psychotherapy
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The Montreal model: an integrative biomedical-psychedelic ... frontiersin.org 26 facts
claimThe authors of the Montreal model report that a brief course of ketamine evokes psychological dynamics that resemble an accelerated short-term psychotherapy more closely than a course of electroconvulsive therapy (ECT).
claimThe Montreal model utilizes concomitant psychotherapy, which allows patients to continue conventional psychotherapy sessions semi-independently of the ketamine treatment process at regular or as-needed frequencies.
claimPsychotherapy provides additive benefits to pharmacological treatments like oral antidepressants and can sustain the therapeutic benefits of antidepressants after the medication is discontinued.
referenceJ. Dore, B. Turnipseed, S. Dwyer, A. Turnipseed, J. Andries, G. Ascani, et al. published 'Ketamine assisted psychotherapy (KAP): patient demographics, clinical data and outcomes in three large practices administering ketamine with psychotherapy' in the Journal of Psychoactive Drugs in 2019.
procedureThe Montreal model requires patients to engage in at least one hour of weekly evidence-based psychotherapy, beginning at least two weeks before the initiation of ketamine treatments.
referenceA 2018 Cochrane review of psychotherapy for treatment-resistant depression, which analyzed six trials involving 698 participants, concluded that while various approaches like Cognitive Behavioral Therapy (CBT) have high acceptability, they provide only modest improvements.
claimPsychedelic treatments require higher levels of trust and vulnerability than conventional psychotherapy, which may magnify both the impact of reparative interpersonal interactions and the potential for interpersonal harms.
measurementPsychotherapy "booster" sessions, when conducted at a frequency of roughly every 3β6 months, have been shown in meta-analysis to successfully maintain the psychological benefits of therapy.
referenceThe Montreal model of ketamine treatment integrates neurobiological and psychological benefits, frames psychoactive effects as opportunities for experiential learning, emphasizes the importance of "set and setting," and utilizes subanesthetic dosages of 0.5β1.0 mg/kg with clinicians present and concomitant psychotherapy.
procedureThe Montreal model combines structured psychiatric care and concomitant psychotherapy with six ketamine infusions, which are administered with psychedelic-inspired nonpharmacological adjuncts such as rolling preparative and integrative psychological support.
procedureA clear and consistent therapeutic frame in psychotherapy includes a shared understanding of treatment activities, a defined schedule of sessions, and clear parameters for communication and follow-up care.
claimImel et al. conducted a meta-analysis of psychotherapy and medication in unipolar depression and dysthymia, published in the Journal of Affective Disorders in 2008.
claimThe Montreal model for ketamine treatment seeks to enhance patient engagement in evidence-based psychotherapy by leveraging ketamine's pro-cognitive and anti-suicide effects, as well as the psychological experiences of dosing sessions.
procedureThe Montreal model maintenance phase for treatment-resistant depression (TRD) consists of three forms: medication/neurostimulation, concomitant psychotherapy, and maintenance ketamine treatments.
claimWampold published an update in World Psychiatry in 2015 regarding the importance of common factors in psychotherapy.
claimThe personal significance of ketamine experiences is shaped by the framing provided to the patient, similar to how the interpretation of dreams varies across cultures and psychotherapy schools.
claimIn standard psychiatric care, patients receiving psychotherapy combined with conventional medications or neurostimulation typically receive care from multiple clinicians who are expected to work in close collaboration.
claimThe Montreal model for ketamine treatment does not mandate a specific type of psychotherapy, but instead requires the use of any evidence-based approach, such as Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT), that the patient is willing to pursue.
referenceGreenway et al. (2020) reviewed the integration of psychotherapy and psychopharmacology, specifically focusing on psychedelic-assisted psychotherapy and other combined treatment approaches.
claimThe Montreal model clinical team observed that ketamine treatment differs from electroconvulsive therapy (ECT) because termination of treatment is a critical consideration in psychotherapy, whereas it is generally only a subject of interest in psychiatry.
