MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial
Open accessAbstract
Cognitive-behavioural conjoint therapy (CBCT) for PTSD has been shown to improve PTSD, relationship adjustment, and the health and well-being of partners. MDMA (3,4-methylenedioxymethamphetamine) has been used to facilitate an individual therapy for PTSD. This study was an initial test of the safety, tolerability, and efficacy of MDMA-facilitated CBCT. Six couples with varying levels of baseline relationship satisfaction in which one partner was diagnosed with PTSD participated in a condensed version of the 15-session CBCT protocol delivered over 7 weeks. There were two sessions in which both members of the couple were administered MDMA. All couples completed the treatment protocol, and there were no serious adverse events in either partner. There were significant improvements in clinician-assessed, patient-rated, and partner-rated PTSD symptoms (pre- to post-treatment/follow-up effect sizes ranged from d = 1.85–3.59), as well as patient depression, sleep, emotion regulation, and trauma-related beliefs. In addition, there were significant improvements in patient and partner-rated relationship adjustment and happiness (d =.64–2.79). These results are contextualized in relation to prior results from individual MDMA-facilitated psychotherapy and CBCT for PTSD alone. MDMA holds promise as a facilitator of CBCT to achieve more robust and broad effects on individual and relational functioning in those with PTSD and their partners.
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Written from the paper’s full text.
TL;DR
In an uncontrolled trial of six couples with one partner diagnosed with PTSD, MDMA-facilitated cognitive-behavioural conjoint therapy (CBCT) was completed by all couples with no serious adverse events and significant improvements in PTSD, comorbid symptoms, and relationship outcomes. The authors conclude MDMA holds promise as a facilitator of CBCT, but the lack of a control condition limits conclusions.
Key findings
- All 6 couples completed the protocol, and there were no serious adverse events; the most common reactions following MDMA sessions were diminished appetite, anxiety, headache, and jaw tightness.
- PTSD symptoms improved significantly: clinician-assessed CAPS-5 (B = −4.64, p < .001; d = 1.88–2.25 at post-treatment/follow-ups), patient-rated PCL-5 (B = −8.14, p < .001; d = 2.72–3.59), and partner-rated PCL-5 (B = −5.90, p < .001; d = 1.85–2.72). All but one patient showed sustained remission in clinician-assessed PTSD diagnosis.
- Secondary outcomes improved: depression (B = −4.24; d = 1.50–2.53), sleep (B = −.81, p < .01; d = .88–1.18), emotion regulation reappraisal (B = 1.38, p < .01; d = 1.09–1.15) and suppression (B = −1.12, p < .01; d = 1.12–1.20), and trauma-related beliefs (B = −12.01, p < .01; d = .98–1.17).
- Relationship outcomes improved: patient CSI (B = 4.55, p < .05; d = .82–1.22), partner CSI (B = 5.73, p < .05; d = .64–.80), patient relationship happiness (B = .35, p < .001; d = 1.42–2.79), and partner relationship happiness (B = .33, p < .001; d = 1.30–1.78).
Methods
- Uncontrolled trial of six couples in which one partner had current PTSD per CAPS-5 for at least 6 months; average age was about 47 years, all participants were Caucasian and heterosexual, four patients were male, five patients had multiple traumas, and all patients had comorbid diagnoses.
- A condensed 15-session CBCT protocol was delivered over 7 weeks with two MDMA sessions in which both partners received 75 mg in the first session and 100 mg in the second, with an optional supplemental half-dose 1.5 hours later.
- Assessments occurred at pre-treatment, mid-treatment, post-treatment, and 3- and 6-month follow-ups; growth curve models in SPSS Version 26 used time as the natural log of days since baseline, with fixed slopes and varying intercepts, and Cohen’s d effect sizes were calculated from estimated means and pooled raw standard deviations.
Limitations
- The paper states there was no randomization or control condition, which severely limits conclusions; therapy was delivered by expert therapists in each modality, limiting generalizability; and the small trial size precluded examination of moderators and mechanisms of treatment action.
- Evident from the text: the sample was very small (N = 6), all Caucasian and heterosexual, and effect-size comparisons with prior trials are described by the authors as tentative; self-report outcome completion was 86%, and one patient retained PTSD and became relationally dissatisfied at post-treatment/follow-ups.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
7 of 12 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured
- Premisecitation
MDMA's empathogenic and neurocognitive properties make it a promising facilitator of CBCT for PTSD.
