What do clinicians think about psychedelic assisted therapy? An Australian perspective.

Background: 

Research into psychedelic assisted therapies (PAT) for the treatment of mental health (MH) and substance use disorders (SUD) has increased tenfold in as many years. Australia is set to be the first country to legalise the medicinal use of 3,4-methelynedioxymethamphetamine and psilocybin. Translating new treatments into practice requires an understanding of the implementation barriers and facilitators at the clinician, client, and organisational level. 

Methods: 

We anonymously surveyed Australian MH and Alcohol and Other Drug (AOD) clinicians on their beliefs, attitudes, and interest (or disinterest) in PAT’s by capturing information about knowledge, beliefs, self-efficacy, attitudes, motivations and goals, contexts and resources, and social influences. Survey design was guided by the Theoretical Domains Framework (TDF) which is a theoretical framework for assessing challenges to implementation.

Results:

Of the 135 clinicians, 68.9% described their gender as female, with an average age of 43.2 (SD = 11.1) years. Personal psychedelic experience was reported by 55.6% of clinicians. Clinicians had the highest agreement (91.9%) with the statement ‘PATs deserve further research for the treatment of mental and substance use disorders’ and lowest agreement (5.9%) with the statement ‘PATs will be accessible to those most in need’. Attitudes toward PATs were associated with older age, relying on peer-reviewed sources of information, practice area as mental health compared to substance use, post-graduate education and years’ experience. When controlling for these factors personal psychedelic experience was significantly associated with higher knowledge (d = 0.91, 95% CI: 0.62 to 1.2), beliefs about capabilities (d = 0.69, 95% CI: 0.36 to 1), beliefs about consequences (d = 0.5, 95% CI: 0.16 to 0.84),  and motivations and goals (d = 1, 95% CI: 0.75 to 1.3) domain scores.

Discussions and Conclusions:

Australian clinicians’ shared openness toward PATs as a novel treatment modality for mental and substance use disorders, displayed a hesitance toward the safety and benefits as well as concern over the socio-economic and organisational barriers to treatment access and delivery. Measurement of expectancy effects is needed in future trial designs to better understand moderating effects of clinician and client characteristics on trial outcomes.