Transdiagnostic Potential of Psychedelic-Assisted Therapy
In the Fundamentals of Psychedelic-Assisted Therapy course, we learned about psychological flexibility and somatic inquiry within the context of psychedelic-assisted therapy.
Process-Based and Other Approaches
Process-based therapies like sensorimotor psychotherapy, hakomi, and somatic experiencing emphasize understanding the psychobiology of trauma, and trauma as a transdiagnostic biopsychosocial factor. They deploy therapeutic methods that assist clients to give descriptions of inner experiences through present moment focus and tracking of components of experience, while using techniques to bring regulation into the nervous system.
These therapies share many common aspects with third wave therapies such as mindfulness-based interventions, dialectical behaviour therapy, and acceptance and commitment therapy. Third wave behaviourist modalities emphasize awareness processes that help a person to improve psychological flexibility, and in general, how they relate to themselves, and their symptoms. Symptom improvement is understood as a side-effect of changes in processes of attention and consequent increase in repertoire of accessible response choices.
In process-based approaches, categorical diagnosis bears less relevance to treatment (Hayes & Hofmann, 2017).
Transdiagnostic Potential of Psychedelic-Assisted Therapy
Koçárová et al. (2021) proposed psychedelic-induced plasticity (pertaining to both the brain and the mind/psychological phenomena) as a primary transdiagnostic mechanism of change, when treatment occurs within the context of a supportive therapeutic environment and can address universally maladaptive behaviours of brain and mind.
As you might recall from the Molecular Foundations course, neuroplasticity is where your brain becomes more malleable which can help to repair neural pathways and form new ones (de Vos et al., 2021). The figure below depicts acute-state effects of psychedelics on brain, behaviour, and mind in addition to related longer-term changes in transdiagnostically relevant constructs of psychological flexibility, cognitive flexibility, and mindfulness.
For this interactive, drag the vertical line to the left and right to see and compare both images. If you are using a keyboard, you can use the left and arrow keys.
Research Domain Criteria
The acute state and longer-term changes of psychedelics can also be mapped onto the RDoC framework.
While supportive of furthering our understanding of transdiagnostic factors amenable to psychedelic-assisted therapy intervention, the RDoC remains focused on individual biological targets and thus may perpetuate a decontextualized view that ignores socioecological factors and their impact on wellbeing, a previously noted criticism of the RDoC approach.
The Numinus Care Model encourages balancing multiple perspectives, maintaining TVIC and JEDI as orienting principles.
References
De Vos, C. M. H., Mason, N. L., and Kuypers, K. P. C. (2021). Psychedelics and Neuroplasticity: A Systematic Review Unraveling the Biological Underpinnings of Psychedelics. Frontiers in Psychiatry, 12(724606).
Hayes, S. C. & Hofmann, S. G. (2017). The third wave of cognitive behavioral therapy and the rise of process-based care. World Psychiatry.
Kočárová, R., Horáček, J., and Carhart-Harris, R (2021). Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential? Frontiers in Psychiatry, 12(661233).