Therapeutic frameworks in integration sessions in substance-assisted psychotherapy: A systematised review.

Serotonergic psychedelics and related substances have been explored as potential adjuncts in substance-assisted psychotherapy (SAPT) for treating various disorders. SAPT can be divided into three phases: preparation, administration and integration. Integration is commonly defined as the comprehension and effective application of insights from psychedelic experiences into everyday life. However, there is limited research regarding the most appropriate therapeutic approach during SAPT. In this article, we discuss the current evidence for different therapeutic frameworks for integration sessions when serotonergic psychedelics and entactogens are used as adjuncts to psychotherapy. We conducted a systematised review of the literature following PRISMA guidelines and searched PsycINFO, MEDLINE and Cochrane Library databases. The final synthesis included 75 clinical trials, mixed-methods investigations, treatment manuals, study protocols, quasi-experiments, qualitative investigations, descriptive studies, opinion papers, reviews, books and book chapters, published until 11 November 2022. The effects that various therapeutic approaches for integration sessions have on therapeutic outcomes have not been investigated by means of rigorous research. Most of the available evidence we retrieved was not supported by empirical data, thus limiting any conclusive statements regarding appropriate therapeutic frameworks for integration sessions for SAPT. Current clinical studies have used a range of therapeutic frameworks with the majority drawing from the humanistic-experiential tradition. While integration is regarded as crucial for the safe application of SAPT, there is currently an insufficient evidence base to suggest that any type of therapy is effective for guiding integration sessions. A systematic investigation of different therapeutic frameworks for integration and additional therapy-related factors is needed.

Behavior change techniques in physical activity interventions for adults with substance use disorders: A systematic review.

OBJECTIVE: Increasing regular physical activity (PA) behavior may be an effective adjunct intervention for substance use disorder (SUD) treatment. This systematic review aims to identify promising behavior change techniques (BCTs), namely, BCTs present in the design of interventions evidencing significant short-term and/or long-term (d ≥ 0.15 for objective measures and d ≥ 0.36 for self-report measures) increase in PA and/or reduction of substance use, secondary psychological measures, and retention in the PA intervention. METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the search was performed on March 11, 2021 across databases including MEDLINE, PsycINFO, SPORTDiscus, Cochrane Library, CINAHL, ProQuest, Web of Science Core Collection, Google Scholar, Open Grey, and ProQuest Dissertations & Theses. Studies were included if they measured PA, included participants aged ≥ 18 years, were randomized control trials, and if participants were diagnosed with SUDs. The Cochrane RoB 2.0 Tool was used to assess risk of bias. BCTs from eligible studies were extracted, coded, and ranked according to their proportional presence across studies. RESULTS: The final synthesis included k = 61 studies with N = 12,887 participants. High heterogeneity across outcome measures, interventions, and control conditions was found. In total, 477 applications of BCTs were identified. Instruction on how to perform the behavior, social support (unspecified), behavioral practice/rehearsal, problem-solving, pharmacological support, goal setting (behavior), self-monitoring (behavior), and biofeedback were the eight most frequently used promising BCTs across studies. CONCLUSIONS: Incorporating the eight most promising BCTs identified in this review in future PA interventions in SUD populations may improve SUD outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Therapeutic (Sub)stance: Current practice and therapeutic conduct in preparatory sessions in substance-assisted psychotherapy-A systematized review.

BACKGROUND: Clinical trials are currently investigating the potential of substance-assisted psychotherapy (SAPT) as treatment for several psychiatric conditions. The potential therapeutic effects of SAPT may be influenced by contextual factors including preparation prior to and integration after the substance-assisted therapy sessions. AIMS: This systematized review outlines recommendations for current practice in preparatory sessions in SAPT including safety measures and screening procedures, preparation of set and setting, session contents, methods, and roles, prerequisites, and appropriate conduct of therapists. METHODS: A systematized review of the literature was conducted based on PRISMA guidelines. MEDLINE (OVID), PsycINFO (OVID), and Cochrane Library were searched and clinical trials, treatment manuals, study protocols, case studies, qualitative studies, descriptive studies, theoretical papers, reviews, book chapters, and conference proceedings published until February 1, 2022 were retrieved. RESULTS: The final synthesis included k = 83 sources. Information about safety measures including screening of participants, set and setting, contextual-, physiological-, and psychological preparation, roles, competencies, prerequisites, and characteristics of the therapists, and the establishment of a therapeutic relationship were summarized and discussed. CONCLUSION: It is concluded that there is a consensus in the literature about the importance of adequate preparation before the administration of psychoactive substances in SAPT. However, the extent and approaches for these sessions vary across different models and there is a need for timelier and more rigorous qualitative and quantitative investigations assessing different approaches and techniques for the optimal preparation of clients in SAPT.

Current Perspective on the Therapeutic Preset for Substance-Assisted Psychotherapy.

The present narrative review is the first in a series of reviews about the appropriate conduct in substance-assisted psychotherapy (SAPT). It outlines a current perspective onpreconditions and theoretical knowledge that have been identified as valuable in the literaturefor appropriate therapeutic conduct in SAPT. In this context, considerations regarding ethics and the spiritual emphasis of the therapeutic approaches are discussed. Further, current methods, models, and concepts of psychological mechanism of action and therapeutic effects of SAPT are summarized, and similarities between models, approaches, and potential mediators for therapeutic effects are outlined. It is argued that a critical assessment of the literature might indicate that the therapeutic effect of SAPT may be mediated by intra- and interpersonal variables within the therapeutic context rather than specific therapeutic models per se. The review provides a basis for the development and adaptation of future investigations, therapeutic models, training programs for therapists, and those interested in the therapeutic potential of SAPT. Limitations and future directions for research are discussed.

Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder.

The present paper discusses the current literature with regard to substance-assisted psychotherapy with Methylenedioxymethamphetamine (MDMA) for posttraumatic stress disorder (PTSD). The aim of the paper is to give a comprehensive overview of the development from MDMA's early application in psychotherapy to its present and future role in the treatment of PTSD. It is further attempted to increase the attention for MDMA's therapeutic potential by providing a thorough depiction of the scientific evidence regarding its theorized mechanism of action and potential harms of its application in the clinical setting (e.g., misattribution of therapeutic gains to medication instead of psychological changes). Empirical support for the use of MDMA-assisted psychotherapy, including the randomized, double-blind, placebo-controlled trails that have been conducted since 2008, is discussed. Thus far, an overall remission rate of 66.2% and low rates of adverse effects have been found in the six phase two trials conducted in clinical settings with 105 blinded subjects with chronic PTSD. The results seem to support MDMA's safe and effective use as an adjunct to psychotherapy. Even though preliminary studies may look promising, more studies of its application in a psychotherapeutic context are needed in order to establish MDMA as a potential adjunct to therapy.

Correction to: Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder.

[This corrects the article DOI: 10.1007/s10879-017-9379-2.].