Trauma-Informed Care in Psychedelic Therapy Research: A Qualitative Literature Review of Evidence-Based Psychotherapy Interventions in PTSD and Psychedelic Therapy Across Conditions

Figures & data

Figure 1 PRISMA flow diagram of evidence-based psychotherapy interventions (EBPI) literature search.

Figure 2 PRISMA flow diagram for psychedelic therapy (PT) literature search.

Table 1 Overview of EBPI Study Methodologies, Settings, Sample Characteristics and CASP Quality Ratings

Author/Year	Study Design	Qualitative Methodology	Type of Intervention (no. of Sessions Where Specified)	Setting	Population	Sample Size/age	CASP Rating
Andersen et al, 2021^Citation94	Non-randomised intervention study	Phenomenology Thematic analysis	CBT with Basic Body Awareness Therapy (BBAT) 12 sessions	Veterans clinic, Denmark	Male veterans	4 Age range: 30–50	10
Booysen and Kagee, 2023^Citation89	Qualitative study	Semi-structured interviews Thematic analysis	Prolonged exposure (PE) 6 sessions	Outpatient services, South Africa	Female PTSD patients	7 Age range: 20–27	8
Borges et al, 2019^Citation82	Qualitative study	Semi-structured interviews Thematic analysis	Various EBPI	Veterans clinic, USA	Male veterans	14 Mean age: 59.5 (range: 25–74)	8
Boterhoven et al, 2021^Citation87	Qualitative study within RCT	Semi-structured interviews Thematic analysis	IREM (imagery rescripting with EMDR) 12 sessions	Outpatient clinics in Australia, Germany, Netherlands	Adult PTSD patients with childhood trauma	44 Mean age: 40	9
Harned and Schmidt, 2019^Citation91	Qualitative study within larger implementation project	Mixed-methods Focus groups Inductive content analysis	Dialectical Behavioural Therapy (DBT) with PE	Outpatient services, USA	Female PTSD patients	19 Mean age: 35	8
Hegarty et al, 2022^Citation99	Qualitative study	Analysis of audio-recorded sessions Thematic analysis	Group-based CBT 18 sessions	Outpatient services, UK	Female cPTSD patients	10 Mean age: 44 (range: 26–60)	9
Hundt et al, 2017^Citation90	Qualitative study of treatment acceptability	Semi-structured interview Grounded theory	PE Cognitive Processing Therapy (CPT) At least 8 sessions	Veterans clinic, USA	Veterans	23 Mean age: 53.7	8
Hundt et al, 2020^Citation88	Qualitative study of treatment dropout	Grounded theory Semi-structured interview	PE CPT Fewer than 8 sessions	Veterans clinic, USA	Veterans	28 Mean age: 45.3	8
Jackson et al, 2020^Citation100	Mixed-methods feasibility study	Semi-structured interview Inductive content analysis	Trauma and violence-informed CBT	Perinatal mental health service, USA	Expectant mothers, victims of intimate partner violence	3 No age data	8
Kehle-Forbes et al, 2022^Citation92	Qualitative study comparing treatment completers vs non-completers	Semi-structured interview Thematic analysis	PE CPT Completers: at least 10 sessions Non-completers: 1–6 sessions	Veterans clinic, USA	Veterans	126 No age data	9
Lowe and Murray, 2014^Citation50	Qualitative	Semi-structured interviews IPA	TFCBT 6–15 sessions (avg.: 12)	Outpatient services, UK	PTSD patients	9 Mean age: 53 (range: 30–63)	8
Matheson and Weightman, 2019^Citation83	Participatory research	Semi-structured interview Thematic analysis	Various EBPI 12–60 sessions	Secondary mental health, UK	Complex PTSD (cPTSD) patients	24 Mean age: 45.5 (range: 27–71)	9
