Journal of Humanistic Psychology
September 16, 2021
Margo A. Jackson, Joseph G. Ponterotto, Bill Brennan et al.
53 citations
Practitioners who have administered MDMA and psilocybin in underground (extralegal) healing contexts face unique relational ethical challenges, including client nudity, the use of touch, and the belief that therapists must continue their own psychedelic experiences. Interviews with 23 practitioners revealed descriptive themes of these challenges and prescriptive themes of helpful practices. Some challenges are unique to psychedelic work, while others represent psychedelic-specific takes on standard ethical considerations like transference and supervision. The findings have implications for training psychedelic psychotherapists and regulatory decisions.
March 6, 2024
Bill Brennan, Alex Belser
6 citations
A new therapeutic framework called EMBARK guides clinicians in administering psychedelic medicines for depression. The model addresses shortcomings in existing psychedelic-assisted therapy, such as neglect of the body, therapist-participant relationship, spiritual counseling, and ethics. It is built on four Cornerstones of Care: Trauma-Informed, Culturally Competent, Ethically Rigorous, and Collective Care. The EMBARK acronym covers six Clinical Domains: Existential-Spiritual, Mindfulness, Body Aware, Affective-Cognitive, Relational, and Keeping Momentum. The approach is transdiagnostic, trans-drug, and open-sourced, with ongoing randomized controlled trials building an evidence base. It aims to be adaptable to various psychedelics, contexts, and populations.
July 18, 2023
Bill Brennan, Alex R. Kelman, Alexander Belser
4 citations
preprint
A systematic review of 33 published psychedelic clinical trials found that many reports inadequately describe the psychosocial interventions provided alongside the drugs. Over 80% did not report assessing treatment fidelity, more than half did not mention using a therapy manual, and nearly half omitted the duration or number of therapy sessions. This underreporting, worse than in non-psychedelic trials, undermines research standardization and the ability to understand how these interventions affect outcomes. The authors recommend improved reporting practices to clarify the role of psychological support in psychedelic treatment.
EMBARK Psychedelic Therapy for Depression
April 23, 2024
Bill Brennan, Alex Belser
Chapter 1 introduces psychedelic-assisted therapy (PAT) and the EMBARK model, a new transdiagnostic and trans-drug approach adaptable to various conditions and psychedelic medicines. It critiques conventional PAT history for omitting harm and marginalized groups' stories. The chapter outlines common PAT elements: preparation, medicine, and integration phases; therapist dyads; set and setting; and the therapeutic container. It notes growing interest in psychedelic medicines for mental health disorders, especially depression, and mentions ongoing randomized clinical trials piloting EMBARK, plus a free open-access training program.
EMBARK Psychedelic Therapy for Depression
April 23, 2024
Bill Brennan, Alex Belser
Chapter 5 describes a preparation phase for psychedelic therapy that consists of three 90-minute nondrug sessions. This phase aims to build trust, understand the participant's depression, identify intentions, and provide psychoeducation. The therapist works across six EMBARK clinical domains: creating an environment for profound spiritual experiences, teaching compassionate internal focus and self-soothing, fostering somatic appreciation, encouraging open reception of emotions and beliefs, cultivating a safe and empowering therapeutic relationship considering trauma and culture, and codeveloping strategies to maintain therapeutic gains. Three session agendas are provided.
EMBARK Psychedelic Therapy for Depression
April 23, 2024
Bill Brennan, Alex Belser
This chapter describes the medicine sessions of psychedelic-assisted therapy (PAT), where the psychedelic medicine is administered. It outlines the therapist's role, emphasizing support, responsiveness, and skillful following, ensuring physical well-being, maintaining boundaries, and providing mindful, compassionate attention. It details working within the six EMBARK psychedelic therapy domains during sessions, offering specific interventions and explanatory language for clinical phenomena. The chapter also discusses responding to common and challenging events, stressing the therapist's presence and quality of attention. It concludes with advice on challenging experiences and what to do if a participant believes they received a placebo.
EMBARK Psychedelic Therapy for Depression
April 23, 2024
Bill Brennan, Alex Belser
Chapter 7 describes the role of integration sessions in psychedelic therapy, where insights from medicine sessions are incorporated into daily life. It presents the EMBARK model's flexible, participant-centric approach, focusing adaptively on six clinical domains. A three-step process for integration is outlined: listening to understand the participant's experience, setting actionable goals for new attitudes and behaviors, and enacting these changes. The chapter introduces three spheres of integration, including participating in social change as a therapeutic growth avenue, and provides guidance on handling disappointing medicine sessions, challenging events, and serious adverse outcomes.