“MDMA’s (3,4-methylenedioxymethamphetamine) empathogenic and neurocognitive properties make it a promising facilitator of this trauma-focused, empirically supported relational therapy (e.g. Feduccia & Mithoefer, 2018).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Feduccia & Mithoefer, 2018 source
The Introduction describes MDMA’s effects as enhancing introspection and the therapeutic alliance, while §2.3 (Oxytocin) discusses its prosocial effects and possible role in psychotherapy. The paper also reviews effects on emotional memory processing in §2. These passages support the proposed rationale for MDMA-assisted PTSD therapy generally, but do not establish that MDMA facilitates CBCT specifically. (LLM, conf=0.87)
Experimental — accuracy not yet measured
- Interpretationcitation
The effect sizes for improvements in PTSD and common co-occurring conditions in this pilot study were greater than those found with individually delivered MDMA-facilitated psychotherapy for PTSD (pooled pre- to post-treatment effect in six phase 2 RCTs of approximately d = 1.20).
“The effect sizes for improvements in PTSD and common co-occurring conditions in this pilot study were greater than those found with individually delivered MDMA-facilitated psychotherapy for PTSD (see Mithoefer et al., 2019 for pooled pre- to post-treatment effect in six phase 2 RCTs of approximately d = 1.20).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Mithoefer et al., 2019 source
The Introduction identifies six phase 2 randomized trials, so the cited paper is an appropriate source for the pooled PTSD treatment results. But the Results (Secondary outcomes; page unavailable) report a pooled within-participant pre- to post-treatment Cohen’s d of 1.4 after two sessions, rising to 1.9 after three—not approximately 1.20. The pilot study’s comparison is the citing authors’ own conclusion, not a finding attributed to this source. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation
CBCT for PTSD has been tested in community and military/veteran samples in uncontrolled and controlled trials.
“CBCT for PTSD (Monson & Fredman, 2012) has been tested in community and military/veteran samples in uncontrolled and controlled trials.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Monson & Fredman, 2012 source
- Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patients' depression (B = −4.24, d = 1.50-2.53).
“Growth curve models also revealed overall improvements in patients’ depression (B = −4.24, d = 1.50–2.53), sleep (B = −.81, p < .01, d = .88–1.18), emotion regulation (reappraisal B = 1.38, p < .01, d = 1.09–1.15; suppression B = −1.12, p < .01, d = 1.12–1.20), and overall trauma-related beliefs (B = −12.01, p < .01, d = .98–1.17) at post-treatment and follow-ups (see Table 2).”
Quote in the paperSubstantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patients' sleep (B = −.81, p < .01, d = .88-1.18).
“Growth curve models also revealed overall improvements in patients’ depression (B = −4.24, d = 1.50–2.53), sleep (B = −.81, p < .01, d = .88–1.18), emotion regulation (reappraisal B = 1.38, p < .01, d = 1.09–1.15; suppression B = −1.12, p < .01, d = 1.12–1.20), and overall trauma-related beliefs (B = −12.01, p < .01, d = .98–1.17) at post-treatment and follow-ups (see Table 2).”
Quote in the paperSubstantial claim
- Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patients' overall trauma-related beliefs (B = −12.01, p < .01, d = .98-1.17).
“Growth curve models also revealed overall improvements in patients’ depression (B = −4.24, d = 1.50–2.53), sleep (B = −.81, p < .01, d = .88–1.18), emotion regulation (reappraisal B = 1.38, p < .01, d = 1.09–1.15; suppression B = −1.12, p < .01, d = 1.12–1.20), and overall trauma-related beliefs (B = −12.01, p < .01, d = .98–1.17) at post-treatment and follow-ups (see Table 2).”
Quote in the paperSubstantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in partner relationship happiness (B = .33, p < .001, d = 1.30-1.78).
“Growth curve modelling of the relationship happiness item across treatment and follow-ups also revealed significant improvements for both patients (B = .35, p < .001) and partners (B = .33, p < .001), with d = 1.42–2.79 for patients and 1.30–1.78 for partners at post-treatment and follow-ups (see Figure 1).”
Quote in the paperSubstantial claim - Findingown data
All couples completed the treatment protocol.
“All couples completed the treatment protocol”
- Also stated in: § Results · plain
“All couples completed the protocol”
Quote in the paperNot a substantial claim - Also stated in: § Results · plain
- Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patients' emotion regulation suppression (B = −1.12, p < .01, d = 1.12-1.20).
“Growth curve models also revealed overall improvements in patients’ depression (B = −4.24, d = 1.50–2.53), sleep (B = −.81, p < .01, d = .88–1.18), emotion regulation (reappraisal B = 1.38, p < .01, d = 1.09–1.15; suppression B = −1.12, p < .01, d = 1.12–1.20), and overall trauma-related beliefs (B = −12.01, p < .01, d = .98–1.17) at post-treatment and follow-ups (see Table 2).”
