Exploring the Use of Psilocybin Therapy for Existential Distress: A Qualitative Study of Palliative Care Provider Perceptions

ABSTRACT

There is a growing body of research suggesting that palliative care patients coping with existential distress may benefit from psilocybin. However, there is a large gap regarding the perceptions of palliative care providers who may provide education, counseling services, recommendations, and/or prescriptions for psilocybin if it is decriminalized, commercialized, and/or federally rescheduled and legalized. The aim of this study was to explore the experiences and perceptions of interdisciplinary palliative care providers regarding existential distress and the use of psilocybin therapy. Five (n = 5) health care providers from a hospital-based palliative care team completed a semi-structured interview related to their experiences supporting patients with existential distress and their beliefs and attitudes related to psilocybin as a possible treatment modality. A qualitative descriptive approach was used to identify key themes which included: 1) multiple barriers to addressing existential distress at the cultural, institutional/organizational, relational, and individual levels, 2) the duality and power of presence, 3) suffering as an intrinsically subjective phenomenon, and 4) uncertainty about the risks and benefits of psilocybin. To inform an inclusive, safe, and holistic approach, more research is needed regarding the possible integration of psilocybin therapy within palliative care for the treatment of existential distress.

KEYWORDS:

• Psilocybin
• existential distress
• hallucinogen
• nursing
• palliative care
• psychedelic
• qualitative

Acknowledgments

We thank our research participants, Kara Fitzgibbon (Director, The Center for Survey Research, University of Virginia) for assistance with the survey, Bethany Coyne, PhD, APRN, PNP-BC (Assistant Professor of Nursing, University of Virginia School of Nursing) for support and assistance throughout the project’s development, and Albert Garcia-Romeu, PhD (Assistant Professor of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine) for helpful feedback on an earlier draft. Lastly, we thank our reviewers for their thoughtful review of our manuscript and the production team.

Disclosure statement

This research received no specific funding/grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors declare no conflicts of interest.

Data Availability

The data that support the findings of the study are available from the corresponding author, CM, upon request, in compliance with institutional data sharing requirements.