Psychedelics and Mental Health Practitioners
Mental health practitioners have been using psychedelics in their practices for decades. Many of these practitioners have led or have participated in research studies demonstrating the effectiveness of psychedelic compounds in treating a range of mental health conditions. Recent research has focused largely on MDMA and psilocybin for treatment of depression, anxiety, end of life therapy, PTSD, and Asperger’s syndrome / autism spectrum disorders. LSD is still the most-studied psychedelic overall as is frequently used in therapy.
Whether used on their own or in combination with other therapy, psychedelics have proven to be incredibly productive in addressing mental health conditions. From hundreds of personal experiences of therapists to double-blind university research studies, patients have shown rapid advances in very short periods of time. A quick search on pubmed will get you the latest studies from a very rapidly growing field.
Research organizations such as the Multidisciplinary Association for Psychedelic Research (MAPS) recommend that mental health professionals have personal experience with any substance that they use with patients. The goal is to increase comfort for both the patient and therapist with the experience and to improve communication and empathy between the two.
Current research protocols at Johns Hopkins and UCLA include training sessions for therapists where they use the substance themselves and discuss their personal experience while learning about the treatment process. See the links below for detailed treatment protocols.
Because use of psychedelic substances is severely restricted in many parts of the world, mental health professionals that work with these substances often do so without official licensing. It is important for any practitioner to carefully consider legal regulations as well as the effect on patient comfort when working outside of those restrictions.
As you would with any other medicine, be absolutely sure to research and rule out any potential drug interactions with supplements or pharmaceuticals that your patient may be taking. Some practitioners will ask patients to provide their own substances, from a source that they feel confident about. Practitioners may also prefer to work with patients who have some previous experience and comfort with the particular psychedelic that they are working with.
One of the more perplexing issues facing practitioners is dosage levels for substances like psilocybin and LSD. Because these drugs induce powerful mental experiences, they can also create anxiety in patients. Traditionally, many therapists believed that beginning with a full strength dose was important to help patients directly break through their anxiety and uncertainty and engage with the exploration. However, recent research from Johns Hopkins suggests that starting patients at smaller doses and increasing the dose in successive sessions tends to moderately reduce incidences of anxiety. What works best for you and your patients will depend on your therapeutic method, patient’s comfort level, planned timeline of the overall therapy process, and other factors.
With MDMA, this consideration appears to be less important, due to MDMA’s strong anxiety reducing effects. Experts tend to recommend a full dose of MDMA at every session (and potentially including a ‘booster’ dose during the session to prolong the effects).
We are interested in hearing from mental health professionals about your experience working with these substances in your practice or suggestions for improving this guide. In particular, we would like to be able to share your experiences and professional perspectives with our readers. If you’d like to share your experience or advice, please write to firstname.lastname@example.org. We will keep all identifying information completely confidential when posting experiences to this site and will only do so with your explicit permission.
Recent Research and Treatment Protocols
A good starting point for practitioners is to explore MAPS.org research protocols for using MDMA, LSD, and psilocybin: MAPS.org research menu. Below are a few research studies, articles, and books that may be helpful in your practice:
Treatment Manual for MDMA-Assisted Psychotherapy for Treatment of PTSD
A study of psilocybin dose levels: Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects
Book Chapter: Use of the Classic Hallucinogen Psilocybin for Treatment of Existential Distress Associated with Cancer
More Resources for Practitioners
This article explores private practitioners' use of MDMA with patients: Can a single pill change your life?
Video: Dr. Sanjay Gupta on MDMA for PTSD
VIDEO: Treating PTSD with MDMA-Assisted Psychotherapy
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