Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia.
Monash Bioethics Centre, Monash University, Clayton, Victoria, Australia.
Psychol Psychother. 2024 Dec;97(4):626-644. doi: 10.1111/papt.12545. Epub 2024 Sep 16.
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.
Interviews with 11 clinicians working on clinical trials of PAT were thematically analysed.
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?
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.
澳大利亚的政策变化意味着迷幻辅助治疗(PAT)现在可供临床试验之外的消费者使用。然而,指导 PAT 实践的监管框架还不够完善,指导临床实践的证据基础多种多样且仍在不断发展,这导致在将其转化为社区实践时预计会面临挑战。在临床试验中提供 PAT 经验的心理健康临床医生可能处于社区实践和培训的前沿,并在有关实施的讨论中具有影响力。然而,人们对他们与 PAT 实施相关的观点、偏好和实践知之甚少。
对 11 名从事 PAT 临床试验的临床医生进行了访谈,并对其进行了主题分析。
确定了四个主题,描述了受访者用来理解 PAT 的治疗框架,并塑造了他们对 PAT 与精神卫生系统接口的看法:(1)治疗折衷主义,(2)增强 PAT 提供者的反思性,(3)在精神卫生中使非医学观点合法化,以及(4)可能在翻译中丢失的内容?
我们认为,临床医生对 PAT 的看法反映了精神卫生保健中医疗模式与其他心理社会、关系模式之间现有的紧张关系。治疗师对 PAT 提供的理想可以被概念化为一种“增强护理”方法,但劳动力发展和经济限制可能会挑战这一愿景的可及性和影响力。