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Spiritual health practitioners “bring unique and specific expertise to psychedelic-assisted therapy,” researchers at Emory University concluded in a recently published study, noting that therapy teams could benefit from including the professionals in their work.
“Psychedelic dosing often produces highly impactful, and sometimes challenging, experiences with pronounced effects on spirituality, worldview, and metaphysical perspectives,” wrote authors of the report, published in the journal PLOS ONE. Spiritual health practitioners (SHPs) “may have unique, and uniquely valuable, contributions to support the participant’s wellbeing and helping them benefit” from psychedelic-assisted therapy (PAT).
As the paper explains, SHPs include those who traditionally served “as chaplains or military settings to provide religiously-based pastoral care to those who share their denomination,” though the term has also come to mean “providing spiritual support for people of any or no religious affiliation.”
Despite that broad description, the work typically requires significant training. Qualifying as a board certified chaplain, for example, “involves completion of 1600 clinical and educational hours, 2000 hours of additional clinical practice, endorsement from a religious/spiritual community, submission of four position papers, and committee approval based on demonstration of 31 competencies”—usually after years of seminary and theological training.
Authors noted the long history of religious and spiritual use of psychedelics, especially in some indigenous traditions, which has often intertwined with medical and therapeutic use.
“A core professional role of SHPs is to address spiritual needs, which are defined as concerns deemed sacred by a person within their life and may or may not include religious components,” they explained. “Given the prevalence and importance of spiritual content in psychedelic experiences, and its potential as a mediator of therapeutic effects, SHPs are uniquely positioned to contribute to PAT in ways likely to optimize its therapeutic benefit.”
The report is the product of the eight-author research team’s interviews with 15 spiritual health practitioners with experience facilitating psychedelic therapy in legal settings. Authors then analyzed “their contributions, application of expertise and professional background, and roles in administering these therapies.” The team said the study is notable in part because the roles and competencies of SHPs in PAT “have not been described in research.”
“As physicians are competent to respond to psychological concerns, and mental health practitioners are competent to respond to psychological concerns,” their report concludes, “SHPs are competent to respond to spiritual concerns of the psychedelic experience.”
And as more patients who are suffering continue to turn to psychedelic-assisted therapy (PAT), it reasons, “treatment teams will have the opportunity to respond to these needs in a holistic manner, taking into account the full dimension of the human experience, inclusive of spiritual dynamics through inclusion of SHPs on their interdisciplinary teams.”
Specifically, researchers said, their qualitative analysis found seven themes that illustrated SHPs’ potential usefulness in PAT, which they divided into unique versus general contributions.
Unique contributions to a therapy team included competency to work with spiritual material, awareness of power dynamics, familiarity with non-ordinary states of consciousness, holding space and offering a counterbalance to more traditional Western biomedical perspectives. General contributions, meanwhile, included fluency with generalizable “therapeutic repertoire” as well as adding to interdisciplinary collaboration.
Though the findings suggest that the incorporation of spiritual health practitioners could benefit some participants in psychedelic-assisted therapy, the study acknowledges it has some limitations. Most notably, because the survey responses from SHPs were qualitative and retrospective, the study “cannot address questions of causality or speak to the effectiveness of the therapeutic approaches used by the SHPs.”
To support adequate sampling, the report added, the study also relied on the interviewers’ professional network, which “may have biased inclusion of professionals who share views similar to those held by the [interviewer], and may have biased responses toward those aligned with those views.”
The study also relied solely on interviews with SHPs practicing in legal contexts, which the report says “may have excluded perspectives of of SHPs with experience in community based (i.e., “underground”) contexts.”
“In community-based settings, SHPs or spiritual guides have been providing psychedelic-assisted care for decades, sometimes building from ancient practices in indigenous communities, suggesting a wealth of knowledge that may inform the conduct of PAT in medical settings,” authors noted. “In the field at large, there has been limited research addressing the experience of Black, Indigenous and people of color with PAT. This limitation characterizes the present research about SHPs providing PAT. In our study SHP participants were predominantly white, and the study included limited perspectives of those who identified as Black, Indigenous, and people of color.”
Limitations notwithstanding, interviews with the SHPs demonstrated that the care providers “have emerged as essential members of the interdisciplinary care team offering bedside care to patients and their care partners,” the study found.
The findings come as support builds for broader access to psychedelic-assisted therapy, including among the nation’s military veterans. Another recent study found that strong majorities of active duty military, veterans and their family members support allowing U.S. Department of Veterans Affairs (VA) doctors to recommend medical marijuana and psychedelics to patients if they believe it would provide a benefit.
Currently, there are no Food and Drug Administration (FDA)-approved psychedelic therapies—but that could change in 2024.
The FDA granted priority review to a new drug application for MDMA-assisted therapy following the completion of multiple clinical trials that supported the drug’s effectiveness as a therapeutic for moderate and severe PTSD. If the application is approved, the Drug Enforcement Administration (DEA) would then need to reschedule MDMA accordingly. It would become the first psychedelic in history to be approved as a pharmaceutical.
The federal agency has already designated MDMA and psilocybin as breakthrough therapies for the treatment of post-traumatic stress disorder (PTSD) and severe depression, respectively.
The Multidisciplinary Association for Psychedelic Studies (MAPS) published the results of a recent Phase 3 trial in the journal Nature in September, finding that MDMA “significantly attenuated PTSD symptomology versus placebo with therapy.”
Meanwhile, a separate study, by researchers at New York University’s Langone Center for Psychedelic Medicine and the Centre for Psychedelic Research at Imperial College London recently found that pairing MDMA with either psilocybin or LSD helped people overcome the “challenging experiences” associated with use of psilocybin or LSD alone.
In 2022, the Biden administration said it was “actively exploring” the possibility of creating a federal task force to investigate the therapeutic potential of psilocybin, MDMA and others ahead of the anticipated approval of the substances for prescription use.
In California, meanwhile, Gov. Gavin Newsom (D) signed a bill in October that would allow doctors to immediately start prescribing certain currently illicit drugs like psilocybin and MDMA if they’re federally rescheduled.
Last year, Australia legalized MDMA and psilocybin for use by prescription.
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