What is Psychedelic Assisted Therapy (KAP)?

The rise of mental health disorders is at an all-time high. Of particular note is Major Depressive Disorder (MDD), a condition characterized by a low, hopeless mood which persists for at least two weeks. It’s one of the most common psychiatric conditions that affects Americans, with an estimated lifetime prevalence rate of 20.6%. 

The increased prevalence of mental health disorders is also associated with tremendous socio-economic costs—$1 trillion per year, to be precise. Loss of productivity due to mental health is also among the leading causes of disability in the US and Canada. 

Many people with MDD and other mental health disorders also may not respond to conventional therapies and medications. Up to 30% of patients diagnosed with MDD have not responded to antidepressant medications, a condition known as treatment-resistant depression. Antidepressants can also take 8-12 weeks before they begin working.

Despite the increase in mental health disorders, research and development of psychopharmacology has been stunted since 2010. FDA approval of new psychiatric drugs decreased from 13 approved in 1996 to one in 2016. 

Researchers have dubbed these circumstances a ‘psychiatric crisis’. The need for fast acting and efficient psychiatric substances has never been higher, which is why psychedelic assisted therapy is such a promising new avenue to explore. 

What is psychedelic assisted therapy? 

Psychedelics are a class of drugs that can induce changes in cognitive processes, mood and perception of reality. Traditional psychedelics (also known as hallucinogens) include LSD, Psilocybin, Mescaline and Ayahuasca. Several other types of drugs are also considered to be psychedelics. This includes MDMA, an entactogen that produces feelings of euphoria, and ketamine, a dissociative anaesthetic.

Many of these substances aren’t new to the market; LSD has been studied by scientists since the 1940’s. Researchers used the drug to help treat patients suffering from severe alcoholism. By administering LSD to willing participants in a controlled setting, researchers at the time established the framework for psychedelic therapy that we use today.

A ban on all psychedelics, however, was implemented by Nixon in 1970 via the Controlled Substances Act, effectively halting research into psychedelics…

Until the 1990s when the tireless work of researchers like Dr. Rick Strassman finally proved that psychedelic substances such as DMT had accepted medical value. Human psychedelic studies began to re-emerge, and with them came more refined ways of approaching psychedelic assisted therapies. 

Today psychedelic assisted therapy is a process in which psychoactive substances are used to induce therapeutic changes in mood and behavior. Substances are administered by trained mental health professionals in controlled settings. Patients are also carefully monitored by other professionals such as anaesthesiologists during each session to ensure safety. Each psychedelic session also entails a preparatory component before the “trip” as well as psychotherapy sessions following the experience. These sessions are known as integration, and they’re designed to help patients make sense of their experiences. 

Psychedelic assisted therapy is currently used to treat several mental health conditions such as Post Traumatic Stress Disorder (PTSD) as well as MDD. Researchers are also evaluating psychedelic assisted therapy’s role in being able to treat other disorders such as Obsessive Compulsive Disorder (OCD) and substance abuse. 

One aspect of psychedelic assisted therapy that makes it so promising is its efficacy. Ibogaine, a psychedelic drug that’s being evaluated for its role in substance abuse disorders, has been shown to exert therapeutic benefit after a single dose. Psilocybin, the main ingredient in “magic mushrooms”, was also shown to produce rapid “robust and enduring anxiolytic and antidepressant effects” in patients. Ketamine, too, has been shown to produce positive results with one to 12 sessions, while LSD can do so in one or 2 sessions. 

Unlike conventional antidepressants psychedelics are extremely fast-acting. They also often demonstrate positive outcomes which persist for up to a year or more after administration. Psychedelics are also of special interest to researchers as they’ve been shown to exert therapeutic effect for patients suffering from treatment-resistant conditions. 

Not all psychedelic assisted therapies, however, are created equal, which is why we’ve worked so hard to create a unique experience for our patients. 

The Field Trip Experience

‘Set’ is a term used to refer to the mindset, or mood, expectations and thoughts of an individual preceding a ‘trip’. ‘Setting’ is used to describe the environment in which the experience will take place. 

Researchers have established that, “...the pharmacology of psychedelics was not solely responsible for determining their subjective effects.” They also noted that, “The expectations and personal experiences of the individual taking them as well as the external environment were recognized as vitally important in influencing users’ experiences...dubbed set and setting.”

The importance of set and setting, then, can not be understated. Having a vital understanding of what to expect during a psychedelic session is integral to its success. 