Quote in the paperNot a substantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patients' emotion regulation reappraisal (B = 1.38, p < .01, d = 1.09-1.15).
“Growth curve models also revealed overall improvements in patients’ depression (B = −4.24, d = 1.50–2.53), sleep (B = −.81, p < .01, d = .88–1.18), emotion regulation (reappraisal B = 1.38, p < .01, d = 1.09–1.15; suppression B = −1.12, p < .01, d = 1.12–1.20), and overall trauma-related beliefs (B = −12.01, p < .01, d = .98–1.17) at post-treatment and follow-ups (see Table 2).”
Quote in the paperNot a substantial claim - Findingown data
Of the three partners who were relationally distressed at baseline, only 1 was relationally distressed at posttreatment and follow-ups.
“Of the three partners who were relationally distressed at baseline, only 1 was relationally distressed at posttreatment and follow-ups (partner of the patient with retained PTSD).”
Quote in the paperNot a substantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in partner relationship satisfaction (B = 5.73, p < .05, d = .64-.80).
“Growth curves revealed significant improvements in overall patient and partner relationship satisfaction (B = 4.55, p < .05, d = .82–1.22 for patients and B = 5.73, p < .05, d = .64-.80 for partners).”
Quote in the paperSubstantial claim - Findingown data
One patient who was relationally satisfied at baseline was relationally dissatisfied at posttreatment and follow-ups.
“One patient who was relationally satisfied at baseline was relationally dissatisfied at posttreatment and follow-ups (this patient also retained their PTSD diagnosis).”
Quote in the paperNot a substantial claim - Findingown data
The most common reactions following MDMA sessions in patients and partners were diminished appetite, anxiety, headache, and jaw tightness.
“the most common reactions following MDMA sessions in patients and partners were diminished appetite, anxiety, headache, and jaw tightness.”
Quote in the paperNot a substantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patient relationship satisfaction (B = 4.55, p < .05, d = .82-1.22).
“Growth curves revealed significant improvements in overall patient and partner relationship satisfaction (B = 4.55, p < .05, d = .82–1.22 for patients and B = 5.73, p < .05, d = .64-.80 for partners).”
Quote in the paperSubstantial claim - Findingown data
Across all outcomes, the effects were generally largest at 6-month follow-up.
“Interestingly, in the current study, across all outcomes, the effects were generally largest at 6-month follow-up, suggesting that MDMA facilitation may confer ongoing benefits.”
Quote in the paperSubstantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patient-rated PTSD symptoms (B = −8.14, p < .001; d = 2.72-3.59 at post-treatment and follow-ups).
“Self- (B = −8.14, p < .001) and partner-rated (B = −5.90, p < .001) PTSD symptoms significantly improved, with d = 2.72–3.59 for patients, and 1.85–2.72 for partners at post-treatment and follow-ups, respectively.”
Quote in the paperSubstantial claim - Findingown data
There were no serious adverse events in either partner.
“there were no serious adverse events in either partner”
- Also stated in: § Abstract · plain
“there were no serious adverse events”
Quote in the paperSubstantial claim - Also stated in: § Abstract · plain
- Findingown data
Both patients who were relationally distressed at baseline were in the satisfied range at posttreatment and follow-ups.
“Both patients who were relationally distressed at baseline were in the satisfied range at posttreatment and follow-ups.”
Quote in the paperNot a substantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in patient relationship happiness (B = .35, p < .001, d = 1.42-2.79).
“Growth curve modelling of the relationship happiness item across treatment and follow-ups also revealed significant improvements for both patients (B = .35, p < .001) and partners (B = .33, p < .001), with d = 1.42–2.79 for patients and 1.30–1.78 for partners at post-treatment and follow-ups (see Figure 1).”
Quote in the paperSubstantial claim - Findingown data
All but one patient showed a sustained remission in their clinician-assessed PTSD diagnosis.
“All but one patient showed a sustained remission in their clinician-assessed PTSD diagnosis.”
Quote in the paperSubstantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant improvements in partner-rated PTSD symptoms (B = −5.90, p < .001; d = 1.85-2.72 at post-treatment and follow-ups).
“Self- (B = −8.14, p < .001) and partner-rated (B = −5.90, p < .001) PTSD symptoms significantly improved, with d = 2.72–3.59 for patients, and 1.85–2.72 for partners at post-treatment and follow-ups, respectively.”
Quote in the paperSubstantial claim - Findingown data
MDMA-facilitated CBCT resulted in significant and sustained improvements in clinician-assessed PTSD symptoms (B = −4.64, p < .001; d = 1.88-2.25 at post-treatment and follow-ups).
