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Disruption as an opportunity or threat: A qualitative analysis of factors influencing the attitudes of experts in serious illness care toward psychedelic-assisted therapies

Published online by Cambridge University Press:  11 October 2023

Roxanne Sholevar Open the ORCID record for Roxanne Sholevar [Opens in a new window] ,
John Peteet ,
Justin Sanders Open the ORCID record for Justin Sanders [Opens in a new window]  and
Yvan Beaussant Open the ORCID record for Yvan Beaussant [Opens in a new window]
Roxanne Sholevar*
Affiliation:
Department of Psychosocial Oncology and Palliative Care, The Dana-Farber Cancer Institute, Boston, MA, USA Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, MA, USA
John Peteet
Affiliation:
Department of Psychosocial Oncology and Palliative Care, The Dana-Farber Cancer Institute, Boston, MA, USA Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, MA, USA
Justin Sanders
Affiliation:
Department of Family Medicine, McGill University, Montreal, QC, Canada
Yvan Beaussant*
Affiliation:
Department of Psychosocial Oncology and Palliative Care, The Dana-Farber Cancer Institute, Boston, MA, USA Department of Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, MA, USA
*
Corresponding authors: Roxanne Sholevar; Email: Roxanne_Sholevar@dfci.harvard.edu; Yvan Beaussant; Email: Yvan_Beaussant@dfci.harvard.edu
Corresponding authors: Roxanne Sholevar; Email: Roxanne_Sholevar@dfci.harvard.edu; Yvan Beaussant; Email: Yvan_Beaussant@dfci.harvard.edu
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Abstract

Background

Psychedelic-assisted therapies (PAT) are emerging as a promising treatment for psycho-existential distress in patients with serious illness. A recent qualitative analysis of perspectives of 17 experts in serious illness care and/or PAT research identified divergent views on the therapeutic potential and safety of PAT in patients with serious illness. This paper further analyzes the factors that may influence these views.

Objectives

To identify factors underlying the attitudes of experts in serious illness care and/or PAT toward PAT and its potential role in serious illness care.

Methods

Semi-structured interviews of 17 experts in serious illness care and/or PAT from the United States and Canada were analyzed to identify factors cited as influencing their views on PAT.

Results

Five factors were identified as influencing experts’ attitudes toward PAT: perception of unmet need, knowledge of empirical studies of PAT, personal experience with psychedelics, professional background, and age/generation. In addition, an integrative theme emerged from the analysis, namely PAT’s disruptive potential at 4 levels relevant to serious illness care: patient’s experience of self, illness, and death; relationships with loved ones and health-care providers; existing clinical models of serious illness care; and societal attitudes toward death. Whether this disruptive potential was viewed as a therapeutic opportunity, or an undue risk, was central in influencing experts’ level of support. Experts’ perception of this disruptive potential was directly influenced by the 5 identified factors.

Significance of results

Points of disruption potentially invoked by PAT in serious illness care highlight important practical and philosophical considerations when working to integrate PAT into serious illness care delivery in a safe and effective way.

Keywords

Psychedelic-assisted therapySerious illness careQualitative researchDisruption
Type
Original Article
Information
Palliative & Supportive Care , Volume 21 , Issue 6 , December 2023 , pp. 967 - 972
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Copyright
© The Author(s), 2023. Published by Cambridge University Press.

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