Ayahuasca ceremony leaders' perspectives on special considerations for eating disorders.

Eating disorders (EDs) are difficult conditions to resolve, necessitating novel treatments. Ayahuasca, a psychedelic plant medicine originating in Indigenous Amazonian communities, is being investigated. Aspects of ceremonial ayahuasca use (purging, dietary restrictions) appear similar to ED behaviors, raising questions about ayahuasca's suitability as an intervention for individuals with EDs. This study explored the perspectives of ayahuasca ceremony leaders on these and other considerations for ceremonial ayahuasca drinking among individuals with EDs. A qualitative content analysis of interviews was undertaken with 15 ayahuasca ceremony leaders, the majority of whom were from the West/Global North. Screening for EDs, purging and dietary restrictions, potential risks and dangers, and complementarity with conventional ED treatment emerged as categories. The findings offer ideas, including careful screening and extra support, to promote safe and beneficial ceremony experiences for ceremony participants with EDs. More research is needed to clarify the impacts of ceremony-related purging and preparatory diets. To evolve conventional models of treatment, the ED field could consider Indigenous approaches to mental health whereby ayahuasca ceremony leaders and ED researchers and clinicians collaborate in a decolonizing, bidirectional bridging process between Western and Indigenous paradigms of healing.

"Getting to the Root": Ayahuasca Ceremony Leaders' Perspectives on Eating Disorders.

Given the mortality, chronicity, and treatment drop-out rates observed among individuals with eating disorders (EDs), innovative approaches are needed. Ayahuasca, a psychedelic plant medicine from the Amazon, is currently being investigated. This study expands on prior exploratory research by describing the perspectives of ayahuasca ceremony leaders regarding their conceptualizations of EDs and the potential therapeutic mechanisms of action of ayahuasca for individuals with EDs. Qualitative content analysis of interviews with 15 ayahuasca ceremony leaders produced two main categories, with relevant subcategories. The first category encompassed the leaders' theories of EDs from a shamanic perspective, including that EDs are symptomatic of an underlying concern, serve a function and affect health in multiple domains. The second category described leaders' perspectives on the potential mechanisms of action of ayahuasca for EDs, including that ayahuasca facilitates "energetic healing"; helps identify, process, and integrate the "root" of the ED; promotes holistic healing; and enhances and/or reorganizes relationships. From the perspectives of ceremony leaders and consistent with previous exploratory research, ceremonial ayahuasca use may offer a potentially useful, novel and complementary intervention for EDs.

Eating disorder therapists' personal eating disorder history and professional ethics: an interpretive description.

This qualitative study sought to explore and understand eating disorder (ED) therapists' perceptions of whether and how their personal ED histories had professional ethical relevance. Analysis of multiple interviews with 11 therapist-participants indicated that they perceived their personal ED histories as having substantial ethical relevance in their day-to-day practice with ED clients. The major categories of ethics experiences that emerged were: boundaries, therapist wellness, helpfulness of personal ED history, and openness regarding therapists' personal ED histories. The findings have practical utility for the education, training, and continuing education of ED-historied practitioners.

Identifying critical competencies for psychotherapeutic practice with eating disordered clients: a Delphi study.

Mental health professionals lack systematic criteria against which to assess their competence to provide psychotherapy to eating disordered clients. In this Delphi study, a multidisciplinary panel of professionals with expertise in eating disorders treatment reached a consensus on essential eating disorders psychotherapy competencies, which included both literature-derived and participant-generated items. Competency domains included specialized knowledge and skills, professional responsibility, and therapist characteristics. An empirically derived, operational definition of minimum competence in psychotherapy for eating disorders was obtained. The essential competencies have utility for practitioners, novice and experienced, who wish to assess and enhance their ethical practice in psychotherapy for eating disorders.

More training needed in eating disorders: A time cohort comparison study of Canadian psychiatry residents.

A time cohort comparison was conducted, via questionnaire, with Canadian psychiatry residents in 1990 and 2004 regarding their education and training in eating disorders (EDs). Instruction and clinical experiences in EDs were not perceived as adequate by senior residents in either cohort, although increases in instruction and clinical opportunities were reported in 2004. Both cohorts endorsed mandatory instruction on EDs. Negative attitudes towards EDs were encountered in training environments. Most respondents indicated some interest in working with EDs. It is recommended that training programs continue to strengthen their EDs content and ensure that residents are exposed to treatment research literature.