“Growth curve modelling revealed significant and sustained improvements in clinician-assessed PTSD (B = −4.64, p < .001), with d = 1.88–2.25 at post-treatment and follow-ups (see Table 3).”
Quote in the paperSubstantial claim - Interpretationown data
MDMA facilitation may confer ongoing benefits.
“Interestingly, in the current study, across all outcomes, the effects were generally largest at 6-month follow-up, suggesting that MDMA facilitation may confer ongoing benefits.”
Quote in the paperSubstantial claim - Interpretationown data
MDMA delivered in combination with CBCT for PTSD may potentiate the treatment effects for PTSD and the larger relationship context.
“Our initial data indicates that MDMA delivered in combination with CBCT for PTSD appears to be safe, does not appear to be treatment-interfering, and may potentiate the treatment effects for PTSD and the larger relationship context in which it exists.”
Quote in the paperSubstantial claim - Interpretationown data
MDMA delivered in combination with CBCT for PTSD appears to be safe.
“Our initial data indicates that MDMA delivered in combination with CBCT for PTSD appears to be safe, does not appear to be treatment-interfering, and may potentiate the treatment effects for PTSD and the larger relationship context in which it exists.”
Quote in the paperSubstantial claim - Interpretationown data
MDMA delivered in combination with CBCT for PTSD does not appear to be treatment-interfering.
“Our initial data indicates that MDMA delivered in combination with CBCT for PTSD appears to be safe, does not appear to be treatment-interfering, and may potentiate the treatment effects for PTSD and the larger relationship context in which it exists.”
Quote in the paperSubstantial claim - Premisecitation
Frontline, recommended therapies for PTSD produce excellent outcomes for many individuals with PTSD.
“Although there are frontline, recommended therapies for PTSD that produce excellent outcomes for many individuals with PTSD (Forbes, Bisson, Monson, & Berliner, in press), there is still a need to innovate treatment approaches for those individuals who do not tolerate these therapies or respond adequately to them.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Forbes, Bisson, Monson, & Berliner, in press
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Classified as probably not a substantial claim. 5
- May combine two claims. 10
Classified as probably not a substantial claim.
PremisecitationMDMA has been used to facilitate an individual therapy for PTSD.
“MDMA (3,4-methylenedioxymethamphetamine) has been used to facilitate an individual therapy for PTSD.”
- Also stated in: § Discussion · plain
“MDMA has more recently been studied to facilitate an individual therapy for PTSD (Mithoefer et al., 2019).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Mithoefer et al., 2019 source
- Also stated in: § Discussion · plain
May combine two claims.
PremisecitationIn Monson et al.'s (2012) waitlist controlled trial with a mixed trauma sample, the effects for clinician-rated PTSD from pre- to post-treatment were g = 1.82, and g = .64 for patient-rated and g = .15 for partner-rated relationship adjustment.
“In that study, the effects for clinician-rated PTSD from pre- to post-treatment were g = 1.82, and g = .64 for patient-rated and g = .15 for partner-rated relationship adjustment.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Monson et al., 2012 source
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
May combine two claims.
PremisecitationPrevious studies using MDMA with individual psychotherapy have yielded significant improvements in PTSD symptoms, and other outcomes such as increased openness to experience, posttraumatic growth, and improvement in comorbid conditions.
“Previous studies using MDMA with individual psychotherapy have yielded significant improvements in PTSD symptoms, and other outcomes such as increased openness to experience, posttraumatic growth, and improvement in comorbid conditions (Gorman et al., 2020; Mithoefer et al., 2019, 2018; Wagner et al., 2017).”
Quote in the paperSubstantial claim1 of 3 sources checked- cites Gorman et al., 2020 source
The Discussion (page unavailable) reports significant reductions in PTSD symptoms and increased posttraumatic growth after MDMA-assisted psychotherapy. It also mentions evidence of changes in the personality domain of openness, citing other studies. The passages examined do not report improvement in comorbid conditions, so the full sentence is not supported by this source. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites Mithoefer et al., 2019, 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Wagner et al., 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Interpretationown dataThe effects on PTSD, other symptoms, and relationship outcomes in this study were on par with, or greater than, those previously achieved with CBCT alone.
“In addition, the effects on PTSD, other symptoms, and relationship outcomes in this study were on par with, or greater than, those previously achieved with CBCT alone.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Monson et al., 2012 source
May combine two claims.
PremisecitationCognitive-behavioural conjoint therapy (CBCT) for PTSD has been shown to improve PTSD, relationship adjustment, and the health and well-being of partners.
