause persistent symptoms across re-experiencing, avoidance, negative cognitions/mood, and hyperarousal, and it carries substantial health-care costs. Existing evidence-based psychological treatments such as trauma-focused cognitive behavioural therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) benefit many young people, but dropout rates (13–36%) and a non-response subgroup (around 20%) leave important unmet needs. Complex PTSD (cPTSD), characterised by severe affect regulation problems, persistent negative self-concept, and interpersonal difficulties, predicts poorer response to conventional therapies, and pharmacotherapy (SSRIs) has not shown clear superiority to placebo in adolescents. Against this background, MDMA-assisted psychotherapy (MDMA-AP) has emerged as a promising, cost-effective adjunct to psychotherapy for treatment-resistant PTSD in adults; recent Phase II and Phase III trials reported safety and substantial symptom reduction. Van Vugt and colleagues note that no empirical research has yet examined MDMA-AP in adolescents. To address this gap they conducted a qualitative study to explore how three stakeholder groups—adolescents with trauma therapy experience, parents of traumatised children, and clinicians specialising in childhood trauma—perceive the feasibility, potential risks and benefits, and necessary precautions prior to any adolescent MDMA-AP clinical trials. The study aimed to answer three questions: Do participants consider MDMA a feasible option for adolescent PTSD, what risks or benefits do they foresee, and what precautions should precede a potential trial?

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Study Details

References (10)

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