Title & Introduction

  • Paper Title: Seeing the Forest for the Trees: An Ecological Systems Theory Approach to Addressing Emergent Issues in Psychedelic-Assisted Therapy Research
  • Published In: Journal of Psychedelic Studies
  • Publish Date: June 5, 2024
  • Authors: Meghan A. Dellacrosse, Albert Garcia-Romeu, Alan K. Davis
  • Objective: To propose an Ecological Systems Theory (EST) model for psychedelic-assisted therapy (PAT) research, addressing gaps in understanding how set, setting, and broader systemic factors influence therapeutic outcomes.
  • Importance: Current PAT research lacks a comprehensive theoretical model to conceptualize the interplay of individual, environmental, and systemic influences on psychedelic therapy outcomes. EST provides a structured framework for integrating these factors.

Summary & Takeaways

Key Takeaway: Applying Ecological Systems Theory (EST) to psychedelic-assisted therapy research offers a structured framework to understand the impact of individual, environmental, and systemic factors on treatment outcomes.

Practical Application: This approach could improve clinical trial designs, refine therapeutic frameworks, and inform policy decisions regarding the implementation of psychedelic treatments.

Key Background Information

  • Context: Psychedelic research increasingly highlights the importance of set (mindset) and setting (environment), but existing models fail to fully integrate broader systemic influences.
  • Hypothesis: An EST-based model will enhance the understanding of how personal, social, cultural, and institutional factors interact to shape psychedelic therapy outcomes.

Methodology

  • Study Design: Theoretical commentary proposing an adaptation of Bronfenbrenner’s Ecological Systems Theory for psychedelic research.
  • Participants: Not applicable (conceptual study).
  • Intervention/Exposure: Review of existing literature and integration of EST principles into psychedelic research.
  • Controls: Not applicable.
  • Duration: Conceptual model developed over multiple iterations based on existing psychedelic and healthcare research.

Key Findings

Primary Outcomes:

  • Current psychedelic research often fails to account for systemic influences beyond set and setting.
  • The EST model proposes five nested levels influencing PAT outcomes:
    • Microsystem: Individual patient factors (e.g., mental health, prior trauma, personality).
    • Mesosystem: Interactions between therapy elements (e.g., relationship between participant and facilitator).
    • Exosystem: Institutional and regulatory influences (e.g., clinical trial protocols, FDA guidelines).
    • Macrosystem: Cultural attitudes and stigma surrounding psychedelics.
    • Chronosystem: Historical and temporal influences (e.g., evolving legal and medical landscapes).

Secondary Outcomes:

  • The model can be applied to psychedelic research design, enhancing understanding of therapy outcomes and risks.
  • Reducing session facilitator involvement, as suggested by the FDA, could weaken therapeutic outcomes by neglecting systemic factors.
  • The EST approach provides a potential framework for psychedelic-informed public health policy.

Interpretation & Implications

  • Conclusion: Ecological Systems Theory offers a valuable model for conceptualizing the multifaceted influences on PAT outcomes, addressing gaps in current psychedelic research.
  • Implications: The model could guide regulatory bodies, clinical researchers, and policymakers in designing safer and more effective psychedelic therapies.
  • Limitations: As a conceptual study, empirical validation is necessary through future research applying EST in clinical trials.

Researchers & Publication

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