Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder
ABSTRACTBackground: MDMA-assisted psychotherapy (MDMA-AP) is a combined psychotherapeutic and pharmacologic intervention that shows promise in the treatment of posttraumatic stress disorder (PTSD). Although therapeutic alliance has been established as a key predictor across psychotherapies and is em...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-01-01
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| Series: | European Journal of Psychotraumatology |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/20008066.2023.2297536 |
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| author | Richard J. Zeifman Hannes Kettner Stephen Ross Brandon Weiss Michael C. Mithoefer Ann T. Mithoefer Anne C. Wagner |
| author_facet | Richard J. Zeifman Hannes Kettner Stephen Ross Brandon Weiss Michael C. Mithoefer Ann T. Mithoefer Anne C. Wagner |
| author_sort | Richard J. Zeifman |
| collection | DOAJ |
| description | ABSTRACTBackground: MDMA-assisted psychotherapy (MDMA-AP) is a combined psychotherapeutic and pharmacologic intervention that shows promise in the treatment of posttraumatic stress disorder (PTSD). Although therapeutic alliance has been established as a key predictor across psychotherapies and is emphasised within MDMA-AP treatment manuals, research has not yet examined the relationship between therapeutic alliance and MDMA-AP treatment outcomes.Objective: Examine whether therapeutic alliance predicts changes in PTSD symptoms following MDMA-AP.Method: Twenty-three individuals with chronic PTSD participated in a MDMA-AP clinical trial that included a randomised (MDMA vs. placebo) and open-label phase. The present analyses focused on participants who were administered MDMA over the course of the randomised and open-label phases (n = 22). Therapeutic alliance was assessed using the Working Alliance Inventory at sessions baseline (pre-session 3) and sessions 4 and 9. PTSD symptoms were assessed using the Clinician Administered PTSD Scale and the Impact of Events Scale-Revised.Results: Controlling for baseline clinician-assessed PTSD severity, therapeutic alliance at sessions 4 and 9 (but not baseline) significantly predicted post-MDMA-AP clinician-assessed PTSD severity. Controlling for baseline self-reported PTSD severity, therapeutic alliance at baseline (although this did not survive correction for multiple comparisons) and sessions 4 and 9 predicted post-MDMA-AP self-reported PTSD severity.Conclusions: The present results provide the first preliminary evidence for the relationship between the therapeutic alliance and treatment outcomes within MDMA-AP for PTSD. These findings highlight the important role of psychotherapy, and common psychotherapeutic factors, within MDMA-AP. Replication in studies with larger and more diverse clinical samples remain necessary.Trial registration: ClinicalTrials.gov identifier: NCT00090064. |
| first_indexed | 2024-03-08T17:02:32Z |
| format | Article |
| id | doaj.art-f853b5bb466445abb185e07d3059d070 |
| institution | Directory Open Access Journal |
| issn | 2000-8066 |
| language | English |
| last_indexed | 2024-03-08T17:02:32Z |
| publishDate | 2024-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | European Journal of Psychotraumatology |
| spelling | doaj.art-f853b5bb466445abb185e07d3059d0702024-01-04T10:09:27ZengTaylor & Francis GroupEuropean Journal of Psychotraumatology2000-80662024-01-0115110.1080/20008066.2023.2297536Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorderRichard J. Zeifman0Hannes Kettner1Stephen Ross2Brandon Weiss3Michael C. Mithoefer4Ann T. Mithoefer5Anne C. Wagner6Department of Psychiatry, NYU Grossman School of Medicine, NYU Langone Centre for Psychedelic Medicine, New York, NY, USACentre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UKDepartment of Psychiatry, NYU Grossman School of Medicine, NYU Langone Centre for Psychedelic Medicine, New York, NY, USACentre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UKMAPS Public Benefit Corporation (MPBC), San Jose, CA, USAMAPS Public Benefit Corporation (MPBC), San Jose, CA, USADepartment of Psychology, Toronto Metropolitan University, Toronto, CanadaABSTRACTBackground: MDMA-assisted psychotherapy (MDMA-AP) is a combined psychotherapeutic and pharmacologic intervention that shows promise in the treatment of posttraumatic stress disorder (PTSD). Although therapeutic alliance has been established as a key predictor across psychotherapies and is emphasised within MDMA-AP treatment manuals, research has not yet examined the relationship between therapeutic alliance and MDMA-AP treatment outcomes.Objective: Examine whether therapeutic alliance predicts changes in PTSD symptoms following MDMA-AP.Method: Twenty-three individuals with chronic PTSD participated in a MDMA-AP clinical trial that included a randomised (MDMA vs. placebo) and open-label phase. The present analyses focused on participants who were administered MDMA over the course of the randomised and open-label phases (n = 22). Therapeutic alliance was assessed using the Working Alliance Inventory at sessions baseline (pre-session 3) and sessions 4 and 9. PTSD symptoms were assessed using the Clinician Administered PTSD Scale and the Impact of Events Scale-Revised.Results: Controlling for baseline clinician-assessed PTSD severity, therapeutic alliance at sessions 4 and 9 (but not baseline) significantly predicted post-MDMA-AP clinician-assessed PTSD severity. Controlling for baseline self-reported PTSD severity, therapeutic alliance at baseline (although this did not survive correction for multiple comparisons) and sessions 4 and 9 predicted post-MDMA-AP self-reported PTSD severity.Conclusions: The present results provide the first preliminary evidence for the relationship between the therapeutic alliance and treatment outcomes within MDMA-AP for PTSD. These findings highlight the important role of psychotherapy, and common psychotherapeutic factors, within MDMA-AP. Replication in studies with larger and more diverse clinical samples remain necessary.Trial registration: ClinicalTrials.gov identifier: NCT00090064.https://www.tandfonline.com/doi/10.1080/20008066.2023.2297536Posttraumatic stress disorderMDMAMDMA-assisted psychotherapytherapeutic alliancemechanism of changeTrastorno de estrés postraumático |
| spellingShingle | Richard J. Zeifman Hannes Kettner Stephen Ross Brandon Weiss Michael C. Mithoefer Ann T. Mithoefer Anne C. Wagner Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder European Journal of Psychotraumatology Posttraumatic stress disorder MDMA MDMA-assisted psychotherapy therapeutic alliance mechanism of change Trastorno de estrés postraumático |
| title | Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder |
| title_full | Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder |
| title_fullStr | Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder |
| title_full_unstemmed | Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder |
| title_short | Preliminary evidence for the importance of therapeutic alliance in MDMA-assisted psychotherapy for posttraumatic stress disorder |
| title_sort | preliminary evidence for the importance of therapeutic alliance in mdma assisted psychotherapy for posttraumatic stress disorder |
| topic | Posttraumatic stress disorder MDMA MDMA-assisted psychotherapy therapeutic alliance mechanism of change Trastorno de estrés postraumático |
| url | https://www.tandfonline.com/doi/10.1080/20008066.2023.2297536 |
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