“Cognitive-behavioural conjoint therapy (CBCT) for PTSD has been shown to improve PTSD, relationship adjustment, and the health and well-being of partners.”
- Also stated in: § Abstract · plain
“Cognitive-behavioural conjoint therapy for PTSD (CBCT; Monson & Fredman, 2012) is a manualized psychotherapy shown to improve posttraumatic stress disorder (PTSD) and comorbid conditions, enhance relationship functioning, and improve intimate partner well-being (Liebman, Whitfield, Sijercic, Ennis, & Monson, in press, for review).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Liebman et al., in press
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Also stated in: § Abstract · plain
May combine two claims.
Study design and conductreasoningThe therapy was delivered by expert therapists in each of the modalities, which limits generalizability.
“Moreover, the therapy was delivered by expert therapists in each of the modalities, which is expected at this stage of treatment development, but limits generalizability.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThere was no missing clinician interview for PTSD data.
“There was no missing clinician interview for PTSD data.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataMDMA-facilitated CBCT holds promise in facilitating trauma recovery and achieving broader relational outcomes not fully realized with individual evidence-based treatment for PTSD.
“This initial study suggests that MDMA-facilitated CBCT holds promise in facilitating trauma recovery and achieving broader relational outcomes not fully realized with individual evidence-based treatment for PTSD.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataAcross all the other self-report outcome measures and occasions, the overall assessment completion rate was 86%.
“Across all the other self-report outcome measures and occasions, the overall assessment completion rate was 86%.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningThe size of the trial precluded examination of potential moderators of treatment outcomes, as well as mechanisms of treatment action.
“The size of the trial precluded examination of potential moderators of treatment outcomes (e.g. gender of patient and partner, pre-treatment relationship distress, type of index trauma), as well as mechanisms of treatment action.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductreasoningThere was no randomization or control condition, which severely limits the conclusions we can draw.
“First and foremost, there was no randomization or control condition, which severely limits the conclusions we can draw.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductnone givenWell-validated measures of the outcomes were used, and independent assessors trained to reliability completed the clinician interviews.
“Well-validated measures of the outcomes were used, and independent assessors trained to reliability completed the clinician interviews.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim. May combine two claims.
PremisecitationThese trials have revealed significant improvements in clinician- and patient-rated PTSD severity, comorbid conditions, and relationship improvements.
“These trials have revealed significant improvements in clinician- and patient-rated PTSD severity, comorbid conditions, and relationship improvements (see Liebman et al., in press for review).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Liebman et al., in press
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductown dataComparison of these effect sizes is tentative because of the small sample and lack of a control condition in the current study.
“It is important to note that comparison of these effect sizes is tentative because of the small sample and lack of a control condition in the current study.”
Quote in the paperSubstantial claim
The paper relies on this without support.
MDMA had not yet been tested alongside a stand-alone, empirically-supported psychotherapy for PTSD.
“MDMA had not yet been tested alongside a stand-alone, empirically-supported psychotherapy for PTSD.”
The paper relies on this without support.
This is the first study to investigate the use of MDMA to facilitate a therapy established to be efficacious outside of MDMA treatment studies.
“This is the first study to investigate the use of MDMA to facilitate a therapy established to be efficacious outside of MDMA treatment studies.”
The paper relies on this without support.
There is still a need to innovate treatment approaches for those individuals who do not tolerate these therapies or respond adequately to them.
“there is still a need to innovate treatment approaches for those individuals who do not tolerate these therapies or respond adequately to them.”
The paper relies on this without support.
MDMA's empathogenic qualities can support the dyadic process in psychotherapy through enhancing feelings of connection and greater ease in communicating.
“MDMA’s empathogenic qualities are posited to be a natural fit with the purported mechanisms of CBCT for PTSD in that MDMA can support the dyadic process in psychotherapy through enhancing feelings of connection and greater ease in communicating.”
The paper relies on this without support.
There is room to expand the breadth of outcomes that might be achieved, including improvements in intimate relationship functioning.
“In addition, there is room to expand the breadth of outcomes that might be achieved, including improvements in intimate relationship functioning.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Patient male percentage does not match the count
MinorFour of six patients is 66.7%, not 60%.
Reported 60 · recomputed 66.666667
“| Male | 60 | 4 | 33.3 | 2 |”
Reported suppression effect-size range omits the post-treatment value
MinorThe results give a post-treatment and follow-up suppression effect-size range of 1.12-1.20, but Table 3 reports 0.91 at post-treatment.
