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MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder: Implications for Social Work Practice and Research

Abstract

The pervasive impact of trauma across populations and stages of life has made it imperative that the field of social work remain at the forefront of trauma-informed theory, research, and practice. The limited, adjunctive use of 3,4-methylenedioxymethamphetamine (MDMA) in the psychotherapeutic treatment of posttraumatic stress disorder (PTSD) is a promising new treatment model that has shown impressive efficacy in phase I and II clinical trials. Preliminary meta-analysis suggests that MDMA-assisted psychotherapy (MDMA-PT) may be superior to prolonged exposure, a first-line treatment for PTSD, and the U.S. Food and Drug Administration (FDA) has granted the treatment “breakthrough therapy” designation, a process of expedited review which signals that a treatment may demonstrate substantial improvement over existing therapies. Though these results are encouraging, much remains unknown and it is essential that the field of social work become informed and engaged in this new body of research. This paper will review the existing literature on MDMA-PT for PTSD, examine ethical and safety concerns, present a preliminary conceptualization of MDMA-PT’s impact on the therapeutic process, and discuss implications for future social work research and practice. This paper finds that the current literature suggests that MDMA-PT is a safe and efficacious treatment that has the potential to revolutionize the treatment of trauma. At the same time, issues of safety, cost, and accessibility should be examined in depth to ensure that this treatment—if approved by the FDA—is accessible to racially and economically marginalized clients.

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Notes

  1. All subjects at study entry had retained a CAPS score of 50 (signifying moderate to severe symptoms) following at least 3 months of prior pharmacological treatment in addition to at least 6 months of psychotherapy. Mean duration of PTSD was 19 years.

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Correspondence to Courtney A. Hutchison.

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Hutchison, C.A., Bressi, S.K. MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder: Implications for Social Work Practice and Research. Clin Soc Work J 48, 421–430 (2020). https://doi.org/10.1007/s10615-018-0676-3

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Keywords

  • Trauma
  • PTSD
  • MDMA
  • Medication-assisted therapy