Meis et al, 2023^Citation80	Qualitative study of treatment dropout from trial	Dyadic qualitative approach Semi-structured interview	CPT	Veterans clinic, USA	Veterans	29 Mean age: 50.9	8
Mott et al, 2013^Citation51	Qualitative study of treatment acceptability	Mixed-methods Open-ended written responses Thematic analysis	Group-based PE 12 sessions	Veterans clinic, USA	Male veterans	20 Mean age: 55 (range: 27–69)	5
Murray et al, 2016^Citation52	Mixed-methods study	Grounded theory Written questionnaire	TFCBT	Outpatient services, UK	PTSD patients	25 Mean age: 41 (range: 28–65)	7
Price et al, 2016^Citation101	Add-on qualitative study to RCT	Written impact statements Thematic analysis	CPT 12 sessions	Veterans clinic, USA	Veterans	15 Mean age: 52.8	6
Sandberg et al, 2017^Citation84	Qualitative study	Semi-structured interviews Thematic analysis	Trauma focused psychotherapy (integrating CBT, EMDR and psychodynamic psychotherapy)	Outpatient services, Sweden	PTSD patients	5 Age range: 26–50	9
Shearing et al, 2011^Citation48	Qualitative study	Semi-structured interviews IPA	TFCBT	Outpatient services, UK	PTSD patients with single event trauma	7 Age range: 20–50	9
Sherrill et al, 2022^Citation81	Mixed-methods non-randomised study	Written questionnaire Theoretical thematic analysis	Group-based PE 18 sessions	Intensive veterans outpatient program, USA	Veterans	25 Mean age: 42.2	7
Sripada and Walters, 2022^Citation54	Qualitative study informed by previous quantitative work	Semi-structured interviews Hypothesized thematic analysis	Individual and group EBPIs (various)	Veterans residential treatment programmes, USA	Veterans	24 No age data	8
Thoresen et al, 2022^Citation86	Qualitative study	Semi-structured interviews Thematic analysis	PE with EMDR (plus physical activity and psychoeducation) 16 sessions (8 PE, 8 EMDR)	Intensive outpatient treatment service, Norway	PTSD patients	8 Mean age: 39.5 (range: 25–57)	10
Unwin et al, 2019^Citation172	Open-label pilot study	Semi-structured interviews Thematic analysis	EMDR	Outpatient intellectual disabilities service, UK	PTSD patients with intellectual disabilities	2 Age range: 23–50	8
van Gelderen et al, 2020^Citation95	Qualitative study within RCT	Grounded theory Open-ended question interviews Thematic analysis	3MDR (multimodular motion-assisted memory desensitization and reconsolidation) 16 sessions (6 3MDR, 10 treatment as usual)	Outpatient tertiary care, Netherlands	Veterans	10 Mean age: 43 (range: 25–59)	10
Vincent et al, 2013^Citation85	Qualitative study	Semi-structured interview Interpretative phenomenological analysis (IPA)	TFCBT within stage-based treatment 7–20 total sessions (2–10 of TF-CBT)	Primary and secondary care, UK	Asylum-seekers	7 Age range: 19–42	7
Wells et al, 2022^Citation70	Add-on qualitative study to RCT (studying treatment dropout)	Semi-structured interview Thematic analysis	PE 4–14 sessions	Veterans clinic, USA	Veterans	22 Mean age: 43 (range: 25–67)	9
Zielinski et al, 2021^Citation93	Mixed-methods acceptability study	Written feedback form Thematic analysis	Group-based PE 8 sessions	Prison, USA	Incarcerated women	61 Mean age: 33 (range: 19–57)	9

