PURPOSE: Psychedelic-assisted therapy (PAT) is becoming a clinically available treatment for patients with treatment-resistant conditions such as depression and post-traumatic stress disorder (PTSD) in several countries. As PAT transitions from research settings into routine clinical practice, there is a growing need for coherent clinical frameworks and evidence-based guidelines to support its safe, effective, and integrated delivery. This paper examines how external therapists and psychiatrists can best support patients throughout the PAT journey; the different models for involving external therapists in PAT; the challenges and opportunities associated with collaboration between external therapists and PAT teams; beneficial characteristics of external therapy; and priority areas for future research.
METHOD: A literature review was conducted, including empirical studies, theoretical papers, and position statements that explored the role of external therapies alongside PAT. This information was integrated with multidisciplinary clinical experiences to develop a series of guiding principles and practical considerations for clinicians.
FINDINGS: There is currently no cohesive framework to guide collaboration or care coordination between external therapists and PAT teams. The review suggests that PAT should not generally be conceptualized as a standalone treatment for patients with treatment-resistant conditions. External therapists play a critical role across preparation, dosing, and integration phases, contributing to patient safety, continuity of care, and therapeutic integration. Models for involving external therapists in PAT are identified, each with opportunities and challenges. Practical strategies are outlined to mitigate risks and address challenges associated with interprofessional collaboration. Further research is required to refine clinical frameworks and inform best practices.
CONCLUSION: While scientific and public narratives often portray PAT as a discrete or self-contained intervention, clinical practice indicates it is most effective when embedded within a broader, integrated therapeutic process. Effective collaboration between external therapists and PAT teams is essential to maximize therapeutic outcomes and ensure patient safety.
Psychedelic Science