“suppression B = −1.12, p < .01, d = 1.12–1.20”
“| Emotion Regulation Questionnaire-Suppression Subscale | .89 | .91 | 1.12 | 1.20 |”
Partner diagnosis percentages do not match the counts
MinorThe table reports four of six partners with a depressive disorder and four of six with an anxiety disorder. Each count corresponds to 66.7%, not the reported 60%.
Reported 60 · recomputed 66.666667
“| Depressive Disorder | 100 | 6 | 60 | 4 | | Anxiety Disorder | 83.3 | 5 | 60 | 4 |”
Partner mental-health diagnosis total conflicts with the table
MinorThe text says 50% of the six partners had at least one mental health condition, but the table lists four partners with a depressive disorder alone. That requires at least four of six partners, or 66.7%, to have a condition.
“In terms of partners, 50% were diagnosed with at least one mental health condition (not PTSD per inclusion/exclusion criteria) according to clinician assessment.”
“| Depressive Disorder | 100 | 6 | 60 | 4 |”
Cited works that were retracted
Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.
Cites a retracted work: 10.1007/s00213-019-05249-5
InfoThe cited work was retracted on 2024-08-10 (notice 10.1007/s00213-024-06666-x), not before this paper was published (2020-12-07).
Cited work 10.1007/s00213-019-05249-5 · retracted 2024-08-10 · notice 10.1007/s00213-024-06666-x · this paper published 2020-12-07
“MDMA has more recently been studied to facilitate an individual therapy for PTSD (Mithoefer et al., 2019).”
Cites
1 retracted
Mithoefer, M. C., Feduccia, A. A., Jerome, L., Mithoefer, A., Wagner, M., Walsh, Z., Hamilton, S., Yazar-Klosinski, B., Emerson, A., & Doblin, R. (2019) · Psychopharmacology · doi:10.1007/s00213-019-05249-5 · Cited by 359 · cited 3× · see citing works
“MDMA has more recently been studied to facilitate an individual therapy for PTSD (Mithoefer et al., 2019).”
BackgroundInfluentialRetractedThe Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989) · Psychiatry Research · doi:10.1016/0165-1781(89)90047-4 · Cited by 35,234 · see citing works
Gross, J. J., & John, O. P. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.85.2.348 · Cited by 11,929 · cited 2× · see citing works
“Secondary outcome measures included selfreport measures of the Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996) for depression, the Pittsburgh Sleep Quality Questionnaire for sleep disturbances (Buysse, Reynolds, Monk, Berman, & Kupfer, 1989), the Emotion Regulation Questionnaire (Gross & John, 2003) for…”
BackgroundBeck, A. T., Steer, R. A., & Brown, G. (2011) · PsycTESTS Dataset · doi:10.1037/t00742-000 · Cited by 7,535 · see citing works
Funk, J. L., & Rogge, R. D. (2007) · Journal of Family Psychology · doi:10.1037/0893-3200.21.4.572 · Cited by 1,806 · cited 4× · see citing works
“…Scale-5 (CAPS-5; Weathers et al., 2013a) was used as the clinician-rated primary outcome measure of PTSD symptoms, and the PTSD Checklist (PCL-5, patient and partner versions; Weathers et al., 2013b) and Couples Satisfaction Index (CSI; Funk & Rogge, 2007) were used as self-report primary outcomes.”
MethodInfluentialAlbeck, J. H. (2001) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.2001.55.2.295 · Cited by 973 · see citing works
Feingold, A. (2009) · Psychological Methods · doi:10.1037/a0014699 · Cited by 851 · cited 2× · see citing works
“guidelines (Feingold, 2009), within-group effect sizes (Cohen’s d) from pre-treatment to each major assessment time point were calculated on estimated means from the models for each outcome and raw pooled standard deviations for the relevant assessment period.”
MethodInfluentialMithoefer, M. C., Mithoefer, A. T., Feduccia, A. A., Jerome, L., Wagner, M., Wymer, J., Holland, J., Hamilton, S., Yazar-Klosinski, B., Emerson, A., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30135-4 · Cited by 439 · cited 1× · see citing works
“…using MDMA with individual psychotherapy have yielded significant improvements in PTSD symptoms, and other outcomes such as increased openness to experience, posttraumatic growth, and improvement in comorbid conditions (Gorman et al., 2020; Mithoefer et al., 2019, 2018; Wagner et al., 2017).”
Self-citationEffect of Cognitive-Behavioral Couple Therapy for PTSD: A Randomized Controlled Trial
Monson, C. M., Fredman, S. J., Macdonald, A., Pukay-Martin, N. D., Resick, P. A., & Schnurr, P. P. (2012) · JAMA · doi:10.1001/jama.2012.9307 · Cited by 303 · see citing works
Self-citationFeduccia, A. A., & Mithoefer, M. C. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.03.003 · Cited by 217 · cited 1× · see citing works
“MDMA’s (3,4-methylenedioxymethamphetamine) empathogenic and neurocognitive properties make it a promising facilitator of this trauma-focused, empirically supported relational therapy (e.g. Feduccia & Mithoefer, 2018).”
