Imperial College London
Alternate

Professor David Nutt DM, FRCP, FRCPsych, FSB, FMedSci

Faculty of Medicine, Department of Brain Sciences

The Edmond J Safra Chair in Neuropsychopharmacology
 
 
 
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Contact

 

d.nutt

 
 
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Location

 

Burlington Danes BuildingBurlington DanesHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Murphy:2022:10.3389/fphar.2021.788155,
author = {Murphy, R and Kettner, HS and Zeifman, R and Giribaldi, B and Kartner, L and Martell, J and Read, T and Murphy-Beiner, A and Baker, Jones M and Nutt, D and Erritzoe, D and Watts, R and Carhart-Harris, R},
doi = {10.3389/fphar.2021.788155},
journal = {Frontiers in Pharmacology},
pages = {1--19},
title = {Therapeutic alliance and rapport modulate responses to psilocybin assisted therapy for depression},
url = {http://dx.doi.org/10.3389/fphar.2021.788155},
volume = {12},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Across psychotherapeutic frameworks, the strength of the therapeutic alliance has been found to correlate with treatment outcomes; however, its role has never been formally assessed in a trial of psychedelic-assisted therapy. We aimed to investigate the relationships between therapeutic alliance and rapport, the quality of the acute psychedelic experience and treatment outcomes. Methods: This 2-arm double-blind randomized controlled trial compared escitalopram with psychedelic-assisted therapy for moderate-severe depressive disorder (N=59). This analysis focused on the psilocybin condition (n=30), who received two oral doses of 25 mg psilocybin, three-weeks apart, with psychological preparation, in-session support, and integration therapy. A new psychedelic therapy model, called ‘Accept-Connect-Embody’ (ACE), was developed in this trial. The primary outcome was depression severity six weeks post treatment (Quick Inventory of Depressive Symptomatology, QIDS-SR-16). Path analyses tested the hypothesis that therapeutic alliance (Scale To Assess the Therapeutic Relationship Patient Version, STAR-P) would predict depression outcomes via its influence on the acute psychedelic experience, specifically emotional-breakthrough (EBI) and mystical-type experiences (MEQ). The same analysis was performed on the escitalopram arm to test specificity. Results: The strength of therapeutic alliance predicted pre-session rapport, greater emotional-breakthrough and mystical-type experience (maximum EBI and MEQ scores across the two psilocybin sessions) and final QIDS scores (β = -0.22, R2 = 0.42 for EBIMax; β = -0.19, R2 = 0.32 for MEQMax). Exploratory path models revealed that final depression outcomes were more strongly affected by emotional breakthrough during the first, and mystical experience during the second session. Emotional breakthrough, but not mystical experience, during the first session had a positive effect on therapeutic alliance ahead o
AU  - Murphy,R
AU  - Kettner,HS
AU  - Zeifman,R
AU  - Giribaldi,B
AU  - Kartner,L
AU  - Martell,J
AU  - Read,T
AU  - Murphy-Beiner,A
AU  - Baker,Jones M
AU  - Nutt,D
AU  - Erritzoe,D
AU  - Watts,R
AU  - Carhart-Harris,R
DO  - 10.3389/fphar.2021.788155
EP  - 19
PY  - 2022///
SN  - 1663-9812
SP  - 1
TI  - Therapeutic alliance and rapport modulate responses to psilocybin assisted therapy for depression
T2  - Frontiers in Pharmacology
UR  - http://dx.doi.org/10.3389/fphar.2021.788155
UR  - https://www.frontiersin.org/articles/10.3389/fphar.2021.788155/full#h15
UR  - http://hdl.handle.net/10044/1/93510
VL  - 12
ER  -
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