Call for evidence-based psychedelic integration.

The use of psychedelics for various purposes was common in different civilizations throughout human history and has been explored scientifically for more than a century. Although the applications of psychedelics show promise in the treatment of various psychiatric and neurological indications, as well as in facilitation of well-being and personal growth, several psychedelic-related risks and challenges have also been identified. Psychedelic integration (PI) refers to various practices that serve to either minimize harms or maximize benefits associated with psychedelic use. PI is also recognized as a substantial part of psychedelic-assisted therapy (PAT), following preparation to and facilitation of the psychedelic experience. In the context of clinical/psychotherapeutic practice, several PI models/methods have already been proposed. However, while a number of these models/methods are theory-driven, or have a history of clinical application, each lack any empirical support and thus cannot be described as evidence based. This is to the disadvantage to countless people who had and who will have their psychedelic experiences in various contexts, as the prevalence of using psychedelics increased in recent years and is expected to grow further. Therefore, consistent with general recommendations for developing and implementing evidence-based mental health practices, this article calls for scientific efforts to the development, examination, and evaluation of psychedelic integration models/methods. This article also briefly summarizes the current literature on psychedelic integration, provides a list of exemplary avenues that research on psychedelic integration might take, as well as anticipates and discusses the limitations and challenges of PI-focused research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Resilience Through Harm Reduction? Protective Behavioral Strategies as a Factor of Resilience Among Polish Young Adults Using Various Psychoactive Substances.

Resiliency theory might provide a conceptual framework for understanding why adverse substance-related consequences vary considerably among young adults using psychoactive substances. Protective behavioral strategies (PBS) are behaviors that reduce substance use and related consequences. Despite such suggestions, to date no research has explicitly treated PBS as resilience factors. The purpose of this study was to examine compensatory and protective models of resilience among young adults using various substances. Data were obtained from an online questionnaire distributed through online social networks. Participants were Polish young adults (18-30 years old; M = 22, SD = 3.6; about 30% female and 1.3% non-binary; N = 7253), who reported using substances, other than alcohol or nicotine, in the last 12 months. After controlling for sociodemographics, hierarchical regression analyses of both substance-related harms and SUDs indicated the main effects of risk and protective factors, and the interaction between substance use and PBS. The models explained about 50% and 52% of the dependent variables variance, respectively. The results of this cross-sectional study provide support for both compensatory and protective models of resilience. This presents a rationale for recognizing PBS use as resilience factors that help young adults reduce substance-related harms. Theoretical discussion and practical implications are provided.

Back from the rabbit hole. Theoretical considerations and practical guidelines on psychedelic integration for mental health specialists.

The growing interest in and prevalence of the use of psychedelics, as well as the potential benefits and negative consequences associated with psychedelic experiences, create a need for mental health specialists to be able to provide adequate and effective intervention regarding the content and consequences of these experiences, that is, psychedelic integration. At the same time, current graduate training in psychiatry, psychology, psychotherapy, counseling, etc., fails to adequately prepare professionals for such interventions. In order to fill this gap, an international, bottom-up project was established to attempt developing guidelines. This project was conducted by means of literature reviews as well as roundtable discussions among project participants, leading to a consensus on the guidelines' final scope and content. Drawing from the outcomes of this project, this article presents proposed comprehensive guidelines covering both theoretical and practical aspects of psychedelic integration, that are intended to serve as a resource for various mental health specialists who may encounter individuals in need of support considering their psychedelic experiences. These guidelines encompass clinician-friendly information on the effects of psychedelics, a definition of psychedelic integration, the general theoretical considerations linked to utilization of psychedelic experiences in clinical practice, a simple model organizing the course of psychedelic integration practice, as well as an overview of the current models of psychedelic integration, along with a selective presentation of basic and specific interventions derived from various psychotherapeutic approaches that can be employed in the practice of psychedelic integration.

Development and validation of the Substance Use Protective Strategies Scale (SUPSS) among Polish young adults using various psychoactive substances.

