Abstract

Anorexia Nervosa is a severe psychiatric condition with the highest mortality rate of any psychiatric diagnosis. There is a current paucity of pharmacological treatment options, and psychotherapeutic treatments have high drop-out rates, and low remission rates, with 20-30% of patients going on to have AN as a lifelong condition.

For our pilot study we recruited adult patients with a diagnosis of anorexia, under the care of UK eating disorder teams, and for whom other previous treatments haven’t worked. Following medical and psychotherapy screening, enrolled patients take three doses of psilocybin with therapeutic support at two-week intervals of over the course of 4 weeks, with the maximum dose set at 25mg. The therapeutic support includes remote and in-person preparation sessions, close support during dosing sessions, and integration session on days after dosing and in the weeks between doses. In addition to this, the therapeutic approach includes the involvement of a “support person”, identified by the patient with whom the therapeutic team will be in regular contact throughout the study. The therapeutic model is an open approach informed by different models, including emotion-focused family therapy, compassion-focused therapy and the ACE model, as well as psychodynamic, object-relations and Groffian perspectives, and features of third wave CBT modalities.

In this presentation we hope to synthesize some of the particular experiences and challenges experienced by participants and clinicians in the course of this clinical trial. This includes a brief overview of the therapeutic model, issues relating to medical and psychotherapy screening, the development of therapeutic relationship, therapeutic themes and insights, challenging experiences, the importance of supervision (with different models), challenges of the therapeutic dyad, integration-related issues, support-person involvement, and the understanding of issues specific to this patient group.