The focus on drug effects in the discussion of psychedelics for medical treatment has been prominent, but a recent study indicates that the key to reducing depression with psychedelic-assisted therapy is the quality of the relationship between the therapist and the study participant.
Examined information from a clinical trial conducted in 2021 that determined the effectiveness of combining psilocybin (magic mushrooms) with psychotherapy in treating major depressive disorder in adults.
The data included the effects of depression and reports from participants regarding their experiences with the drugs and their interactions with therapists. The findings revealed that the better the relationship between a participant and clinician, also known as a therapeutic alliance, the lower the depression scores were one year later.
<p”The most significant factor that remained consistent was the connection between the therapeutic alliance and long-term outcomes, highlighting the importance of a strong relationship.Adam Levin, a psychiatry and behavioral health resident at The Ohio State University College of Medicine, stated, “Past research has revealed that a trusting relationship between clients and clinicians is crucial for better outcomes as mental health treatments evolve.” Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education in The Ohio State University College of Social Work, added, “While the concept is not new, it is innovative that very few have examined this concept in the context of psychedelic-assisted therapy.” Davis continued, “This data suggests that a trusting relationship remains important even in this unique form of therapy.”The study, published in the journal PLOS ONE, suggests that psychedelic-assisted therapy relies heavily on the therapeutic alliance, similar to any other treatment. In the trial, twenty-four adults received two doses of psilocybin and 11 hours of psychotherapy. They were asked to complete a therapeutic alliance questionnaire three times: after eight hours of preparation therapy and one week after each psilocybin treatment. Participants also filled out questionnaires about any mystical and psychological experiences.their depression symptoms were evaluated one week, four weeks, and up to one year after the study concluded.
The study found that the alliance score increased over time and indicated a connection between a higher alliance score and more intense mystical and/or psychologically insightful experiences during the drug treatment. The immediate effects were related to reduced depression at the four-week mark after treatment, but did not show a correlation with improved depression outcomes one year after the trial.
“The mystical experience, which is something that is most ofAccording to Davis, the ten relationships that were reported as having an impact on the outcome were not found to be related to depression scores after 12 months. This does not diminish the importance of acute effects, as psychological insight still predicted long-term improvement. However, this does help to establish the significance of the therapeutic alliance in addition to the more well-known effects. The analysis also revealed that a stronger relationship during the final therapy preparation session predicted a more mystical and psychologically insightful experience, which in turn strengthened the therapeutic alliance even further.This stu alliance.”
“That’s why I believe the connection has been demonstrated to be significant in this analysis — because, really, the entire intervention is designed for us to establish the trust and rapport that’s necessary for someone to enter an alternative state of consciousness safely,” Davis said. Considering that psychedelics are stigmatized as Schedule I drugs under the Controlled Substances Act, efforts to reduce negative experiences in future research on their therapeutic potential should be of utmost importance — and therapy is crucial in creating a supportive environment for patients, the authors stated.Levin mentioned that ideally, the aim is to clearly establish psychedelics treatment as a form of psychotherapeutic intervention, rather than just focusing on drug administration. He emphasized the need to expand the existing psychiatric paradigm to incorporate the findings from psychedelics, instead of trying to force psychedelics into the current framework. Levin expressed concern that reducing therapeutic support could lead to safety issues or negative events. The study provided evidence of the significance of the therapeutic alliance in preventing such events and optimizing outcomes.This study was funded by the Center for Psychedelic and Consciousness Research, which received support from the Steven & Alexandra Cohen Foundation, the RiverStyx Foundation, private donors, and the Center for Psychedelic Drug Research and Education (CPDRE) with funding from anonymous donors. The co-authors of this study include Rafaelle Lancelotta, Nathan Sepeda, Theodore Wagener, Natalie Gukasyan, Sandeep Nayak, Frederick Barrett, and Roland Griffiths. Davis is affiliated with the Center for Psychedelic and Consciousness Research at Johns Hopkins University.
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