What is Psychedelic-Assisted Psychotherapy (PAP)?
The psychedelic therapy process can lead to great moments of insight and healing. Understanding the various containers or frameworks available to help you to achieve your goals or desired outcomes is important.
If you’re considering treatment using psychedelic medicine through psychedelic therapy, it’s not immediately obvious what the difference is between psychedelic therapy and psychedelic-assisted psychotherapy.
This resource will explore the important differences between the two, so you can make informed decisions for your healing journey.
The role of psychedelics in psychedelic therapy
There are many different compounds that may induce a psychedelic experience.
The “classic” psychedelics include psilocybin, LSD, and DMT. Additional psychedelic compounds include: ketamine, MDMA, ayahuasca, and a host of novel research chemicals.
A psychedelic is usually defined according to two potential qualifiers:
- The compound’s impact on the serotonin system, specifically as a 5HT2A receptor agonist. This is what separates “classic” psychedelics from others.
- The experience induced by the compound possesses several of the classic hallmarks of a psychedelic experience.
It’s recommended that these compounds or medicines be applied as part of a clinically-supportive container, with protocols and practices in place to help ensure safety, efficacy, and healing potential.
The use, context, and protocols of the experience are what differentiate psychedelic experiences from psychedelic therapy.
What is Psychedelic-Assisted Psychotherapy?
Psychedelic-assisted psychotherapy (PAP) involves a licensed therapist who combines or supports psychotherapeutic methods—such as cognitive behavioral therapy (CBT)— alongside psychedelic experiences.
These psychedelic experiences can be conducted in the presence of a trained or knowledgeable therapist. Alternatively, the therapist can help the client “unpack” directly after a psychedelic experience, or in the days or weeks following.
The difference between psychedelic therapy and PAP
Psychedelic therapy is the combination of therapeutic techniques with experiences brought on by psychedelic compounds.
Psychedelic-assisted psychotherapy is a type of psychedelic therapy, supported by a licensed mental health professional.
Talk therapy is the most common therapeutic method in combination with psychedelic medicine, but other methods such as somatic bodywork, EMDR, or group therapy can provide similar benefits.
How psychedelic-assisted psychotherapy works
Psychedelic-assisted psychotherapy is often conducted by including several psychedelic dosing sessions alongside a personal psychotherapeutic protocol.
The psychedelic sessions can provide the emotional catharsis, personal insights, and embodied experiences that can catalyze the conversations that happen in psychotherapy sessions.
The specific structure of these programs differs based on the medicines used, the psychotherapeutic modality offered, and the specifics of the protocol.
There are high-level similarities you can find across nearly all existing psychedelic-assisted psychotherapy programs:
- Dedicated Care Team: You will be assigned a dedicated care team, either an individual therapist, or a team who will remain with you throughout the duration of your program.
- Several Preparation Sessions: Working with trained therapists to help prepare your mind and body for the sessions. Preparation is essential, and psychotherapy can help you identify core wounds and formulate clear and powerful intentions.
- Multiple Dosing Sessions: Most PAP programs include several dosing sessions spaced out at regular intervals, helping to manage baseline mood and build momentum over time.
- In-Between Integration Services: There may be one or several integration sessions in-between dosing experiences, helping to solidify learnings and begin taking action on your insights/experiences.
- Ongoing Psychotherapy: Afterwards there are wrap-up/closing sessions, with the possibility of continuing long-term psychotherapy to help ensure these experiences become enduring changes in your life.
While the specifics for each program and protocol may differ, these high-level themes tend to be similar across all of the offerings.
Working with trained and experienced therapists along the way can help you further explore the insights and experiences that you have, and translate those to clear, effective action in your life.
Benefits of psychedelic-assisted psychotherapy
There are several unique benefits that may be found in choosing for a psychedelic-assisted psychotherapy protocol.
While not exhaustive, these are some benefits that may be more difficult to do on your own, or without the support of a trained therapist working alongside you.
- Setting Clear Intentions: Intention-setting can be hard for some. Working with a therapist to identify core wounds or opportunity areas helps make your intentions clear, personal, and relevant for your healing journey.
- Psychological Preparation: Preparation isn’t only about setting up your space. It’s about preparing your mind and body and emotions to go to the places that you may have been avoiding. Professional therapy can help you build a strong foundation to head into your dosing sessions with.
- Integration Support: Unpacking and understanding your experiences isn’t always straightforward. Psychedelic experiences can be confusing or challenging. Working with a therapist for your integration sessions can help you better understand the meaning and messages and experiences that you had.
- Insights & Accountability: Professional therapists can help you unlock key insights, and provide a level of social and personal accountability to take real, tangible action during your integration periods. Lacking accountability is something that can stall or stop the healing process.
Drawbacks of psychedelic-assisted therapy
Psychedelic-assisted psychotherapy is not without drawbacks or obstacles.
These programs can be more expensive, take longer amounts of time for the total program, and the individual dosing sessions are often done in clinical settings.
The outcomes also depend on the quality and experience of the therapist themselves.
PAP combines the potential for insight, support, and progress familiar to psychotherapy with the emotional processing and deep insights that arise through the psychedelic experience.
It is important to note that different locations, practitioners, companies, and organizations will offer different programs and protocols.
If you wish to specifically enroll in a psychedelic-assisted psychotherapy program, it is important to ask about this when you are signing up.
Guided psychedelic therapy and PAP are powerful healing modalities in their own right, with decades of personal and professional outcomes data behind them. Both modalities have their own strengths and challenges, based on the client’s needs.
Psychedelic-assisted psychotherapy is an emerging field of treatment that seeks to bring out the best in both of these modalities by helping individuals with their psychedelic experiences in combination with traditional psychotherapy sessions.
With the clients interest, safety, and healing at heart, it will be exciting and interesting to see how this space develops more.
The opportunity for new synergies exists, as well as more clinical and scientific research to find the best programs and protocols. While this new practice continues to grow, it presents real potential for healing here and now.
This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.
Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.
Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).
Do not proceed with ketamine treatment if any of the following apply to you:
- Allergic to ketamine
- Symptoms of psychosis or mania
- Uncontrolled high blood pressure
- CHF or other serious heart problem
- Severe breathing problem
- History of elevated intraocular or intracranial pressure
- History of hyperthyroidism
- Other serious medical illness
- Pregnant, nursing, or trying to become pregnant
Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.
While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.
- In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
- Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
- Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
- The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.
To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:
- Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
- Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
- Continue to take antihypertensive medication as prescribed
- Avoid hangovers or alcohol intake
- Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
- Ketamine treatment should never be conducted without a monitor present to ensure your safety