Psychothérapie assistée par psychédéliques (PAP) : le modèle genevois

Article Article scientifique Article Psychothérapie assistée par psychédéliques (PAP) : le modèle genevois fre 2024-07 author Seragnoli Federico 0000-0001-9261-770X 876311 author Thorens Gabriel 0000-0002-3622-9179 88882 Département de psychiatrie (PSYAT) author Penzenstadler Louise Emilie 0000-0003-1379-0243 821101 Département de psychiatrie (PSYAT) author De Carvalho Furtado Leonice Capristano 428643 author Buchard Albert 843137 author Bachmann Silke 982686 author Iuga Radu author Khatcherian Eugénie 953601 Eugenie Khatcherian author Nowotarski Adam 0009-0009-2962-4785 955978 author Sabe Michel 889218 Département de psychiatrie (PSYAT) author Richard Lepouriel Hélène 0000-0002-0778-3728 797416 Département de psychiatrie (PSYAT) author Glangetas Alban 779424 author Girani Léa 908063 author Anastasova Raya Boyanova 920329 author Girardet Alexis Sami 906368 author Yang Ray author Lécureux Léo 930643 services communs de la faculté de droit (DROCO) author Alaux Sylvie author Mabilais Cedric author Amberger Repond Caroline Marie 46144 author Dubuc Charles author Szczesniak Laurent author Blanc Johanna 821188 Centre de soutien psychologique (PSY) author Tudor Maria author Elrhaoussi Akram 938931 author de Chambrier Pablo Pierre 923412 author Petignat Cyril 854216 author Rochat Lucien 538210 author Briefer Jean-François 526811 author Rothen Stéphane 691816 author Aboulafia Brakha Tatiana 683594 author Qusaj Visar 430250 author Cheminal Ségolen author Billieux Joel 0000-0002-7388-6194 557453 author Zullino Daniele Fabio 649976 Département de psychiatrie (PSYAT) 10.1016/j.amp.2024.05.014 0003-4487 https://linkinghub.elsevier.com/retrieve/pii/S0003448724002105 Dans cet article, nous avons pour objectif de décrire un modèle interdisciplinaire de psychothérapie assistée par psychédéliques (PAP) que nous avons développé dans un cadre institutionnel aux hôpitaux universitaires de Genève. La psychothérapie assistée par psychédéliques (PAP) est une approche psychothérapeutique exploitant l’altération de l’état de conscience induite par une substance psychédélique. Cette approche, longtemps négligée pour des raisons historiques non scientifiques, fait de nouveau l’objet de recherches grâce à des résultats préliminaires importants concernant son potentiel thérapeutique dans divers troubles mentaux. En Suisse, depuis 2014, il est possible d’obtenir des autorisations médicales exceptionnelles pour traiter des patients avec du LSD et de la psilocybine. Nous soutenons que l’altération de la conscience induite par les psychédéliques est un outil thérapeutique puissant qui pourrait être développé pour appuyer la psychothérapie traditionnelle basée sur le dialogue afin de relancer le processus psychothérapeutique. Background : In this article, we aim to describe an interdisciplinary model for psychedelic assisted psychotherapy (PAP) that we have developed at the Geneva University Hospitals, in an institutional setting. Our model integrates the collaborative efforts of psychiatrists, psychologists, and nurses establishing a structured framework for administering PAP in a safe, controlled, and standardized manner. Introduction : Psychedelic assisted psychotherapy (PAP) is a psychotherapeutic approach that utilizes the profound alteration of the state of consciousness induced by psychedelic substances to enhance therapeutic outcomes. This innovative approach, which has been neglected due to historical biases rather than empirical evidence, is now experiencing a renewed interest among clinicians. Contemporary research, equipped with advanced methodologies and a rigorous scientific approach, is showing significant therapeutic potential for a range of mental health disorders. In Switzerland, the legal framework authorizes the medicinal use since 2014 for exceptional authorizations for the medicinal use of LSD and psilocybin for therapeutic purposes, under strict regulations. Method : We provide a comprehensive description of the PAP protocol implemented at the Geneva University Hospitals, beginning with its inception in September 2020. Our methodological outline includes the administrative and clinical selection criteria for patient eligibility; the preparatory sessions designed to introduce the patients with psychoeducation interventions and the analysis of intention and therapeutical objectives; the controlled administration of psychedelics in a supportive environment; and the integration sessions that follow psychedelic experiences. Our protocol emphasizes safety, ethical considerations, and the importance of a supportive therapeutic relationship throughout the process. We also describe questionnaires we use to qualify and assess the alteration in the state of consciousness, namely The Five Dimension Altered States of Consciousness (5AD-ASC) and the Mystical Experience Questionnaire (MEQ). Since the start of the program in September 2020 and up to February 2024, a total of 224 personal authorizations (114 LSD, 110 Psilocybin) have been issued to the Geneva University Hospital PAP team, for a total of 396 individual sessions. Discussion : The core argument presented in this article is that the psychedelic-induced alteration of consciousness is a novel therapeutic tool, which works as a potent catalyst that can be synergistically combined with traditional dialogue-based psychotherapy. This combination has the potential to support the psychotherapeutic processes and enable breakthroughs in cases where conventional therapy has reached its limits. We discuss the implications of this approach, reflecting on both its challenges and its transformative potential within its clinical application. Conclusion : The conclusion of our article is an endorsement of the continued basic and clinical research on PAP. By presenting a detailed framework of the PAP process, including its preparatory, experiential, and integrative phases, we advocate for a structured and scientifically grounded exploration of its therapeutic efficacy. Our conclusion calls for a broader acceptance and integration of PAP within clinical practice, provided it is underpinned by ongoing research, ethical practice, and institutional su Psychédélique Psychothérapie LSD Psilocybine Conscience Dewey 616.89 Dewey 613 Dewey 616 Dewey 150 60 Département de psychiatrie 225 56 Département de médecine 221 66 Institut de santé globale 22A1 108 Section de psychologie 71 false 496 Abus de substances 834 1241 Affective sciences Annales médico-psychologiques ff709283-9401-45ec-b140-16615d9aefdf Article (Published version) Public PAP_Modèle_Genevois_2024_archive_ou.pdf 1055761 application/pdf CC BY-4.0 a47f12010e886f9953141f5165bcf875b9388e1cb975cd679d58f494707638de openAccess Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale Faculté de psychologie et des sciences de l'éducation / Section de psychologie

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