Case Study: Acceptance and Commitment Therapy Plus Psychedelics in Treating Sexual and Cannabis Addiction

Acceptance and commitment therapy (ACT) has shown promising preliminary results for sexual addiction, and psychedelics have recently been theorized as a potential treatment option as well. Sexual addiction often presents with comorbidities, such as anxiety, depression, and substance use disorder. This case study thus describes and evaluates an ACT-informed approach to simultaneously treat an adult male's sexual and cannabis addiction, along with symptoms of depression and anxiety. It also presents the patient's spontaneously reported complementarity between ACT and a posttreatment recreational psychedelic use, and how this was subsequently integrated to deepen the therapeutic outcomes. Quantitative and qualitative results indicated clinically significant and persistent improvements of all aforementioned dimensions after ACT, that is, reduction of the cannabis and sex addiction, as well as anxiety and depression symptoms. Patient's reports suggested shared mechanisms of ACT and psychedelics, notably psychological flexibility. This case study, which describes an integrated ACT-based approach for sexual addiction with comorbidities, provides useful information for clinicians; and a clinical-although anecdotical-support of complementarity between ACT and psychedelics in a patient with sexual addiction, which indirectly gives credit to the hypothesis that ACT-based psychedelic therapy could be efficient for this condition. This article may encourage the development of more controlled studies of ACT-informed, and potentially psychedelic-assisted therapy for the treatment of sexual addiction. Clinical Impact Statement This case study suggests that acceptance and commitment therapy (ACT) may be efficient in treating concurrent sexual and cannabis addiction, and anxiety and depression symptoms. Additionally, it highlights a potential complementarity between ACT and a posttreatment naturalistic, recreational psychedelic use. Future practice and research on sexual addiction with comorbidities could use and further explore psychological flexibility models, and potentially consider combining ACT and psychedelics as a treatment option.