BackgroundSelf-citationWagner, M. T., Mithoefer, M. C., Mithoefer, A. T., MacAulay, R. K., Jerome, L., Yazar-Klosinski, B., & Doblin, R. (2017) · Journal of Psychopharmacology · doi:10.1177/0269881117711712 · Cited by 160 · cited 1× · see citing works
“…using MDMA with individual psychotherapy have yielded significant improvements in PTSD symptoms, and other outcomes such as increased openness to experience, posttraumatic growth, and improvement in comorbid conditions (Gorman et al., 2020; Mithoefer et al., 2019, 2018; Wagner et al., 2017).”
Self-citationPosttraumatic Growth After MDMA‐Assisted Psychotherapy for Posttraumatic Stress Disorder
Gorman, I., Belser, A. B., Jerome, L., Hennigan, C., Shechet, B., Hamilton, S., Yazar‐Klosinski, B., Emerson, A., & Feduccia, A. A. (2020) · Journal of Traumatic Stress · doi:10.1002/jts.22479 · Cited by 44 · cited 1× · see citing works
“…using MDMA with individual psychotherapy have yielded significant improvements in PTSD symptoms, and other outcomes such as increased openness to experience, posttraumatic growth, and improvement in comorbid conditions (Gorman et al., 2020; Mithoefer et al., 2019, 2018; Wagner et al., 2017).”
Self-citationCurrent Treatment Options in Psychiatry
Kropotov, J. D. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-410513-3.00040-1 · Cited by 42 · see citing works
Wagner, A., Mithoefer, M., Mithoefer, A., & Monson, C. (2019) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2019.1589028 · Cited by 27 · see citing works
Self-citation
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Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review
Burback, L., Brémault‐Phillips, S., Nijdam, M. J., McFARLANE, A. C., & Vermetten, E. H. G. J. M. (2023) · Current Neuropharmacology · doi:10.2174/1570159x21666230428091433 · Cited by 232 · see citing works
Breeksema, J. J., Kuin, B. W., Kamphuis, J., van den Brink, W., Vermetten, E., & Schoevers, R. A. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811221116926 · Cited by 178 · see citing works
“, 2020), one case series (Monson et al., 2020; Wagner et al., 2019), and one qualitative study (Barone et al.”
BackgroundInfluentialPsychedelic-Assisted Psychotherapy—A Systematic Review of Associated Psychological Interventions
Cavarra, M., Falzone, A., Ramaekers, J. G., Kuypers, K. P. C., & Mento, C. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.887255 · Cited by 171 · see citing works
“, 2014) and in the CBCT plus MDMA (Monson et al., 2020), no explicit mention of interventions to improve therapeutic alliance was made.”
BackgroundMethodInfluentialBrennan, W., & Belser, A. B. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.866018 · Cited by 90 · see citing works
The Psychedelic Future of Post-Traumatic Stress Disorder Treatment
Zaretsky, T. G., Jagodnik, K. M., Barsic, R., Antonio, J. H., Bonanno, P. A., MacLeod, C., Pierce, C., Carney, H., Morrison, M. T., Saylor, C. F., et al. (2024) · Current Neuropharmacology · doi:10.2174/1570159x22666231027111147 · Cited by 85 · see citing works
MDMA and MDMA-assisted therapy
Wolfgang, A. S., Fonzo, G. A., Gray, J. C., Krystal, J. H., Grzenda, A., Widge, A. S., Kraguljac, N. V., McDonald, W. M., Rodriguez, C. I., & Nemeroff, C. B. (2025) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20230681 · Cited by 62 · see citing works
Neurobiology and Treatment of Posttraumatic Stress Disorder
Shalev, A. Y., Cho, D., & Marmar, C. R. (2024) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20240536 · Cited by 63 · see citing works
Rosa, W. E., Sager, Z. S., Miller, M. E., Bernstein, I., Rinaldi, A. D., Addicott, K., Ljuslin, M., Adrian, C., Back, A. L., Beachy, J., et al. (2022) · Journal of Palliative Medicine · doi:10.1089/jpm.2022.0036 · Cited by 49 · see citing works
Brennan, B., Kelman, A. R., & Belser, A. (2023) · Psychedelic Medicine · doi:10.1089/psymed.2023.0007 · Cited by 47 · see citing works
Relational and Growth Outcomes Following Couples Therapy With MDMA for PTSD
Wagner, A. C., Liebman, R. E., Mithoefer, A. T., Mithoefer, M. C., & Monson, C. M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.702838 · Cited by 38 · see citing works
