UCSF

ABSTRACT

Problem Statement

Mental health disorders and existential distress are prevalent among individuals with serious or terminal illnesses, often leading to poor quality of life (QOL), anxiety, and depression. Traditional treatments, such as selective serotonin reuptake inhibitors (SSRIs), have limited efficacy and may not address the unique psycho-spiritual needs of this population. Psychedelic-assisted therapy (PAT) has emerged as a potentially novel approach to addressing existential distress, demoralization (DM), and death acceptance (DA) in seriously ill individuals (SIIs). However, there is limited research on the impact of PAT on DA and related constructs such as DM and QOL.

Methods

This dissertation utilizes a mixed-methods approach to explore the effects of PAT on DA, and how this outcome impacts DM, and QOL in SIIs. The research includes an exploratory scoping review, along with two distinct studies: a qualitative constructivist grounded theory analysis based on transcribed interviews from a previous psychedelic study, and a quantitative secondary analysis using a mixed-effects model from an existing dataset. The convergent mixed-methods design allows for the simultaneous evaluation of qualitative and quantitative data to provide a comprehensive understanding of PAT's impact on these constructs.

Summary of Findings

Preliminary findings suggest that PAT may significantly improve DA while reducing DM and enhancing QOL in seriously ill individuals. The qualitative analysis revealed that participants experienced PAT-induced emotional breakthroughs and increased psychological flexibility while revealing major themes of 1.) acceptance of death, dying, and impermanence, 2.) acceptance of illness, and 3.) embracing complex emotions. Quantitative results supported these findings, showing significant reductions in DM and improvements in QOL following a single PAT session over eight weeks. These results highlight the potential of PAT as a transformative therapeutic approach for improving DA and alleviating various forms of distress in palliative care settings. Further research is needed to confirm these findings and explore long-term effects.