Earleywine Mitch, Gomez Samantha G
Department of Psychology, University at Albany, SUNY, Albany, New York, USA.
Psychedelic Med (New Rochelle). 2024 Sep 4;2(3):138-145. doi: 10.1089/psymed.2023.0054. eCollection 2024 Sep.
Many authors assert that those who provide psychedelic-assisted therapy (PAT) likely benefit from having personal experiences with psychedelics (PEP) as part of their training. Meta-analytic results confirm advantages of experiential learning in other forms of training as well. Potential PAT clients, especially those who identify as members of underrepresented groups, report that PEP is important to them in their choice of guides. Establishing PAT's efficacy will require more trained professionals for generating appropriately powered clinical trials. Despite these rationales for PEP for trainees, prevalent legal prohibitions limit access to psychedelics, preventing trainees from obtaining experiences that many potential clients deem important. A randomized clinical trial comparing outcomes in those trained with PEP to those trained without the experience has intuitive appeal. Nevertheless, a close look at challenges related to design suggests that a definitive experiment would require more resources than almost every previous study of PAT or therapist effects. (Based on effect size estimates from other therapist effects, power analyses reveal that an experiment with 80-160 participants could offer meaningful data. An ideal design would require 80 therapists treating 30 clients each.) Underpowered designs, however, could lead to serious misinterpretations that would suggest that PEP fails to provide advantages. Given the severity of symptoms targeted by PAT, the current need for treatment providers (especially members of underrepresented groups), the rarity of serious negative consequences in supervised drug administration trials, and the low potential for PEP-induced symptoms of dependence, permitting trainees access likely would create more positives than harms.
许多作者断言，那些提供迷幻剂辅助治疗（PAT）的人可能会从将迷幻剂个人体验（PEP）作为培训的一部分中受益。荟萃分析结果也证实了体验式学习在其他形式培训中的优势。潜在的PAT客户，尤其是那些属于代表性不足群体的客户报告称，PEP在他们选择指导者方面对他们很重要。要确定PAT的疗效，将需要更多训练有素的专业人员来开展有足够效力的临床试验。尽管有这些支持学员进行PEP的理由，但普遍的法律禁令限制了获取迷幻剂的途径，使学员无法获得许多潜在客户认为重要的体验。一项将接受PEP培训的人与未接受该体验培训的人进行结果比较的随机临床试验具有直观的吸引力。然而，仔细审视与设计相关的挑战表明，一项确定性的实验将需要比以往几乎所有关于PAT或治疗师效果的研究更多的资源。（根据其他治疗师效果的效应量估计，功效分析表明，一项有80 - 160名参与者的实验可以提供有意义的数据。理想的设计需要80名治疗师，每人治疗30名客户。）然而，功效不足的设计可能会导致严重的误解，即表明PEP无法提供优势。鉴于PAT所针对症状的严重性、当前对治疗提供者（尤其是代表性不足群体的成员）的需求、在监督药物管理试验中严重负面后果的罕见性以及PEP引发依赖症状的可能性较低，允许学员获得体验可能产生的积极影响将多于危害。
