Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting
Although effective evidence-based trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) are available, a significant proportion of patients show a suboptimal response or do not complete them. MDMA-assisted therapy (MDMA-AT) for PTSD is a promising intervention currently being evalu...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1433999/full |
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| author | Dimitri Perivoliotis Dimitri Perivoliotis Kayla Knopp Kayla Knopp Shannon Remick Allie Kaigle Allie Kaigle Christopher S. Stauffer Christopher S. Stauffer Chandra Khalifian Chandra Khalifian Tamara R. Wachsman Bettye E. Chargin Andrew W. Bismark Andrew W. Bismark Al Alam Al Alam Leslie Morland Leslie Morland Leslie Morland |
| author_facet | Dimitri Perivoliotis Dimitri Perivoliotis Kayla Knopp Kayla Knopp Shannon Remick Allie Kaigle Allie Kaigle Christopher S. Stauffer Christopher S. Stauffer Chandra Khalifian Chandra Khalifian Tamara R. Wachsman Bettye E. Chargin Andrew W. Bismark Andrew W. Bismark Al Alam Al Alam Leslie Morland Leslie Morland Leslie Morland |
| author_sort | Dimitri Perivoliotis |
| collection | DOAJ |
| description | Although effective evidence-based trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) are available, a significant proportion of patients show a suboptimal response or do not complete them. MDMA-assisted therapy (MDMA-AT) for PTSD is a promising intervention currently being evaluated in numerous studies worldwide, including investigation for potential Food and Drug Administration (FDA) approval in the United States. The concepts of set and setting are foundational in psychedelic therapy and refer to the mindset a person brings to therapy and the environment in which it takes place, respectively. Both are believed to play a critical role in the individual’s experience and efficacy of MDMA-AT. In this article, we describe the importance of set and setting in MDMA-AT for PTSD and outline the advantages and challenges of implementing this novel intervention in large healthcare settings such as the Veterans Health Administration (VHA). Mostly derived from our experience conducting clinical trials of MDMA-AT for PTSD in VHA, we present specific and practical suggestions for optimizing set and setting from both the participant’s and clinician’s perspective in a manner that both leverages the opportunities of such settings and adapts to their challenges. These recommendations are intended to inform future MDMA-AT for PTSD research and, potentially, eventual clinical implementation efforts in traditional healthcare systems. |
| format | Article |
| id | doaj-art-80d68bb342c741adae2400756be8e4b6 |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-80d68bb342c741adae2400756be8e4b62025-01-24T15:54:55ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-01-011610.3389/fpsyt.2025.14339991433999Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and settingDimitri Perivoliotis0Dimitri Perivoliotis1Kayla Knopp2Kayla Knopp3Shannon Remick4Allie Kaigle5Allie Kaigle6Christopher S. Stauffer7Christopher S. Stauffer8Chandra Khalifian9Chandra Khalifian10Tamara R. Wachsman11Bettye E. Chargin12Andrew W. Bismark13Andrew W. Bismark14Al Alam15Al Alam16Leslie Morland17Leslie Morland18Leslie Morland19Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesDepartments of Psychiatry & Research, Veterans Affairs Loma Linda Healthcare System, Loma Linda, CA, United StatesDepartments of Psychiatry & Research, Veterans Affairs Loma Linda Healthcare System, Loma Linda, CA, United StatesDepartment of Pharmacy, Veterans Integrated Services Network (VISN) 23 Clinical Resource Hub, Eagan, MN, United StatesMental Health, Veterans Affairs Portland Healthcare System, Portland, OR, United StatesDepartment of Psychiatry, Oregon Health & Science University, Portland, OR, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesMental Health, Veterans Affairs San Diego Healthcare System, San Diego, CA, United StatesDepartment of Psychiatry, University of California, San Diego, San Diego, CA, United StatesWomen’s Health Sciences Division, National Center for PTSD, Department of Veterans Affairs, Boston, MA, United StatesAlthough effective evidence-based trauma-focused psychotherapies for posttraumatic stress disorder (PTSD) are available, a significant proportion of patients show a suboptimal response or do not complete them. MDMA-assisted therapy (MDMA-AT) for PTSD is a promising intervention currently being evaluated in numerous studies worldwide, including investigation for potential Food and Drug Administration (FDA) approval in the United States. The concepts of set and setting are foundational in psychedelic therapy and refer to the mindset a person brings to therapy and the environment in which it takes place, respectively. Both are believed to play a critical role in the individual’s experience and efficacy of MDMA-AT. In this article, we describe the importance of set and setting in MDMA-AT for PTSD and outline the advantages and challenges of implementing this novel intervention in large healthcare settings such as the Veterans Health Administration (VHA). Mostly derived from our experience conducting clinical trials of MDMA-AT for PTSD in VHA, we present specific and practical suggestions for optimizing set and setting from both the participant’s and clinician’s perspective in a manner that both leverages the opportunities of such settings and adapts to their challenges. These recommendations are intended to inform future MDMA-AT for PTSD research and, potentially, eventual clinical implementation efforts in traditional healthcare systems.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1433999/fullimplementationMDMAMDMA-assisted therapypsychedelicspsychotherapyPTSD |
| spellingShingle | Dimitri Perivoliotis Dimitri Perivoliotis Kayla Knopp Kayla Knopp Shannon Remick Allie Kaigle Allie Kaigle Christopher S. Stauffer Christopher S. Stauffer Chandra Khalifian Chandra Khalifian Tamara R. Wachsman Bettye E. Chargin Andrew W. Bismark Andrew W. Bismark Al Alam Al Alam Leslie Morland Leslie Morland Leslie Morland Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting Frontiers in Psychiatry implementation MDMA MDMA-assisted therapy psychedelics psychotherapy PTSD |
| title | Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting |
| title_full | Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting |
| title_fullStr | Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting |
| title_full_unstemmed | Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting |
| title_short | Bringing MDMA-assisted therapy for PTSD to traditional healthcare systems: tending to set and setting |
| title_sort | bringing mdma assisted therapy for ptsd to traditional healthcare systems tending to set and setting |
| topic | implementation MDMA MDMA-assisted therapy psychedelics psychotherapy PTSD |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1433999/full |
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