- Cognitive-behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD), when combined with MDMA, resulted in significant improvements in PTSD symptoms
- Six couples, in which one partner was diagnosed with PTSD, participated in a seven-week protocol; both members in the couple received MDMA-assisted psychotherapy in two sessions
- Improvements were observed in clinician-assessed, participant-rated, and partner-rated PTSD symptoms; participant depression, sleep, emotion regulation, and trauma-related beliefs; and participant- and partner-rated relationship adjustment and happiness
- MDMA holds promise as a facilitator of CBCT to achieve more robust and broad effects on individual and relational functioning in those with PTSD and their partners
A pilot trial to assess the safety, feasibility, and efficacy of Cognitive-Behavioral Conjoint Therapy (CBCT) for PTSD and MDMA-assisted therapy for PTSD resulted in significant reductions in PTSD symptoms and relational outcomes for couples, according to a peer-reviewed paper published today in the European Journal of Psychotraumatology. This initial trial, sponsored by the Multidisciplinary Association of Psychedelic Studies (MAPS) and organized by MAPS Public Benefit Corporation (MAPS PBC), included six couples with a range of baseline relationship satisfaction in which one member was diagnosed with PTSD resulting from a range of traumas including childhood physical abuse, childhood sexual abuse, and active military service.
CBCT for PTSD focuses on the relationship between the participant and their partner, encouraging skill development as a couple. CBCT alone has been shown to improve PTSD, enhance relationship functioning, and improve intimate partner well-being. MDMA-assisted psychotherapy for PTSD, currently in Phase 3 trials to gain approval from the U.S. Food and Drug Administration (FDA), has yielded significant improvements for individuals in PTSD symptoms and other outcomes such as increased openness to experience, posttraumatic growth, and improvement in comorbid conditions. This study represents the first in which MDMA’s potential to facilitate the effects of a stand-alone, empirically-supported psychotherapy – other than the protocol developed by MAPS — for PTSD was tested.
Candice M. Monson, Ph.D., is a Professor of Psychology and Clinical Training Director at Ryerson University. Dr. Monson is an expert on traumatic stress and CBCT, having researched CBCT as a treatment for PTSD since 2012 and MDMA-assisted psychotherapy for PTSD since 2015. She described the treatment as promising because, “PTSD in one partner can cause distress in the relationship and barriers to understanding each other. It seems that MDMA-assisted psychotherapy can engender empathy and connection, opening a pathway to remembering why came together in the first place and a desire to understand the other. The literature that inspired this study suggests that MDMA may allow people to talk about painful experiences without experiencing the pain again. The therapist can guide couples to talk about very difficult things that they’ve either experienced themselves or experienced together—against the other or with the other— with a greater sense of understanding, openness, connection, and empathy.”
Participants received the session content comprising CBCT in a condensed format, including intensive weekends and bi-weekly sessions, over seven weeks. The two MDMA sessions were timed to synergize with the CBCT interventions and both members of the couple were administered 75mg or 100mg of MDMA with an optional supplemental dose. Each member of the couple was scheduled for assessment at pre-treatment, mid-treatment, post-treatment, and three- and six-month follow-ups. In addition, participants completed assessments of self- and partner-reported PTSD symptoms and overall relationship happiness at those assessment points, as well as at each treatment occasion. No unexpected adverse events were observed.
This initial study suggests that MDMA-facilitated CBCT holds promise in facilitating trauma recovery and achieving broader relational outcomes not fully realized with individual evidence-based treatment for PTSD. Though the comparison of effect sizes is tentative due to the small sample size, the effects across all outcomes were largest at six-month follow-up, suggesting that MDMA facilitation may confer ongoing benefits. The authors are currently preparing for a Phase 2 randomized trial led by co-author Anne Wagner, Ph.D., C. Psych., to more rigorously investigate the safety and efficacy of MDMA-facilitated CBCT and to address treatment outcomes across a diversity of participant and partner genders, pre-treatment relationship distress, and type of initial trauma.
Interviews with study authors are available via maps.org/mediarequest.
The safety and efficacy of MDMA-assisted psychotherapy is currently under investigation. It has not yet been approved by the FDA, does not work for everyone, and carries risks even in therapeutic settings. These statements are no guarantee of future FDA approval or availability of MDMA-assisted psychotherapy. These statements necessarily involve known and unknown risks and uncertainties, which may cause actual outcomes to differ materially from our projections.
1 Participants were assessed using the Structured Clinical Interview for DSM-5 (SCID-5; First, Williams, Karg, & Spitzer, 2015) at baseline to determine eligibility and characterize the sample. The Clinician-Administered PTSD Scale-5 (CAPS-5; Weathers et al., 2013a) was used as the clinician-rated primary outcome measure of PTSD symptoms, and the PTSD Checklist (PCL-5, patient and partner versions; Weathers et al., 2013b) and Couples Satisfaction Index (CSI; Funk & Rogge, 2007) were used as self-report primary outcomes. The overall relationship happiness item from the CSI was also completed at each visit.
Betty Aldworth, Interim Communications Director
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Founded in 1986, MAPS is a 501(c)(3) non-profit research and educational organization that develops medical, legal, and cultural contexts for people to benefit from the careful uses of psychedelics and marijuana. Since its founding, MAPS has raised over $100 million for psychedelic therapy and medical marijuana research and education.
ABOUT MAPS PUBLIC BENEFIT CORPORATION (MAPS PBC)
MAPS Public Benefit Corporation (MAPS PBC) catalyzes healing and well-being through psychedelic drug development, therapist training programs, and sales of prescription psychedelics while prioritizing public benefit above profit. Founded in 2014, MAPS PBC is a wholly owned subsidiary of the Multidisciplinary Association for Psychedelic Studies (MAPS), a 501(c)(3) non-profit organization.