Assessment and Preparation
During assessment, the health professional will seek to determine if psychedelic-assisted therapy (PAT) is a good fit for the client.
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In the Molecular Foundations of Ketamine, MDMA, and Psilocybin courses, you will learn about the current relative and absolute contraindications for each medicine as well as the concomitant medications and supplements.
Common Indications
The modern Western research and empirical applications of psychedelic-assisted therapy include primarily:
- Depression (Carhart-Harris et al., 2021; Goodwin et al., 2022; Davis et al., 2021)
- End-of-life anxiety and existential distress (Ross et al., 2022; Yaden et al., 2021)
- Substance use disorder (Garcia-Romeu et al., 2014; Johnson et al., 2017)
- Anxiety (Raison et al., 2022; Banov et al., 2019; Danforth et al., 2018)
- Post-traumatic stress disorder (Mitchell et al., 2021; Mithoefer et al., 2019)
We explore these indications in greater depth with realistic cases in the Applied Psychedelic-Assisted Therapy course, part of Numinus’ certification pathway in Psychedelic-Assisted Therapy.
There’s also some additional indications for which there are ongoing investigations. For example, MDMA-assisted therapy for social anxiety in people with autism spectrum neurodivergence (Danforth et al., 2018). MDMA has been recently analyzed for its potential benefit for treating chronic pain (Christie et al., 2022) and has been proposed to potentially be used in couples therapy (Wagner, 2021). Other researchers are looking at psilocybin primarily to treat different chronic pain conditions like fibromyalgia and other central sensitivity syndromes (Glynos et al., 2023), complex regional pain disorder (Schindler & Hendricks, 2023), phantom limb pain (Ramachandran et al., 2018), and cluster headaches (Rusanen, 2022).
There's an opening evolving field of expanding application of psychedelic-assisted therapy into a realm of medicine and suffering of chronic pain that has a lot of co-morbidity and overlap with a lot of different mental health concerns.
Did You Know?
Numinus doesn’t only provide training programs in psychedelic-assisted therapy. Numinus is also heavily involved in research and clinical trials that investigate the efficacy of this treatment and continue to advance the evidence and research for this new, exciting field.
Numinus’ Cedar Clinic Research (CCR) leading research site for psychedelic clinical trials. CCR was a participating site for a recently published randomized clinical trial that investigated the efficacy of a single dose of psilocybin to treat major depressive disorder. The 25mg dose resulted in a rapid, sustained change in depressive effects in comparison with the placebo. Read the full study below.
Preparation
Following Assessment, health professionals will conduct Preparation Sessions with clients. During these sessions, the health professional will work with the client to prepare them for what to expect. With many psychedelics (especially the classic psychedelics), individual experiences can be vastly different. So, the role of the health professional during Preparation is to help the client build skills so that they are equipped to navigate the experience. Some topics that are typically covered during Preparation include:
- How psychedelics work
- How psychedelics affect sensation, perception, and cognition
- Intention setting
- Teaching clients about their own inner healing intelligence
- Possible adverse effects
- Identifying a resource (in other words, a person/place/memory/object that brings a client feelings of safety and security and warmth which can be used when they’re dysregulated)
- Set and setting
References
Banov, M. D., Young, J. R., Dunn, T., & Szabo, S. T. (2019). Efficacy and safety of ketamine in the management of anxiety and anxiety spectrum disorders: a review of the literature. CNS Spectrums, 1–12.
Carhart-Harris, R., Giairbaldi, B., Watts, R., . . . Nutt, D. J. (2021). Trial of psilocybin versus escitalopram for depression. New England Journal of Medicine, 384, 1402-1411.
Christie, D., Yazar-Klosinski, B., Nosova, E., Kryskow, P., Siu, W., Lessor, D., & Argento, E. (2022). MDMA-assisted therapy is associated with a reduction in chronic pain among people with post-traumatic stress disorder. Frontiers in psychiatry, 13, 939302.
Danforth, A. L., Grob, C. S., … & Emerson, A. (2018). Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Psychopharmacology, 235, 3137-3148.
Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., Finan, P. H., & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: A random clinical trial. JAMA Psychiatry, 78(5), 481-489.
Garcia-Romeu, A., Davis, A. K., Erowid, F., Erowid, E., Griffiths, R. R., & Johnson, M. W. (2019). Cessation and reduction in alcohol consumption and misuse after psychedelic use. Journal of psychopharmacology (Oxford, England), 33(9), 1088–1101.
Glynos, N. G., Pierce, J., Davis, A. K., McAfee, J., & Boehnke, K. F. (2023). Knowledge, Perceptions, and Use of Psychedelics among Individuals with Fibromyalgia. Journal of psychoactive drugs, 55(1), 73–84.
Goodwin, G. M., Aaronson, S. T., Alvarez, O., Arden, P. C., Baker, A., Bennett, J. C., Bird, C., Blom, R. E., Brennan, C., Brusch, D., Burke, L., Campbell-Coker, K., Carhart-Harris, R., Cattell, J., Daniel, A., DeBattista, C., Dunlop, B. W., Eisen, K., Feifel, D., Forbes, M., … Malievskaia, E. (2022). Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. The New England journal of medicine, 387(18), 1637–1648.
Johnson, M. W., Garcia-Romeu, A., & Griffiths, R. R. (2017). Long-term follow-up of psilocybin-facilitated smoking cessation. The American journal of drug and alcohol abuse, 43(1), 55–60.
Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., . . . Doblin, R. (2021). MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebocontrolled phase 3 study. Nat Med, 27(6), 1025-1033.
Mithoefer, M. C., Feduccia, A. A., Jerome, L., Mithoefer, A., Wagner, M., Walsh, Z., . . . Doblin, R. (2019). MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology (Berl), 236(9), 2735-2745.
Raison, C. L., Jain, R., Penn, A. D., Cole, S. P., & Jain, S. (2022). Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States. Frontiers in Psychiatry, 13.
Ramachandran, V., Chunharas, C., Marcus, Z., Furnish, T., & Lin, A. (2018). Relief from intractable phantom pain by combining psilocybin and mirror visual-feedback (MVF). Neurocase, 24(2), 105–110.
Ross, S., Agrawal, M., Griffiths, R. R., Grob, C., Berger, A., Henningfield, J. E. (2022). Psychedelic-assisted psychotherapy to treat psychiatric and existential distress in life-threatening medical illnesses and palliative care. Neuropharmacology. 15(216).
Rusanen, S. S., De, S., Schindler, E. A. D., Artto, V. A., & Storvik, M. (2022). Self-Reported Efficacy of Treatments in Cluster Headache: a Systematic Review of Survey Studies. Current pain and headache reports, 26(8), 623–637.
Schindler, E. A. D., & Hendricks, P. S. (2023). Adapting psychedelic medicine for headache and chronic pain disorders. Expert Review of Neurotherapeutics, 23(10), 867-882.
Wagner A. C. (2021). Couple Therapy With MDMA-Proposed Pathways of Action. Frontiers in psychology, 12, 733456.
Yaden, D. B., Nayak, S. M., Gukasyan, N., Anderson, B. T., & Griffiths, R. R. (2021). The potential of psychedelics for end of life and palliative care. Disruptive Psychopharmacology, 169-184.