Developing a Direct Observation Measure of Therapeutic Connection in Psilocybin-Assisted Therapy: A Feasibility Study

Area of Science:

• Psychiatry and Psychology
• Neuroscience
• Clinical Trials Research

Background:

• Measuring therapeutic connection is crucial for understanding psilocybin-assisted therapy mechanisms.
• This connection informs therapist training and quality improvement initiatives.
• Direct observation methods are needed to assess this therapeutic alliance.

Purpose of the Study:

• To evaluate the feasibility of directly observing indicators of therapeutic connection.
• To assess observable expressions of empathic abiding presence and interpersonal grounding.
• To analyze audio-visual data from psilocybin administration encounters.

Main Methods:

• Evaluation of audio and video data from four 8-hour psilocybin therapy sessions.
• Independent coding by three interprofessional team members using a structured checklist.
• Recording of audible and visible cues, interaction qualities, and their temporal distribution.

Main Results:

• 372 moments of therapeutic connection were identified across 2074 minutes of video.
• 83% of moments were identified by at least two coders; 41% by all three.
• Audible and visual cues were used in 51% of identified therapeutic connection events.
• Observed cues and qualities varied with psilocybin's temporal effects on consciousness.

Conclusions:

• Direct observation of therapeutic human connection during psilocybin therapy is feasible.
• This method is sensitive to changes in states of consciousness.
• Evaluation requires analysis of both audible and visual data streams.