Mechanisms of therapeutic change after psychedelic treatment in OCD

• Published in: Psychiatry research 2024-06, Vol.336, p.115907, Article 115907
• Main Authors: Maloney, Gayle, Ching, Terence, Kichuk, Stephen A., Pittenger, Christopher, Kelmendi, Benjamin
• Format: Article
• Language: English
• Subjects: Imagery rescripting (ImRs); Obsessive-compulsive disorder (OCD); Psilocybin-assisted psychotherapy (PAP); Psychological mechanisms
• ISSN: 0165-1781; 1872-7123; 1872-7123
• DOI: 10.1016/j.psychres.2024.115907

•Safe and effective delivery of PAP based on psychotherapeutic frameworks is critical in treatment delivery and optimization.•Psychological mechanisms of change underpinning two novel alternative treatments for OCD: psilocybin and ImRs are explored.•An ImRs-guided psychotherapeutic framework may synergistically support psilocybin treatment of individuals with OCD.•In future research, ImRs could be included to prime and process psilocybin treatment in a range of other psychological conditions. Novel treatments are required for the 30–50% of individuals with obsessive-compulsive disorder (OCD) who remain resistant to first-line pharmacological and psychotherapeutic treatments. Recent pilot data suggest benefit from psilocybin-assisted psychotherapy (PAP) and from imagery rescripting (ImRs). We explore psychological mechanisms of change underpinning both interventions that appear to allow for reprocessing of negative emotions and core beliefs associated with past aversive events. A next critical step in PAP is the development of psychotherapeutic frameworks grounded in theory. We propose that basing PAP on an ImRs framework may provide synergistic benefits in symptom reduction, modification of core beliefs, and value-based living.