What is the therapeutic alliance, and why is it important?
At Journey Clinical, we believe that the ongoing, positive, and trusted relationship between the patient and their psychotherapist is the key to delivering Psychedelic-assisted psychotherapy (PAP) safely and effectively.
In the conventional medical model, mental health problems have been regarded as brain diseases caused by chemical imbalances that can be corrected with disease-specific drugs. However, for many patients who live with mental health challenges, existing pharmaceutical treatments do not always work: approximately 30% of all patients diagnosed with major depression are resistant to conventional treatments. Moreover, studies have suggested that while effective in the short term, SSRIs rarely provide long-term improvements in quality of life.
In contrast, Psychedelic-assisted psychotherapy represents a paradigm shift in the way mental health conditions are treated, not only because of the promise of psychedelics as a category of drugs, but because psychotherapy with a trusted clinician is a key component of the treatment process.
The therapeutic alliance in particular is of unique importance. The therapeutic alliance is defined as the collaborative relationship between the patient and their psychotherapist. Beyond a standard relationship between patient and practitioner, a major component of the therapeutic alliance is the agreement and collaboration on treatment goals as well as a positive emotional bond. The trust and safety of this therapeutic container creates the conditions needed for the patient to be able to unfold deeper content in their PAP sessions, leading to the possibility of more frequent breakthroughs and longer-term improvement in clinical outcomes.
Many clinical trials have demonstrated that the delivery of psychedelics within the context of psychotherapy drives better outcomes than prescribing psychedelic medicines alone:
- Ketamine-Assisted Psychotherapy: In a 2019 study led by Jennifer Dore, patients experienced significantly decreased depression & anxiety scores (HAM-A & BDI at p<0.0001) in private practice setting with a licensed mental health professional vs. receiving ketamine alone.
- MDMA-Assisted Psychotherapy: In a 2021 study by Mitchell et al, the effect size of MDMA-assisted therapy for severe PTSD was 2.1 vs. MDMA alone at 0.91, more than double with the inclusion of psychotherapy.
- Psilocybin-Assisted Psychotherapy: A 2021 study by Davis et al found that the stronger the therapeutic alliance, the better the patient outcomes for major depressive disorder.
Furthermore, drug development companies like MAPS and Compass Pathways are leading clinical trials within this psychedelic-assisted psychotherapy paradigm, positioning the therapeutic alliance as the key component to delivering psychedelic medicines at scale.
At Journey Clinical, we have built our entire platform around the therapeutic alliance. In our patient-centered collaborative care model, our highly-trained, in-house medical team takes on all medical responsibilities of KAP (patient eligibility, prescriptions, and outcome monitoring) while our member psychotherapists take on the psychotherapy (preparation sessions, dosing journey and integration sessions). This approach allows patients to remain in therapy with existing clinicians, receive personalized treatment plans, and experience the highest quality of comprehensive care possible.
If you are a licensed mental health professional interested in delivering Ketamine-Assisted Psychotherapy (KAP) in your practice, we invite you to join our platform.