Palliative care provider attitudes toward existential distress and treatment with psychedelic-assisted therapies

This interview study with palliative care providers (n=19) in the US assessed their attitudes toward including psychedelic-assisted therapy (PAT) in palliative care. Common themes included: existential distress is currently insufficiently treated, care providers see existential distress as a psychosocial-spiritual issue, PAT holds promise but does not fit with existing models of care and more evidence is needed.

Abstract

Background: Existential distress is a significant source of suffering for patients facing life-threatening illnesses. Psychedelic-Assisted Therapies (PAT) are novel treatments that have shown promise in treating existential distress, but openness to providing PAT may be limited by the stigma surrounding psychedelics and the paucity of education regarding their medical use. How PAT might be integrated into existing treatments for existential distress within palliative care remains underexplored.

Methods: The present study aimed to elucidate the attitudes of palliative care clinicians regarding treatments for existential distress, including PAT. We recruited palliative care physicians, advanced practice nurses, and spiritual and psychological care providers from multiple US sites using purposive and snowball sampling methods. Attitudes toward PAT were unknown prior to study involvement. Semi-structured interviews targeted at current approaches to existential distress and attitudes toward PAT were analyzed for thematic content.

Results: Nineteen respondents (seven physicians, four advanced practice nurses, four chaplains, three social workers, and one psychologist) were interviewed. Identified themes were 1) Existential distress is a common experience that is frequently insufficiently treated within the current treatment framework; 2) Palliative care providers ultimately see existential distress as a psychosocial-spiritual problem that evades medicalized approaches; 3) Palliative care providers believe PAT hold promise for treating existential distress but that a stronger evidence base is needed; 4) Because PAT do not currently fit existing models of existential distress treatment, barriers remain.

Conclusions: PAT is seen as a potentially powerful tool to treat refractory existential distress. Larger clinical trials and educational outreach are needed to clarify treatment targets and address safety concerns. Further work to adapt PAT to palliative care settings should emphasize collaboration with spiritual care as well as mental health providers and seek to address unresolved concerns about equitable access.”

Authors: Halsey Niles, Colleen Fogg, Ben Kelmendi & Mark Lazenby

Study details

Topics studied
Equity and Ethics

Study characteristics

Participants
19 Humans

Institutes

Institutes associated with this publication

Massachusetts General Hospital
Massachusettes General Hospital has launched the MGH Center for the Neuroscience of Psychedelics. The announcement has now been done via YouTube, and the formal launch will be in fall 2020.