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Psychedelic-assisted therapy (PAT) is a burgeoning treatment with growing interest across a variety of settings and disciplines. Empirical evidence supports PAT as a novel therapeutic approach that provides safe and effective treatment for people suffering from a variety of diagnoses, including treatment-resistant depression, substance use disorder, and post-traumatic stress disorder. Within the palliative care (PC) field, one-time PAT dosing may lead to sustained reductions in anxiety, depression, and demoralization-symptoms that diminish the quality of life in both seriously ill patients and those at end of life. Despite a well-noted psychedelic renaissance in scholarship and a renewed public interest in the utilization of these medicines, serious illness-specific content to guide PAT applications in hospice and PC clinical settings has been limited. This article offers 10 evidence-informed tips for PC clinicians synthesized through consultation with interdisciplinary and international leading experts in the field with aims to: (1) familiarize PC clinicians and teams with PAT; (2) identify the unique challenges pertaining to this intervention given the current legalities and logistical barriers; (3) discuss therapeutic competencies and considerations for current and future PAT use in PC; and (4) highlight critical approaches to optimize the safety and potential benefits of PAT among patients with serious illness and their caregivers.

Caregivers of patients with glioblastoma multiforme (GBM) are at significant risk for existential distress. Such distress negatively impacts caregivers’ quality of life and capacity to serve in their role as healthcare proxies, and ultimately, contributes to poor bereavement outcomes. Our team developed Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C), the first targeted psychosocial intervention that directly addresses existential distress in caregivers. The purpose of this study was to evaluate the feasibility, acceptability, and preliminary effects of MCP-C among caregivers of patients with GBM via a mixed-method pilot trial. Caregivers were randomized to seven sessions of MCP-C or Enhanced Usual Care (EUC), which included distress screening and the provision of targeted referrals and completed quantitative assessments at baseline (T1), after completion of MCP-C (T2), and at 2-month follow-up (T3). A subset of participants engaged in semistructured interviews at T2. Of 60 caregivers randomized, 55 were evaluable for preliminary efficacy analysis. Constrained linear mixed models indicated the MCP-C arm had statistically significant improvement relative to the EUC arm in the primary outcome of personal meaning and multiple secondary outcomes, including benefit finding, depressive symptomatology, and spiritual wellbeing. MCP-C demonstrated preliminary efficacy in facilitating caregivers’ capacity to experience a sense of meaning and purpose despite the challenges and suffering associated with providing care to patients with GBM. Future studies are needed among more diverse samples of caregivers and should include the opportunity for concurrent patient enrollment to allow for a reciprocal and augmented experience of meaning among patient–caregiver dyads.

The high prevalence, underassessment, and undertreatment of pain throughout the course of HIV disease make understanding the barriers and inequalities in HIV/AIDS-related pain care essential. There is a tremendous need for integrated implementation of pharmacological and psychosocial interventions. Part 2 of this review aims to discuss mood, anxiety, and substance abuse assessments; barriers to care; and psychiatric treatments in the context of HIV-AIDS-related pain. Recommendations are made from the gathered data that highlight the need for an interdisciplinary comprehensive approach to managing pain in HIV disease. Further research is needed to examine the relationship of pain and psychiatric issues in order to formulate effective treatment strategies.

HIV/AIDS-related pain remains a clinically challenging condition despite recent advances in treatment modalities. The existing data on pain in HIV-positive persons demonstrate a high prevalence, wide variability in clinical presentation, significant negative impact on health-related quality of life, and alarmingly inadequate assessment and management. Patients with HIV/AIDS have clearly identified physician attention to pain control as extremely important. This article discusses the psychiatric components and considerable impact of pain in the HIV population. Special attention is given to psychological assessment issues, psychosocial barriers to treatment, and psychotherapeutic approaches. An integrated, flexible, and interdisciplinary team approach model for treating HIV/AIDS-related pain is presented with specific recommendations.