Research supports protective behavioral strategies (PBS) as effective in reducing substance use, intoxication, and/or related risks/harms. However, despite the predominance of polysubstance use and common co-occurrence of different substance use disorders (SUDs), previous PBS research has been limited in terms of substance-specific measurement. This study sought to develop and validate a measure of PBS that is not substance-specific. Building from initial pilot work, we tested the psychometric properties of the Substance Use Protective Strategies Scale (SUPSS) in a large sample of young adults (N = 7325, aged 18-30), who reported using multiple psychoactive substances (other than alcohol and nicotine), recruited via social media in Poland. By splitting the sample, we conducted exploratory (n = 3709) and confirmatory factor analysis (n = 3614), which supported a 4-factor structure with 19 items (7 items dropped): Preparation for use (α = 0.66), Manner of use (α = 0.85), Additional concerns (α = 0.74), and Setting (α = 0.62). Configural, metric and scalar invariance were supported across sex, age, and user status for most substance types (cannabis, dissociatives, etc.). Further, the SUPSS factors were strongly associated with substance-related harms (R-squared = 0.495) and SUD symptoms (DUDIT, R-squared = 0.570). Our model fit was adequate (but not excellent), and two subscales had low internal consistency, highlighting the need for further improvement of the SUPSS. Despite its limitations, we found the SUPSS to have strong psychometric properties and it holds promise to enhance PBS research and harm reduction-oriented interventions.

Profiles of alcohol and cannabis protective behavioral strategies use across two large, multi-site college student samples of concurrent alcohol and cannabis users.

Concurrent use of alcohol and cannabis among college students is common and confers greater harms than the use of either of these substances alone. Large and growing bodies of literature have demonstrated the independent utility of behaviors used before, during, after, or instead of alcohol and cannabis use that minimize related harms (i.e., protective behavioral strategies [PBS]). However, little is known about the relationship between alcohol and cannabis PBS and their joint influence on harms among college students who concurrently use alcohol and cannabis. In the present study, we used data from two large, multi-site samples of college students, and restricted analyses to those who reported at least one episode of alcohol and cannabis use in the past 30 days (Study 1: N = 1104[Mage = 20.3, SD = 3.8; 70.0 % female; 79.5 % white]; Study 2: N = 2034[Mage = 20.2, SD = 3.2; 69.1 % female; 76.6 % white]). A latent profile analysis supported a 4-profile solution that was largely consistent across samples: Profile 1 (low alcohol/cannabis PBS; 8.8-11.9 %), Profile 2 (average alcohol/cannabis PBS; 33.1-37.7 %), Profile 3 (average alcohol PBS/low cannabis PBS; 16.3-25.2 %), and Profile 4 (high alcohol/cannabis PBS; 29.8-37.2 %). Profile 4 reported the least alcohol/cannabis use, fewest negative alcohol-/cannabis-related consequences, and lowest alcohol/cannabis use severity. In contrast, Profile 1 was the opposite for alcohol-related outcomes, and Profile 3 was the opposite for cannabis-related outcomes. These findings are preliminary but may suggest that targeting both alcohol and cannabis PBS in intervention is generally beneficial except some groups at risk for a particular substance may benefit from increased focus on that substance in intervention.

Drinking and alcohol-related problems among at-risk adolescents: The role of protective behavioral strategies.

INTRODUCTION: Protective Behavioral Strategies (PBS) are an alcohol-specific cognitive-behavioral strategies that may be employed before, during and/or after drinking, in order to reduce alcohol consumption and related consequences, particularly in the at-risk populations. Previous research on PBS was limited to North American college students. The purpose of this study was to examine the role of PBS use in a sample of Polish adolescents attending Special Educational Centers (SEC). METHOD: Data were collected from a nationwide sample of 12-19 year-old (Mean = 15.8; SD = 1.22) students attending SEC in Poland (N = 1585; about 33% female). The self-administered anonymous questionnaires were completed on-site in the SEC. PBS were measured by the authors adaptation of the PBSS-20. Alcohol-related problems were assessed by the Polish adaptation of the measures used in the MINI-KID tool. Alcohol use was measured by a single question on drinking frequency. These two latter variables were measured in the past year timeframe. Hierarchical regression models were used to test the main and interaction effects of employing PBS (total and subscales scores) on alcohol-related problems, after adjusting for demographics (gender, family composition and type of SEC) and alcohol use. RESULTS: The majority (about 94%) of study participants reported employment of some PBS. Regression analyses indicated that PBS use was associated with reduced risk of alcohol use and alcohol-related problems. We found that PBS significantly moderated the relationship between alcohol use and alcohol-related problems, for PBS total scale (F-change (1,1555) = 15.96, p < .001) and one of the PBS subscale: Limiting/Stopping Drinking (F-change (1,1555) = 4.80, p < .029). Findings were discussed within the results of PBS literature and resilience theory framework. CONCLUSION: The use of PBS helps to reduce alcohol-related problems among adolescents attending SEC. Implementation of tailored interventions that teach PBS among vulnerable adolescents may be an effective way to strengthen adolescent self-protection, reduce risky alcohol use and related negative consequences.