Therapist training: Frontiers in Psychiatry
Summary of a paper published in Frontiers in Psychiatry on 3 February 2021 “Development and Evaluation of a Therapist Training Programme for Psilocybin Treatment for Treatment-Resistant Depression in Clinical Research”
In recent years, there has been increased interest in the therapeutic potential of psychedelic compounds such as psilocybin for a range of mental health challenges. In psilocybin treatment, a dose of psilocybin is administered in conjunction with psychological support from trained therapists.
COMPASS Pathways, a mental health care company, is currently conducting a phase 2b clinical trial of psilocybin treatment for treatment-resistant depression, using its synthetic COMP360 psilocybin. The trial is taking place in 22 sites in the US, Canada and Europe.
Since the psychological support provided is a core element of the psilocybin treatment, there is a clear need for specially trained therapists who can provide high quality care to patients on the trial.COMP360 received Breakthrough Therapy designation by the US Food and Drugs Administration (FDA) in 2018, which is a process designed to speed up the development of drugs that potentially offer substantial improvement over current treatments.
This paper examines the development, implementation and key learnings from the rigorous therapist training programme that was developed for this clinical trial of psilocybin treatment for treatment-resistant depression.
Description of the training programme
The therapist training programme was devised by COMPASS in consultation with leading experts in mental health and psychedelic research, using a newly developed, ‘manualised’ approach, based on current evidence-based psychotherapeutic approaches. This means the psychological support was provided according to specific guidelines, maximising the chances of the therapy being conducted consistently across different sites, settings, therapists and patients. In previous psilocybin studies, varied approaches to psychological support had made it difficult to replicate and evaluate.
The training programme consists of four parts:
- an online learning platform, with more than 20 hours of video and training sessions
- face-to-face group training, led by experienced therapists and trainers
- applied clinical training, where trainees gain real-world experience from actual therapy sessions
- ongoing individual mentoring and professional development
The training programme was completed by 65 healthcare professionals across the US, Canada and Europe. They were invited to give feedback on the programme.
Respondents said that the teaching and interactive learning helped them gain understanding of and skill development in this therapeutic approach. Clinical training and engagement in care of the trial participants, under the guidance of experienced therapists, were considered to be the most beneficial and the most challenging aspects of the training.
Psychological support is an integral element of psilocybin treatment and must be provided by trained therapists. Clinical training for therapists is therefore essential to ensure delivery of consistently high quality psilocybin treatment. Developing a rigorous and effective programme that can be documented, implemented and expanded, is an important step in this training.
This training programme was a collaborative effort by a number of experts and is a starting point for further collaboration and learning, as therapist training continues to evolve and psilocybin treatment progresses through clinical trials and potentially to bringing benefit to patients.