Using Group Model Building to Identify Research Priorities for Translating Psychedelic-Assisted Therapies from Research into Practice

Background: Psychedelic-assisted therapies (PAT) integrate the supervised administration of psychoactive medicines (e.g., psilocybin) that alter consciousness with psychotherapy. Randomized clinical trials of PAT are showing promising results in treating common mental disorders (e.g., depression). The FDA has granted breakthrough therapy status to five psychedelics acknowledging their potential safety and efficacy. As psychedelics advance towards FDA approval, the mental health field in the U.S. is at a critical junction to examine how to best implement these novel treatments. Yet, translating these findings into practice involves complex regulatory, organizational, and social systems. Multidisciplinary planning is essential to safely and equitably translate PAT from research into community care. In this study, we used Group Model Building (GMB), a system science method that engages a group of experts through a participatory process, to: (1) explore the systems involved in translating PAT research into practice and (2) identify research priorities.

Methods: We convened a 2-day GMB workshop with 22 PAT experts representing social work, psychiatry, health policy, neuroscience, anthropology, indigenous studies, health equity, and implementation science to develop the strategic vision of a new research center focused on how to best move PAT from research to practice. We facilitated a group process using structured activities to iteratively develop causal loop diagrams (CLDs) of the system involved in moving PAT from research into practice. CLDs are visual tools used in GMB to illustrate the interconnected variables and feedback loops within complex systems to map dynamic relationships between variables and identify points for interventions. We used standard modeling practices, including two rounds of model refinements with our participants, to generate a CLD of the factors that can influence PAT’s translation from research into practice.

Results: The GMB process yielded a synthesized CLD illustrating the structural dynamics of PAT’s proliferation. Key themes emerged regarding the growth of unregulated community use of psychedelics driven by social media, the influence of stigma on public perception, the shifting legislative landscape regarding the decriminalization and legal use of PAT in regulated sites, and challenges of workforce development. These insights were reformulated as research priorities to inform our center’s working units, including a clinical trial unit focused on precision clinical trials; a policy analysis unit to track and understand state and federal legislations; and a workforce development unit to support equitable practitioner training.

Conclusions: The value of GMB is that it synergized the collective knowledge of stakeholders to develop a deeper understanding of the systems impacting the use of PAT in community and research settings. GMB enabled us to identify our center’s priorities in advancing the science and health benefits of PAT.