Articulation de la thérapie d’acceptation et d’engagement à la psychothérapie assistée par psychédéliques en addictologie

Abstract

Objectives

Addictive behaviors are currently considered a major public health concern worldwide. The observation of limited results of existing treatments encourages the search for new therapeutic modalities. This paper examines, through a qualitative literature review, the relevance of using Acceptance and Commitment Therapy (ACT) as a psychotherapeutic framework for Psychedelic-Assisted Psychotherapy (PAP), as well as the perspective of the articulation of this approach in the field of addiction.

Methods

After briefly introducing the current context of addiction, its mechanisms and treatments, we will address both Psychedelic-Assisted Psychotherapy and Acceptance and Commitment Therapy. We will then discuss their synergy and their association, before concluding on perspectives for addictology.

Results

The results of published studies suggest significant efficacy of these two approaches when used separately and for different conditions, including addiction. The promising efficacy of Psychedelic-Assisted Psychotherapy is equally based on its psychotherapeutic component, which is necessary to optimize the beneficial effects.

Discussion

Due to the synergy between their mechanisms of action, ACT seems particularly suited to PAP. While this association, recently used in two recent research studies on treatment-resistant depression, has not yet been explored in the field of addiction, the preliminary results that suggest their complementarity open up perspectives on their association within a therapeutic framework in addictology, and encourage a reflection upon an adapted protocol to implement.

Conclusions

To this day, psychological processes of change involved in PAP remain insufficiently studied and require further understanding. ACT appears as an appropriate proposal for the therapeutic framework of PAP, worthy of future investigation in the field of addiction, where the underlying processes of psychological flexibility – targeted by both psychedelics and this psychotherapeutic approach – play a major role in treatment outcomes. In a field that remains understudied, this perspective participates in the search for a unifying and integrative psychotherapeutic component, in the service of a global overview of the treatment of addiction disorders.