From Evidence to Practice: A Systematic Review of Implementation of Psychedelic-Assisted Psychotherapy

Background: Evidence supporting psychedelic-assisted psychotherapy (PAP) for treating posttraumatic stress disorder, depression, and other historically difficult to treat mental health disorders is growing rapidly. Interest from the public and within the US government to provide access to these treatments has also grown. Considering the gap between discovery of effective treatments and implementing them in clinical settings, it is important to synthesize current knowledge of implementing these complex treatment modalities to aid efforts for systematic implementation going forward. Objectives: The specific objectives of this systematic review were to: (1) identify extant literature on implementation of PAP, and (2) synthesize and present findings to understand current implementation knowledge and inform future directions. Methods: This systematic review followed the procedures outlined in Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Six databases were searched using a string developed with the keywords “implementation,” “psychedelic (methylenedioxymethamphetamine, psilocybin, lysergic acid diethylamide, ketamine),” and “psychotherapy” along with Elsevier expansions and synonyms. The study only included peer-reviewed research on PAP, which reported on the implementation of the interventions. The implementation science framework, the Practical, Robust, implementation and Sustainability Model, guided the data extraction and synthesis about implementation-relevant factors. Results: A total of 2,406 articles were identified, and 2,074 of these were screened by title and abstract after the initial elimination of duplicates and sources that were not peer-reviewed research articles (e.g., gray literature). Forty-seven were retrieved for full text review, and 20 studies were included in the review. Most studies (15) were cross-sectional surveys and/or qualitative interviews assessing organizational perspective. The remaining (5) presented included aspects of patient perspective (2), infrastructure (2), and patient characteristics (1). Conclusion: There is a noticeable gap in implementation-focused research on best practices for translating PAP from academic settings into accessible clinical programs. Addressing this gap is essential to support the safe and effective implementation of PAP in real-world settings.