Trauma-Informed Care in Psychedelic Therapy Research: A Qualitative Literature Review of Evidence-Based Psychotherapy Interventions in PTSD and Psychedelic Therapy Across Conditions.
Study Goal
To systematically review qualitative research on patients' subjective experiences of evidence-based psychotherapy interventions (EBPI) for PTSD and psychedelic therapy (PT), examining areas of overlap and divergence between them.
Results Summary
The study identified core themes in patient experiences of PT, including indirect trauma processing, reorganization of self-narratives, and key treatment characteristics. Overlap with EBPI was noted in mechanisms of change, psychological safety, and readiness for treatment.
Population
Patients with PTSD, substance use disorders, anxiety related to physical illness, and depression.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
pharmacotherapies and evidence-based psychotherapy interventions (EBPI) | no change | PTSD | patients with PTSD | - | are effective | #1 |
pharmacotherapies and evidence-based psychotherapy interventions (EBPI) | no change | treatment outcomes | patients with PTSD | - | inadequate outcomes | #2 |
pharmacotherapies and evidence-based psychotherapy interventions (EBPI) | decrease | treatment adherence | patients with PTSD | - | high treatment dropout | #3 |
Psychedelic therapy (PT) | increase | difficult-to-treat conditions | patients with difficult-to-treat conditions | - | has shown preliminary promise | #4 |
MDMA-assisted therapy | increase | PTSD | patients with PTSD | - | has shown preliminary promise | #5 |
CBT, EMDR, CPT and PE | neutral | PTSD | patients with PTSD | - | studied | #6 |
psilocybin, ibogaine, LSD, MDMA and ketamine | neutral | substance use disorders, anxiety relating to physical illness, depression, and PTSD | patients with substance use disorders, anxiety relating to physical illness, depression, and PTSD | - | studied | #7 |
INTRODUCTION: Post-traumatic stress disorder (PTSD) is associated with significant patient burden. While pharmacotherapies and evidence-based psychotherapy interventions (EBPI) are effective, studies consistently highlight inadequate outcomes and high treatment dropout. Psychedelic therapy (PT) has shown preliminary promise across difficult-to-treat conditions, including MDMA-assisted therapy for PTSD, however trials of classical psychedelics in PTSD are lacking. Understanding patients' experiences of EBPI could help promote safety in PT. AIM: To systematically review qualitative research on patients' subjective experience of EBPI for PTSD, and of PT, and examine areas of overlap and divergence between them. METHODS: Systematic literature searches for studies published between 2010 and 2023 were conducted on OVID, PubMed, Web of Science, and PsycInfo. Included were original studies in English that presented qualitative data of patient experiences of EBPI in PTSD, or PT for any indication. Extracted data from included studies were analysed using thematic synthesis. Syntheses were completed separately for EBPI and PT, before similarities and differences between the therapies were identified. RESULTS: 40 research articles were included for review: 26 studies on EBPI for PTSD, and 14 studies on PT. EBPI studied were CBT, EMDR, CPT and PE. Psychedelic compounds studied were psilocybin, ibogaine, LSD, MDMA and ketamine, for treatment of substance use disorders, anxiety relating to physical illness, depression, and PTSD. Core themes from patient experiences of EBPI: 1) patient burden in PTSD treatment; 2) readiness; 3) key mechanisms of change; 4) psychological safety and trust. Themes identified in the review of PT: 1) indirect trauma processing; 2) reorganisation of self-narratives via processes of relatedness and identification; 3) key treatment characteristics. CONCLUSION: This study suggests overlap between patients' experience of EBPI and PT in terms of key mechanisms of change, the importance of psychological safety and readiness to engage in treatment. Trauma-informed care paradigms and practices may improve safety and acceptability of PT research.