OPTICS: Opinions and Preferences for Treatments In Community Samples

Among individuals with PTSD symptoms, preferences for MDMA-assisted therapies and standard psychotherapies vary, with many favoring less directive approaches. In an online survey, participants rated MDMA-Assisted Inner-Directed Psychotherapy as more appealing than Prolonged Exposure or Present-Centred Therapy, citing perceived efficacy and lower fear. Treatment appraisals and clinical factors shaped these preferences, highlighting the importance of aligning emerging interventions with patient expectations.

Study at a glance

Abstract

PTSD is a prevalent and debilitating condition, for which many individuals do not seek or complete treatment. As new PTSD treatments are being evaluated, such as psychedelic-assisted therapies, it’s important to understand the preferences of individuals for whom these treatments are being developed. To date, no research has directly compared preferences for psychedelic-assisted therapies relative to psychotherapy without psychedelics. While some prior work has examined PTSD treatment preferences, it has not examined how individuals with PTSD symptoms perceive less directive versus more directive therapeutic modalities, particularly in the context of MDMA-assisted therapy. This gap is timely given ongoing debates about the optimal psychotherapeutic frameworks to pair with psychedelics. Understanding treatment preferences among individuals with PTSD symptoms is important for aligning emerging interventions with patient needs and expectations and for supporting effective framing and uptake of care. To address these gap, the current online cross-sectional study aims to: (1) characterize and compare treatment preferences for distinct psychotherapies (Present-Centred Therapy (PCT); Prolonged Exposure (PE); MDMA-Assisted Inner-Directed Psychotherapy (MDMA+IDP); and MDMA-Assisted Prolonged Exposure Psychotherapy (MDMA+PE); (2) characterize and compare treatment appraisals (perceived efficacy, fear, suitability); (3) discern psychosocial and clinical factors influencing treatment preferences; and (4) qualitatively explore the reason behind treatment preferences.