Lost in translation? Qualitative interviews with Australian psychedelic-assisted therapy trial clinicians.

Mental health clinicians who have delivered psychedelic-assisted therapy (PAT) in clinical trials see it as requiring a therapeutic approach that blends multiple methods, demands heightened self-reflection from providers, and legitimizes non-medical perspectives in mental health care. They worry that when PAT moves from tightly controlled trials to broader community practice, key elements of this 'enhanced care' model may be lost due to underdeveloped regulations, workforce shortages, and economic pressures. The clinicians' views reflect an ongoing tension between a purely medical model of mental health and more psychosocial, relational approaches.

Study at a glance

Abstract

BACKGROUND: Policy changes in Australia mean that psychedelic-assisted therapy (PAT) is now available to consumers outside of clinical trials. Yet, the regulatory frameworks guiding the practice of PAT are underdeveloped, and the evidence base for guiding clinical practice is diverse and emerging, resulting in anticipated challenges in translation to community practice. Mental health clinicians who have experience delivering PAT in clinical trials are likely to be at the forefront of community practice and training, and influential in discussions about implementation. Yet little is known of their perspectives, preferences, and practices associated with the implementation of PAT. METHOD: Interviews with 11 clinicians working on clinical trials of PAT were thematically analysed. RESULTS: Four themes were identified, describing the therapeutic frames that interviewees used to understand PAT and shaped their views on its interface with the mental health system: (1) therapeutic eclecticism, (2) enhanced reflexivity for PAT providers, (3) legitimisation of extra-medical perspectives in mental health, and (4) what might be lost in translation? CONCLUSION: We argue that clinicians' perspectives on PAT are reflective of existing tensions between a medical model of mental health care and other psychosocial, relational models. Therapists' ideals for the delivery of PAT can be conceptualised as a sort of 'enhanced care' approach, but workforce development and economic constraints are likely to challenge the accessible and impactful translation of this vision.