Trial PaperAlcohol Use Disorder (AUD)Substance Use Disorders (SUD)Psilocybin

The psychedelic debriefing in alcohol dependence treatment: illustrating key change phenomena through qualitative content analysis of clinical sessions

This open-label pilot study (n=10) of psilocybin-assisted treatment of alcohol dependence (21mg/70kg) presents a qualitative content analysis of the 17 debriefing sessions conducted in the pilot study, which occurred the day after corresponding psilocybin medication sessions. Participants articulated a series of key phenomena related to change in drinking outcomes and acute subjective effects of psilocybin.

Authors

  • Michael Bogenschutz
  • Elizabeth Nielson

Published

Frontiers in Pharmacology
individual Study

Abstract

Background

Research on the clinical applications of psychedelic-assisted psychotherapy has demonstrated promising early results for treatment of alcohol dependence. Detailed description of the content and methods of psychedelic-assisted psychotherapy, as it is conducted in clinical settings, is scarce.

Methods

An open-label pilot (proof-of-concept) study of psilocybin-assisted treatment of alcohol dependence (NCT01534494) was conducted to generate data for a phase 2 RCT (NCT02061293) of a similar treatment in a larger population. The present paper presents a qualitative content analysis of the 17 debriefing sessions conducted in the pilot study, which occurred the day after corresponding psilocybin medication sessions.

Results

Participants articulated a series of key phenomena related to change in drinking outcomes and acute subjective effects of psilocybin.

Discussion

The data illuminate change processes in patients' own words during clinical sessions, shedding light on potential therapeutic mechanisms of change and how participants express effects of psilocybin. This study is unique in analyzing actual clinical sessions, as opposed to interviews of patients conducted separately from treatment.

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Research Summary of 'The psychedelic debriefing in alcohol dependence treatment: illustrating key change phenomena through qualitative content analysis of clinical sessions'

Introduction

Kraehenmann and colleagues situate this work within a resurgence of clinical research on psychedelic-assisted psychotherapy, noting that psilocybin has shown safety and potential efficacy for alcohol dependence in an open-label pilot and that a larger FDA-approved Phase II trial was underway. They describe the typical treatment structure used in these studies: a 12-week psychotherapy programme with two psilocybin medication sessions (weeks 4 and 8), therapists working as a co-therapist dyad, and debriefing sessions held the day after medication sessions to assess mental status and to allow patients to describe and reflect on their experiences. The paper aims to characterise how participants themselves talk about change-related phenomena during these immediate post-medication debriefing sessions. Because detailed descriptions of what actually occurs in clinical psychedelic-assisted psychotherapy are scarce, the investigators analysed transcripts of debriefing sessions from their open-label pilot to illustrate phenomena—such as mysticomimetic experiences, ego-dissolution, motivation, commitment to change, dysphoria, and stigma—that may relate to changes in drinking behaviour and to therapeutic mechanisms more broadly.

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Study Details

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