Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Transcult Psychiatry. 2022 Oct;59(5):652-664. doi: 10.1177/1363461520983684. Epub 2021 Jan 26.
Psychedelic-assisted treatment is at first glance markedly different in structure and approach from mainstream forms of psychotherapy in the West. A major criticism of clinical psychedelic research rests on the difficulty of executing placebo-controlled studies and distinguishing drug effects from those of the psychotherapeutic container in which psychedelics are typically presented. Detractors also tend to find fault in spiritual or mystical themes that often arise in the context of psychedelic use. Common factors theory of psychotherapy is a useful and extensively studied framework that can help make sense of these issues, and has much to contribute to our understanding of contextual effects that are often discussed in psychedelic literature as "set and setting." In this article, we examine four major contextual "common factors" shared by various healing traditions: 1) the therapeutic relationship; 2) the healing setting; 3) the rationale, conceptual scheme, or myth; and 4) the ritual. We explain how these factors show up in psychedelic-assisted treatment and how they may contribute to therapeutic effects. Lastly, we discuss the implications of these factors for the concept of placebo, and for future research.
迷幻辅助治疗在结构和方法上与西方主流形式的心理治疗截然不同。对临床迷幻药物研究的一个主要批评是，执行安慰剂对照研究以及区分迷幻药物的作用和通常呈现迷幻药物的心理治疗容器的作用具有难度。批评者也往往对在迷幻使用背景下经常出现的精神或神秘主题提出批评。心理治疗的共同因素理论是一个有用且经过广泛研究的框架，可以帮助理解这些问题，并为我们理解在迷幻文献中经常讨论的“设定和环境”等上下文效应做出贡献。在本文中，我们研究了各种治疗传统共有的四个主要的上下文“共同因素”：1）治疗关系；2）治疗环境；3）基本原理、概念框架或神话；4）仪式。我们解释了这些因素如何在迷幻辅助治疗中出现，以及它们如何有助于治疗效果。最后，我们讨论了这些因素对安慰剂概念以及未来研究的影响。
