As Patients Turn to Psychedelics, Integration Must Be In Therapists’ Toolkits: Paper

Media contact: Brad Burge (Fluence)

Today, Fluence, a leading provider of professional training in psychedelic integration and therapy, announced the first peer-reviewed publication to define psychedelic integration and provide a cohesive model for psychedelic integration services—Psychedelic Harm Reduction and Integration (PHRI). Published on March 15, 2021, in Frontiers in Psychology, the paper provides a complete framework for therapists working with patients who use, have ever used, or are considering using psychedelics.

With psychedelic-assisted therapy rapidly gaining mainstream acceptance, and as non-clinical psychedelic use also increases, many healthcare and wellness practitioners lack an understanding of why people use psychedelics, or how to help their patients integrate insights from psychedelic experiences into their lives.

Ketamine therapy is already administered legally in hundreds of clinics nationwide as a prescription treatment for depression, and psilocybin (for depression) and MDMA (for posttraumatic stress disorder, or PTSD) are both in late-stage FDA trials and available now (or soon) through Compassionate Use/Expanded Access programs. Psychedelic use in non-clinical settings continues to increase, such as ayahuasca and psilocybin mushroom ceremonies, transformational and music festivals, and underground psychedelic-assisted therapy sessions. It is estimated that over 30 million people in the U.S. have used psychedelics, and that past-year LSD use among adults grew by 56.4% between 2015 and 2018.

“Our clinical experience and review of the literature offer a way forward for the field of psychotherapy to engage psychedelics, even when patients’ psychedelic experiences occur outside of psychotherapy,” says Fluence co-founder Dr. Elizabeth Nielson. “By learning how to have honest, respectful, and non-judgemental conversations with patients about psychedelics, clinicians can counter the harms of years of prohibition, misinformation, and stigma associated with these experiences.”

Despite the growing variety of available avenues for people to access psychedelics, traditional approaches to professional education only teach clinicians to define and diagnose negative consequences of psychedelic use, viewing any psychedelic use as abuse. PHRI offers an alternative to conventional therapeutic training by providing clinicians with tools for ethically integrating conversations about psychedelics into their existing practice.

According to the study authors, examples of individuals who might benefit from PHRI include: people who have used psychedelics on their own to try to resolve psychiatric symptoms; people who ingested psychedelics and are currently experiencing psychological distress; or people who intend to use psychedelics in therapeutic, ceremonial, or other contexts, but are unaware of the possible risks and contraindications.

“Many psychotherapists and other providers have encountered clients who use psychedelics already, but there hasn’t been a consistent approach to working with these individuals,” says Fluence co-founder Dr. Ingmar Gorman. “We’re hoping that this publication will start a conversation that’s been missing in the field, so that we can be most helpful to those who need us.”

PHRI involves supporting patients who use psychedelics without encouraging them to use psychedelics. PHRI does not involve the administration of psychedelics, or providing therapy during a psychedelic experience.

PHRI is not a treatment modality or technique, but serves as a perspective which therapists of all training backgrounds can incorporate into their practice.  PHRI is intended to guide clinical work with people who have used psychedelics in a variety of contexts, including clinical therapies, spiritual practices, with peer groups, or on their own.

There is not yet empirical research about PHRI, and the study authors underscore that future research should focus on establishing standards and evaluating the efficacy of this approach when working with people who use or are considering using psychedelics.

The Frontiers in Psychiatry paper, “Psychedelic harm reduction and integration: A transtheoretical model for clinical practice,” was authored by Ingmar Gorman, Ph.D., Elizabeth M. Nielson, Ph.D., Aja Molinar, Ksenia Cassidy, and Jonathan Sabbagh. Drs. Gorman and Nielson are co-first authors.

Fluence is an expertise-driven educational platform that provides professional certification and training in psychedelic therapy and psychedelic integration for psychiatrists, psychotherapists, social workers, and other healthcare practitioners. Fluence’s mission is to give healthcare providers the clinical skills and knowledge to provide effective, compassionate, evidence-based psychedelic therapy and integration services to patients through dynamic, interactive online and in-person training.

· Article: View online (open access)

· Citation: Gorman I, Nielson EM, Molinar A, Cassidy K and Sabbagh J (2021) Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice. Front. Psychol. 12:645246. doi: 10.3389/fpsyg.2021.645246

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