Systematized Review of Psychotherapeutic Components of Psilocybin-Assisted Psychotherapy
This review (2021; s=11) found that psilocybin-assisted psychotherapy consisted of three stages; 1) pretreatment sessions, 2) treatment sessions (dosing, non-directive support, music therapy), and 3) integration sessions.
Authors
- Horton, D. M.
- Morrison, B.
- Schmidt, J.
Published
Abstract
Objective
This systematized review sought to fill a gap in psilocybin research by investigating the structure and format of psilocybin-assisted psychotherapy (PAP), with a focus on the counselling components of the treatment.
Methods
A systematized review of PAP was conducted by using the PubMed and PsycInfo databases to search for peer-reviewed studies of human clinical trials, published within the past 25 years, in which psilocybin was administered with psychological support in a clinical setting.
Results
Eleven articles matched the criteria necessary for inclusion in this review. PAP was found to consist of three stages: pretreatment sessions to prepare participants for psilocybin, treatment sessions in which psilocybin was administered, and posttreatment sessions to integrate the experience with daily life. Conventional psychotherapy was primarily seen in the pre-and posttreatment sessions. Psychotherapies included in PAP differed among studies but most often included music therapy and a non-directive supportive approach to treatment.
Conclusions
This systematized review found important commonalities among clinical trials of PAP published within the past 25 years and revealed key differences among studies in psychotherapy's incorporation into PAP. Additional research is needed to identify the unique effect of psychotherapy in PAP.
Research Summary of 'Systematized Review of Psychotherapeutic Components of Psilocybin-Assisted Psychotherapy'
Introduction
Research on mental illness treatment has expanded to include renewed clinical interest in psychedelic-assisted approaches that combine pharmacology with psychotherapeutic processes. Horton and colleagues frame psilocybin-assisted psychotherapy (PAP) as an intervention in which both the drug and the psychological context — commonly discussed as "set and setting" — are considered central mechanisms of therapeutic change. Although multiple trials over the past 25 years have reported promising clinical outcomes for conditions such as depression, anxiety, substance use and demoralisation, the authors note a gap in the literature regarding the detailed structure, content, and role of psychotherapy within PAP protocols. This systematized review therefore aims to characterise how psychotherapy has been integrated into modern PAP trials. Specifically, Horton and colleagues sought to answer: what roles do therapists play in PAP, what is the typical structure of PAP sessions, and which psychotherapeutic modalities and techniques have been used alongside psilocybin? Treatment outcomes from eligible trials were also summarised to provide context for how psychotherapeutic components relate to clinical results. The intent is to inform future work that seeks to refine PAP procedures and identify which psychotherapeutic adjuncts are most appropriate for different clinical indications.
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Study Details
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- APA Citation
Horton, D. M., Morrison, B., & Schmidt, J. (2021). Systematized Review of Psychotherapeutic Components of Psilocybin-Assisted Psychotherapy. American Journal of Psychotherapy, 74(4), 140-149. https://doi.org/10.1176/appi.psychotherapy.20200055
References (23)
Papers cited by this study that are also in Blossom
Johnson, M. W., Richards, W. A., Griffiths, R. R. · Journal of Psychopharmacology (2008)
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Carhart-Harris, R. L., Bolstridge, M., Rucker, J. et al. · Lancet Psychiatry (2016)
Ross, S., Bossis, A. P., Guss, J. et al. · Journal of Psychopharmacology (2016)
Rucker, J., Young, A. H., Jelen, L. A. et al. · Journal of Psychopharmacology (2016)
Dos Santos, R. G., Bouso, J. C., Hallak, J. E. · Expert Review of Clinical Pharmacology (2018)
Anderson, B. T., Danforth, A. L., Daroff, R. et al. · EClinicalMedicine (2020)
Griffiths, R. R., Johnson, M. W., Richards, W. A. et al. · Journal of Psychopharmacology (2017)
Grob, C. S., Danforth, A. L., Chopra, G. S. et al. · JAMA Psychiatry (2011)
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Show all 23 referencesShow fewer
Moreno, F. A., Wiegand, C. B., Taitano, E. K. et al. · Journal of Clinical Psychiatry (2006)
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Bogenschutz, M. P., Podrebarac, S. K., Duane, J. H. et al. · Frontiers in Pharmacology (2018)
Noorani, T., Garcia-Romeu, A., Swift, T. C. et al. · Journal of Psychopharmacology (2018)
Swift, T. C., Belser, A. B., Agin-Liebes, G. et al. · Journal of Humanistic Psychology (2017)
Belser, A. B., Agin-Liebes, G. I., Swift, T. C. et al. · Journal of Humanistic Psychology (2017)
Ross, S., Malone, T. C., Mennenga, S. E. et al. · Frontiers in Pharmacology (2018)
Phelps, J. · Journal of Humanistic Psychology (2017)
Griffiths, R. R., Richards, W. A., Mccann, U. et al. · Journal of Psychopharmacology (2006)
Carhart-Harris, R. L. · Current Opinion in Psychiatry (2019)
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Kaelen, M., Giribaldi, B., Raine, J. et al. · Psychopharmacology (2018)
Johnson, M. W., Garcia-Romeu, A., Griffiths, R. R. · The American Journal of Drug and Alcohol Abuse (2016)
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