Table 2 Overview of PT Study Methodologies, Settings, Sample Sizes and CASP Quality Ratings

Author/Year	Study Design	Qualitative Methodology	Substance Studied	Psychological Support Model (No. of Sessions Where Specified)	Treatment Indication	Setting	Sample Size/Age	CASP Scoring
Agin-Liebes et al, 2021^Citation107	Open label pilot study	Microphenomenological interviews IPA	Psilocybin	Group PSI (preparation, support, integration) 8–10 group sessions (4 prep, 4–6 integration) 2 individual sessions (1 psychedelic treatment session, 1 post-dosing integration)	AIDS survivors	Inpatient medical facility, USA	9 Mean age: 57.9 (range 50–66)	7
Agin-Liebes et al, 2023^Citation108	Retrospective follow-up to double-blind RCT	Semi-structured interviews IPA	Psilocybin	Motivational interviewing + CBT + PSI	Alcohol use disorder	USA	13 Mean age: 48.1 (28–63)	8
Barone et al, 2019^Citation38	Retrospective follow-up to crossover, double-blind RCT	Semi-structured interviews IPA	MDMA	Weekly psychotherapy	Treatment-resistant PTSD Veterans, police, firefighters	Clinical research facility, USA	19 Mean age: 35.9 (24–56)	10
Belser et al, 2017^Citation109	Retrospective follow-up to crossover, double-blind RCT	Semi-structured interviews IPA	Psilocybin	Psychotherapy derived from diverse modalities 9 sessions	Anxiety associated with life-threatening illness	Clinical research facility, USA	13 Mean age: 50 (22–69)	9
Camlin et al, 2018^Citation110	Qualitative study	Semi-structured interviews Constant comparative thematic analysis	Ibogaine	Unspecified psychological support	Opioid use disorder	Inpatient medical facility, Mexico	10 Mean age: 28.8 (21–48)	8
Gasser et al, 2015^Citation111	Follow-up qualitative study to RCT	Semi-structured interviews Qualitative Content Analysis	LSD	Unspecified psychotherapy 6–8 sessions	Anxiety associated with life-threatening illness	Inpatient medical facility, Switzerland	10 Mean age: 51.1 (39–64)	7
Malone et al, 2018^Citation112	Add on qualitative study to RCT Case series	Semi-structured interviews Analysis of study therapist notes	Psilocybin	PSI 11 sessions (3 prep, 2 psychedelic treatment sessions, 6 integration)	Anxiety associated with life-threatening illness	Cancer centre, USA	4 Age range: 20–70	7
Mollaahmetoglu et al, 2021^Citation113	Parent study: double-blind RCT	Semi-structured interviews Reflexive thematic analysis	Ketamine	Manualised relapse-prevention psychotherapy 7 sessions	Alcohol use disorder	Clinical research facility, UK	12 Mean age: 46.5 (22–59)	9
Nielson et al, 2018^Citation123	Qualitative follow-up to open-label proof-of-concept study	Directive content analysis of debriefing sessions	Psilocybin	Integrated therapy model (motivational interviewing + CBT + PSI)	Alcohol use disorder	Clinical research facility, USA	10 Mean age: 40.1 (25–56)	9
Noorani et al, 2018^Citation114	Retrospective follow-up to open-label pilot study	Semi-structured interviews Thematic analysis	Psilocybin	Smoking cessation CBT + mindfulness PSI 14 sessions (4 prep, 10 integration)	Smoking cessation	Clinical research facility, USA	12 Mean age: 54 (31–67)	8
Schenberg et al, 2017^Citation115	Qualitative study	Semi-structured interviews Directive content analysis	Ibogaine	CBT with relapse prevention	Substance use disorder (various)	Private residential clinic and hospital, Brazil	22 Mean age: 33 (22–53)	8
Schenberg et al, 2017^Citation116	Qualitative study	Semi-structured interviews Interpretative phenomenological analysis (IPA)	Ibogaine	CBT with relapse prevention	Substance use disorder (various)	Private residential clinic and hospital, Brazil	22 Mean age: 33 (22–53)	8
Swift et al, 2017^Citation117	Retrospective follow-up to crossover, double-blind RCT	Semi structured interviews IPA	Psilocybin	Psychotherapy derived from diverse modalities 9 sessions	Anxiety associated with life-threatening illness	Clinical research facility, USA	13 Mean age: 50 (18–69)	8
Watts et al, 2017^Citation55	Open label feasibility study	Semi-structured interviews Constant comparative thematic analysis	Psilocybin	PSI 5 sessions (1 prep, 2 psychedelic treatment sessions, 2 integration)	Treatment-resistant depression	Clinical research facility, UK	20 Mean age: 44 (30–64)	8

Figure 3 Core Themes diagram demonstrating the 7 key themes from Psychedelic Therapy (PT) and Evidence-based Psychotherapy Interventions (EBPI) in PTSD which may contribute to Trauma Informed Care (TIC) in PT.

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