Training for MDMA-based psychotherapy for PTSD

The Multidisciplinary Association for Psychedleic Studies (MAPS) training program for MDMA-assisted psychotherapy was developed by Annie Mithoefer and her husband Michael Mithoefer in collaboration with MAPS and introduced in 2012. The Mithoefers were the first two therapists to carry out therapeutic studies. In 2005, a group associated with the Mithoefers and Rick Doblin started working on a treatment manual for MDMA-assisted psychotherapy for PTSD. It was developed in collaboration with Lisa Jerome, June Ruse, Elizabeth Gibson and Marcela Ot'alora. Six preliminary versions preceded the release of the final version in 2015.

The handbook describes qualifications and procedures that are required for the implementation of MDMA-assisted psychotherapy in a standardized format. This is important for phase 2 and 3 studies because these must follow a standardized procedure. The manual contains sections on:

  • Qualification and background of the therapist

  • Supporting the process of the patient

  • Conducting preparatory sessions

  • Conducting MDMA-assisted psychotherapy sessions

  • Conducting integrative follow-up meetings

  • The therapist's psycho-hygiene

The manual is available here.

The training for MDMA therapists offered by MAPS is recognized by the FDA. It is a five-stage program designed to prepare therapists for work in phase 3 studies. The participants must have appropriate pre-qualifications. This includes training as a psychologist or physician with additional qualifications as a psychotherapist. The training schedule includes a one-day online course, a one-week seminar that is mainly devoted to practical questions (e. g. discussion of video clips of therapy sessions). The aim is to learn how to accompany patients and work with them therapeutically during the MDMA-induced condition. In the third part, the therapist has the opportunity to take MDMA in a self-awareness session. The fourth and fifth part deal with the practical treatment of one’s own patients, including intervision / supervision sessions, which should take place in peer groups.

Most MDMA therapists believe that it is important for the therapist to experience MDMA themselves in order to learn about its effects and to better understand and empathize with the experiences of its patients. In order to enable such self-awareness, a special research project had to be set up. The research protocol was based on the approach of the LSD research team headed by Albert Kurland at Spring Grove Hospital (Baltimore, Maryland) in the early 1970s. This team had FDA approval to administer LSD to nurses, doctors, and psychologists who worked with patients as part of LSD studies.

After the FDA reviewed the curriculum, MAPS received approval in 2009 from the FDA and the relevant Institutional Review Board (IRB). In 2010, the first therapists took MDMA as part of their training. So far, 85 therapists have completed the self-experience study. At the moment, participation in several locations is possible, but limited to therapists who are working on the clinical studies sponsored by MAPS.     

A few years ago, the overall concept of the training program was finally approved by the FDA. The first training in Europe took place in Austria in 2012, the second in Maastricht in 2018. There, MAPS employees conducted a one-week training course for 60 therapists who are to conduct the phase 3 studies in Europe. By 2019, over 500 doctors, nurses, counselors and other psychiatric professionals have participated in the program.