People with depressive symptoms appear to think it is relatively important that guides for psilocybin-assisted psychotherapy have personally used the psychedelic substance themselves, according to a new study published in the Journal of Psychoactive Drugs.
Psilocybin, when combined with psychotherapy in a controlled setting, has shown promise in the treatment of various mental health issues, including depression. One aspect of the therapy that has received relatively little attention is the use of guides, trained professionals who facilitate the psychedelic experience.
It’s possible that having a guide who had previously used psilocybin could raise concerns among clients. For example, a previous study found that researchers who admit to personally using psychedelic substances tend to be viewed as having less integrity. But it is also possible that clients would value having a guide who has also experienced what they’re experiencing during a psychedelic session.
Mitch Earleywine, a professor of psychology at the University at Albany, told PsyPost he was partially inspired to conduct the new research based on his own personal experience: “It’s kind of a funny story but I sent a client to the local ketamine clinic, which has a very friendly physician in charge. She asked if I thought he’d ever used ketamine and I had to admit that I did not think so. She seemed a little disappointed. Then I heard that some of the psychedelic guides are encouraged to have a psychedelic experience before they ever sit for someone else.”
The study included 803 individuals recruited from Amazon’s Mechanical Turk crowdsourcing platform between December 5, 2020 and January 13, 2021, who had at least mild depressive symptoms as measured via the Center for Epidemiological Studies-Depression scale.
The participants read several paragraphs describing psilocybin-assisted treatment for depression and were then asked, “If you were depressed and wanted to try this treatment, how important would it be to you that the guides had: experienced depression personally? Experience taking a different hallucinogen? Experience taking psilocybin? More than one experience using psilocybin? Experience taking psilocybin in this kind of setting (with eyeshades and music, etc.)? Experience taking psilocybin in this kind of setting more than once? The same gender identity as you? The same race as you?” They answered using a 100-point sliding scale, which ranged from “Not at all important” to “Extremely important.”
The participants also read several paragraphs describing cognitive-behavioral therapy for depression and then completed a similar assessment.
The importance of having a guide who had used psilocybin was rated at 63.79 on average. People rated having a guide who had used psilocybin as more important than having a guide or CBT therapist who had personally experienced depression.
“People who hear about psilocybin-assisted treatment for depression think it’s important to have a guide who has used psilocybin, too,” Earleywine told PsyPost. “In fact, they think it’s more important than having a therapist who has experienced depression, been in the same kind of therapy, or who shares their gender or ethnicity. So training programs for psychedelic guides would likely be better if they included a psilocybin session. The legal issues around getting psilocybin for trainees are pretty complicated, and we should probably make the process a lot easier.”
The substance is illegal in much of the world. Psilocybin is currently a Schedule I substance in the United States and a Schedule III substance in Canada.
“The legal issues surrounding getting psychedelics for people who are training to be guides are probably getting in the way of client preferences,” Earleywine said. “People seem to want a guide who has used psilocybin if they are going to use it! The more we can align the treatment with client preferences, the better the potential for the treatment to work, most likely.”
“We’re not recommending psilocybin use,” Earleywine added. “Any study that administers psilocybin in the lab screens participants very carefully. (One turned away 800 people to get their trial off the ground!)”
The study, “How Important Is a Guide Who Has Taken Psilocybin in Psilocybin-Assisted Therapy for Depression?“, was authored by Mitch Earleywine, Fiona Low, Brianna R. Altman, and Joseph De Leo.