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The TRIP Protocol: A New Standard for Psychedelic Therapy

Psychedelic research has always been a decentralized field, and not entirely by choice. Advancements in the science of how psychedelics can help patients suffering from conditions like depression, PTSD, and traumatic disorders (even where conventional medication has failed) have often been the result of the isolated, lonely work of researchers in distant antipoles —from the Colombian Amazon to rural Saskatchewan, from prestigious university labs to the Tin Pan alleys of the counterculture

The challenge for these resourceful and disparate practitioners has been how to build a consensus body of shared knowledge in the face of mainstream anxiety about psychedelics and a global War on Drugs. Scientists who saw the promise of these substances augment and improve patient outcomes often found themselves working at the margins of the law, and far afield of public respectability. To share case studies or therapeutic modalities with like-minded therapists came with a risk, one that could threaten the existence of an already delicate equilibrium in which they practiced.

Measuring Psychedelic Success

Today, some things have changed and some things have not. Psychedelic therapy has captured the public spotlight, but its development has been uneven. Not only have legalization efforts proceeded state-by-state (in some cases, city-by-city), the industry lacks an effective benchmark for care. Clinics operate independently of one another, calling upon differing modalities of treatment that result in completely different patient experiences.

A first patient study using the TRIP Protocol showed almost a 47% reduction in symptoms of depression after treatment.

This is what MindSetting is trying to change. An integrative mental health company based in southern Ontario, MindSetting has developed the TRIP (Therapeutic Reset of Internal Processes) Protocol, a 5-step protocol for psychedelic treatment the organization teaches to healthcare practitioners through their institute and practices through their clinics. A first patient study using the TRIP Protocol showed almost a 47% reduction in symptoms of depression after treatment, which makes it a promising step forward to a standard of care that the industry is sorely missing.

The TRIP Protocol

The protocol begins with a consultation, either virtually or at a MindSetting clinic, where therapists work with patients to diagnose their distress and  rule out any physiological or psychiatric contraindications the patient may have with the ketamine treatment the TRIP Protocol uses.

Next, patients collaborate with their therapist on a treatment plan, identifying both their short and long term goals (similar to the intention-setting exercises many recommend for psychedelic first timers) and practicing mindfulness techniques that can help them during their session.

During the therapy session itself, patients self administer a prescribed dose of oral ketamine, before spending some time wearing an eye mask and listening to specially selected music (read more about the art of the psychedelic playlist). They’ll then engage in talk therapy with their therapist, who calls upon CBT and insight-oriented theory to explore their emotional reaction.

This stands in contrast to the ketamine infusions provided to patients in most other psychedelic therapy clinics, where clinicians function more as “tripsitters” or “guides”, playing a passive role to ensure patient safety but not engaging with them directly. That MindSetting therapists engage in active therapeutic discourse with patients during their psychedelic experience is a prime differentiator, and allows them to not only keep patients engaged with the goals they outlined before their session but also to help them combat anxiety or disorientation that psychedelic experiences can trigger.

“Individuals who have gone through the TRIP protocol consistently note that the analysis and integration are tremendously helpful,” says Dr. Tatiana Zdyb, clinical psychologist, and founder of MindSetting. The protocol is designed to help people recognize the compulsions, defense mechanisms, and other psychological factors that are contributing to the onset and maintenance of their symptoms. “By bringing these factors into conscious awareness,” Dr. Zdyb explains, “we can help the patient create new ways of reframing, regulating, and responding to them.”

Ketamine is like a truth serum. With the infusions, they were great but it was very bio-focused. [TRIP] is next level. It’s biological, cognitive, mind, soul. It’s transformative.

Dr. Zdyb says that it isn’t uncommon for her clinic to see patients who have undergone ketamine infusions elsewhere, but are looking for a more impactful experience. According to one of these patients, who wished to remain unnamed, “ketamine is like a truth serum. With the infusions, they were great but it was very bio-focused. [TRIP] is next level. It’s biological, cognitive, mind, soul. It’s transformative.”

After the session, MindSetting therapists use established psychiatric frameworks to analyze the session transcript, developing insights that will help patients understand their experience.

Psychedelic impressions are often intense, but they can also be confusing and fleeting, so examining them with a trained professional can make the experience feel less overwhelming and more intuitive. 

Finally, there’s integration, where the patient shares their reflections on their experience, and their therapist presents a summarized analysis based on their notes. From this, patient and psychotherapist can discuss strategies and interpretations either for further treatment or for them to take with them into the world.

The Future of Psychedelic Therapy

MindSetting’s TRIP Protocol is a massive step for psychedelic therapy: a structured, safe set of guidelines and procedures that limit the variables and ensure that the patient is both guided and supported at every moment of their journey. MindSetting has also announced that they’re developing TRIP Protocols designed to address trauma and burnout for healthcare workers specifically. As interest (and investment) in psychedelic research continues to grow, milestones like this will become even more indispensable, and hopefully, inevitable.

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