Briefing patients on what to expect is just one type of harm reduction measure employed in psychedelic assisted therapy. Field Trip offers a number of additional safety protocols to ensure the wellbeing of every patient. These include:

1. Set and what to expect

Mindset, or initial attitude preceding a trip, plays a huge role in psychedelic assisted therapies. As such we encourage patients to engage in several mindfulness-based behaviors prior to a trip. These can include journaling or reading guided mindfulness content available through the Field Trip Portal; avoiding negative media; talking walks in nature and eating well. 

All interested participants will have a consult session with a psychiatrist to determine if treatment is suitable. Intake sessions are also used to identify contraindications, or other comorbid conditions that may interfere with treatment. 

This initial consult is then followed up by an intake session with a psychotherapist. These sessions are designed to establish a therapeutic and trusting relationship between patients and therapists. This is especially necessary for successful treatment as research indicates trust and knowledge of psychedelics are two competencies essential to psychedelic therapists. Psychotherapists will also provide insight into what to expect during a typical psychedelic experience to help better prepare patients. 

Patients are then invited to create an account on Field Trip Portal so they can access additional resources, content, appointment information and be able to message their Care Team. They can also set an intention for their experience through Portal. Patients are also encouraged to express concerns or any sources of discomfort to their Care Team.

If psychotherapists believe psychedelic assisted therapy is not in the best interest of the client their concerns are forwarded to the Director of Clinical Therapy for review.

1. Interdisciplinary approach 

Several different types of medical and mental health practitioners are required for successful psychedelic assisted therapy. That’s why we’ve adopted an interdisciplinary, team-based approach to facilitate a seamless client experience. Every Field Trip clinic has licensed psychiatrists on staff as well as naturopathic doctors, nurse practitioners, psychotherapists and a medical director to ensure the safety and positive outcome of all participants. 

1. Comfortable setting

All of our spaces are designed with setting in mind. Environments are created with the goal of providing a safe, comforting space in which patients can feel at ease. This effect is achieved through careful, meticulous interior design of Field Trip clinics. Patients can expect to find an abundance of plant life including mossy walls, curated music playlists, plush sofa cushions and weighted blankets for additional comfort. Other features used for this purpose include virtual reality touchpoints, use of zero gravity chairs and state of the art sound design. 

Your psychotherapist will also be present for the entirety of your session to support you through any challenges you may experience. 

1. Preparation 

Additional safety protocols are provided to patients before their initial psychedelic treatment session. These include:

• Asking patients to refrain from alcohol, cannabis, opioids or other psychedelics before sessions

• Encouraging patients to fast for at least 4 hours prior to treatment in order to avoid nausea or gastrointestinal discomfort

• Recommending patients abstain from liquids 4 hours prior so as to minimize bathroom trips during treatment

• Suggesting patients get a full night’s sleep and avoid stressful situations or media in advance if possible

1. Integration sessions

Integration, or processing your experience with a trained professional, is an integral part of successful treatment. All patients are invited to participate in integration sessions following their experience. This is where psychotherapists can provide support to help process new insights and assist with integrating them into everyday life.

1. Aftercare planning

Additional safety protocols are also recommended for patients following treatment. These include a requirement for patients to arrange rides after sessions, aftercare integration such as taking a day off work to recover and engaging in additional self-care practices such as meditation. We’ll also text you important follow-up questions to help better tailor your treatment. Clients can also request additional sessions if deemed necessary.

1. COVID safety protocols

To help ensure the safety of all patients and staff, we’ve implemented a number of additional COVID-19 related safety protocols. These include:

• Scheduling: Appointments are made to ensure social distancing is maintained between clients

• Pre-appointment screening: All individuals will be contacted one day prior to their appointment to ensure they haven’t experienced recent COVID-19 symptoms. Patients displaying symptoms 14 days prior to appointments are encouraged to reschedule. 

• Temperature screening at entrances to all Field Trip clinics.

• All individuals entering clinics are required to wear masks and sanitize hands upon entrance.

• Only one individual is allowed in waiting rooms at a time.

• Treatment rooms are regularly cleaned and disinfected throughout the day. 

We care deeply about our patients, which is why we’ve put so much thought into our safety protocols and user experience. 

The future of fast-acting psychedelic medicines is bright. It’s our hope that this psychedelic assisted therapy model will continue to be refined so that it can provide therapeutic experiences for consumers, especially those suffering from mental health conditions.