Anon Psych

The requirement should be upheld at the institutional level, not the regulatory one. But that requirement is no more "unethical" than the parallel one for becoming a psychoanalyst. Precisely the opposite: in each case it's essential to the formation of the practitioner. 7/7

I think the same ought to go for psychedelic therapy. Cultures with a serious psychedelic practice (indigenous peoples, Western underground therapy, etc) have been consistent: one cannot and must not serve a psychedelic medicine without years of personal experience with it. 6/

I find the ethical argument against requiring clinicians to have personal experience to train as psychedelic therapists (that it's coercive, violates autonomy etc) to be spurious. If you do not want to go thru the experience then simply don't become a psychedelic therapist. 1/

Can psychedelics turn therapists into vampires? Ethical issues regarding personal psychedelic experience by health professionals esmed.org/MRA/mra/articl…

@PaulAustin3w Leary coined "imprint vulnerability" in the 60s

@zach_haigney She's right;)

Unsolicited advice from my Gen Z psychotherapist sister

"The characterization of this intervention as categorically distinct from psychotherapy and unrelated to treatment efficacy is difficult to sustain, and is further contradicted by the present results."

"A more defensible interpretation is that the preparatory sessions were highly effective at establishing strong therapeutic alliance across pts, & that this almost uniformly strong alliance contributed to the acute experiences, which in turn facilitated therapeutic benefits."

"The available evidence is more consistent with a meaningful role of therapeutic alliance in shaping both the psychedelic experience and clinical outcomes."

@BadreNicolas There is nothing simple about helping patients "feel safe to engage autonomously with the drug experience"

@alphaporgs Alliance predicts subjective fx, subj fx predict therapeutic outcomes. That's path analysis

@AnonPsych2 "The therapeutic alliance appeared to facilitate the psychedelic experience, and these experiences in turn had stronger nominally significant direct effects on clinical outcomes. The effects of the alliance itself on therapeutic efficacy were either limited or absent."

Even in Compass trials where "psychological support" is minimalized, therapeutic alliance modulates outcomes "there were nominally significant effects of therapeutic alliance on psychedelic experience" sciencedirect.com/science/articl…

@insidepharma @DrAdamBorecky Trials rely on highly trained mental health professionals for a reason. If REMS allows MAs to oversee sessions at scale, how confident are we that the real-world benefit–risk profile will match trial outcomes?

Yes - the hourly reimbursement rate is the same, but a Spravato room's real margin comes from staggering 3-4 patients through overlapping windows with one MA. That's the multiplier. Whether COMP360 or CYB003 can do the same thing comes down to one regulatory decision: does REMS allow multi-patient monitoring by an MA, or require 1:1 licensed clinician presence? If it's the former, your math works. If it's the latter, the same rate per hour yields completely different room economics.

Totally disagree. Who wants to trip (in many instances probably for the first time) with a minimally trained stranger with you as your only source of support and guidance?