claimKetamine's rapid benefits against suicidality and the cognitive impairments of depression theoretically reduce obstacles to productive psychotherapy.
procedureThe Montreal model for ketamine treatment preparation involves nine specific goals: (1) establishing a treatment frame, (2) cultivating a therapeutic alliance, (3) psychoeducation and management of expectations, (4) determining behavioral treatment goals, (5) optimizing medications, (6) framing the ketamine experience, (7) trial mindfulness exercise, (8) music discussion, and (9) arranging for concomitant psychotherapy.
referenceThe article 'The use of dreams in psychotherapy' by Schredl et al. was published in The Journal of Psychotherapy Practice and Research in 2000.
referenceMarkowitz et al. (2022) addressed the neglected role of psychotherapy in the treatment of treatment-resistant depression.
claimA strong patient-therapist relationship is a core common factor of psychotherapy and serves as a key source of corrective interpersonal experiences.
claimNo published clinical trial has explored the use of ketamine with concomitant psychotherapy to treat depression.
Neuroimaging in psychedelic drug development: past, present, and ... nature.com Sep 27, 2023 7 facts
claimModern psychedelic therapy is conceptualized by many as 'psychedelic-assisted psychotherapy,' a model where therapeutic benefit is attributed to a synergistic combination of the drug and accompanying psychotherapy.
referenceThe question of whether psilocybin must always assist psychotherapy was addressed in the American Journal of Psychiatry in 2023.
claimPsychotherapy of various types is established to produce measurable changes in brain function.
referenceThe integration of psychotherapy and psychopharmacology, specifically psychedelic-assisted psychotherapy, was reviewed in Expert Review of Clinical Pharmacology in 2020.
perspectiveSome researchers challenge the model of psychedelic-assisted psychotherapy, asserting that the drug effects themselves hold primacy in the therapeutic action.
referenceFunctional neuroimaging studies of the effects of psychotherapy were reviewed in Dialogues in Clinical Neuroscience in 2014.
referenceThe effects of psychotherapy on brain function were systematically reviewed in Progress in Neurobiology in 2014.
Published Studies β Johns Hopkins Center for Psychedelic and ... hopkinspsychedelic.org 3 facts
referenceMathai, D. S., Mora, V., and Garcia-Romeu, A. published a study in Frontiers in Psychology in 2022 regarding the potential synergies of combining ketamine and psychotherapy.
referenceThe article 'Psychedelics and Psychotherapy' by S. Nayak and M. W. Johnson was published in Pharmacopsychiatry in 2021.
referenceA 2023 article in 'Clinical Pharmacology & Therapeutics' explored the relationship between psychedelics and psychotherapy, questioning whether the combination is greater than the sum of its parts.
History and Current Status of Psychedelics and Entactogens ... - NCBI ncbi.nlm.nih.gov 1 fact
claimCharles Grob noted that unlike conventional psychopharmacologic compounds, which are typically administered daily for long periods, psychedelics are administered only once or a few times within the context of ongoing psychotherapy.
What Western medicine can learn from the ancient history of ... - BBC bbc.com Sep 11, 2024 1 fact
claimWestern medicine is increasingly interested in using psychedelics alongside psychotherapy to help people process trauma and alter patterns of introspective thought associated with conditions like anxiety and depression.
the consumption of psychoactive plants in ancient global and ... academia.edu 1 fact
referenceMetzner R authored 'Hallucinogenic drugs and plants in psychotherapy and shamanism', published in the Journal of Psychoactive Drugs in 1998.
Effects of psychedelics on neurogenesis and broader neuroplasticity link.springer.com Dec 19, 2024 1 fact
claim3,4-Methylenedioxymethamphetamine (MDMA) is in the final stages of clinical research and may be employed for the treatment of post-traumatic stress disorder (PTSD) with assisted psychotherapy, according to Emerson et al. (2014), Feduccia and Mithoefer (2018), and Sessa (2017).