Sitting with Suffering, Sitting with Humanity: In the Common Ground of Emerging Psychedelic-Assisted Therapies and Palliative Care (FR208)

Outcomes 1. Discuss advances in psychedelic-assisted therapy science relevant to palliative care settings 2. Explain implications of psychedelic-assisted therapy from myriad disciplinary perspectives with the goal of advancing collaboration and the field more broadly 3. Reflect on palliative care practice models as exemplars for relationship-based psychedelic-assisted therapy integration within the health system In 2021, two landmark randomized controlled studies of psychedelic-assisted therapy generated intense public and scientific interest as well as speculation that MDMA and psilocybin may be granted federal regulatory approval within the next several years for a wide array of mental health indications. Potential applications pertinent to palliative care extend well beyond management of anxiety and depression among those with serious illness to include demoralization, existential distress, grief, meaning making, and life completion. Unlike other drug therapies where efficacy can be reduced to the biochemical action of the drug, the clinical benefit (or harm) of psychedelic medicines is highly contingent on the mindset of the patient and the physical and emotional setting in which they are used. The quality of presence and skills of the therapist are paramount to establish a trusting relationship and safe environment fostering healing. In many traditions, the therapeutic relationship is considered the “medicine,” and psychedelics act to catalyze and deepen the relational aspects of care that may ease suffering and allow each patient's innate healing processes to unfold. Training clinicians and therapists skilled in this modality presents a major bottleneck to this developing field and limitation to widespread accessibility, not simply because clinical infrastructure must be converted or developed but because the safety and efficacy of the intervention uniquely depend on the preparation of the clinician. To meet this need, several training programs have developed over the last 5 years. We present a diverse panel of palliative care and hospice clinicians training and working in psychedelic-assisted therapies to share their experiences of training and clinical care and how the interdisciplinary, intensively relationship-centered approach of palliative care may serve as a model for the successful implementation of psychedelic medicines more broadly across society.