Self-citationSide-effects of mdma-assisted psychotherapy: a systematic review and meta-analysis
Colcott, J., Guerin, A. A., Carter, O. L., Meikle, S. E., & Bedi, G. (2024) · Neuropsychopharmacology · doi:10.1038/s41386-024-01865-8 · Cited by 40 · see citing works
Psychedelic-Assisted Therapy for Substance Use Disorders and Potential Mechanisms of Action
Rieser, N. M., Herdener, M., & Preller, K. H. (2021) · Current Topics in Behavioral Neurosciences · doi:10.1007/7854_2021_284 · Cited by 37 · see citing works
Zeifman, R. J., Kettner, H., Ross, S., Weiss, B., Mithoefer, M. C., Mithoefer, A. T., & Wagner, A. C. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2297536 · Cited by 37 · see citing works
“…randomised controlled (Mitchell et al., 2021; Mithoe-fer et al., 2011, 2018; Oehen et al., 2013; Ot ’ alora et al., 2018) and uncontrolled (Jardim et al., 2021; Monson et al., 2020; Wang et al., 2021) trials suggesting that MDMA-AP leads to signi fi cant reductions in PTSD and depression severity.”
BackgroundMethodQuality of reporting on psychological interventions in psychedelic treatments: a systematic review
Seybert, C., Schimmers, N., Silva, L., Breeksema, J. J., Veraart, J. K. E., Bessa, B. S., d’Orsi, D., Schoevers, R. A., & Oliveira-Maia, A. J. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00333-x · Cited by 34 · see citing works
Zeifman, R. J., Landy, M. S. H., Liebman, R. E., Fitzpatrick, S., & Monson, C. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102030 · Cited by 32 · see citing works
Self-citationLyubomirsky, S. (2022) · Perspectives on Psychological Science · doi:10.1177/17456916211055369 · Cited by 30 · see citing works
Thal, S. B., Baker, P., Marinis, J., Wieberneit, M., Sharbanee, J. M., Bruno, R., Skeffington, P., & Bright, S. J. (2023) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2945 · Cited by 30 · see citing works
Luoma, J. B., Shahar, B., Lear, M. K., Pilecki, B. C., & Wagner, A. (2021) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2824 · Cited by 27 · see citing works
“However, the one pilot trial that incorporated a more structured approach, cognitive‐behavioral conjoint therapy, appeared promising, suggesting more structured interventions might be successfully coupled with MDMA (Monson et al., 2020).”
BackgroundSelf-citation(2024) · doi:10.1177/02698811231215420 · Cited by 25 · see citing works
“Psychedelic-assisted therapies have emerged as promising interventions in various psychiatric indications, encompassing depression, anxiety, posttraumatic stress disorder (PTSD), substance use disorders, and the alleviation of distress related to serious illnesses.”
MethodInfluentialSet and setting in microdosing: an oft-overlooked principle
Hartogsohn, I., & Petranker, R. (2022) · Psychopharmacology · doi:10.1007/s00213-022-06249-8 · Cited by 22 · see citing works
“This trend appears in MDMA research, where certain participants initially experience worse symptoms as their avoidance is reduced and they become more able to confront their trauma (Monson et al. 2020).”
BackgroundMDMA-assisted psychotherapy for PTSD in adolescents: rationale, potential, risks, and considerations
Kangaslampi, S., & Zijlmans, J. (2023) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-023-02310-9 · Cited by 22 · see citing works
Marchetta, E., Mancini, G. F., Morena, M., & Campolongo, P. (2022) · Current Neuropharmacology · doi:10.2174/1570159x21666221207162750 · Cited by 17 · see citing works
“1007/s002130050714 PMID: 9784083 [203] Monson, C.”
BackgroundStocker, K., & Liechti, M. E. (2024) · Journal of Psychopharmacology · doi:10.1177/02698811241265352 · Cited by 19 · see citing works
“…publications use the term “empathogen” only (except perhaps for a random mentioning of the other term) (e.g., Hysek et al., 2014; Molla et al., 2023; Monson et al., 2020; Schmid et al., 2014; Straumann et al., 2023; Wardle and de Wit, 2014), some “entactogen” only (e.g., Adam et al., 2024;…”
BackgroundMethodPsychedelics and Evidence-based Psychotherapy
Leone, L., McSpadden, B., DeMarco, A., Enten, L., Kline, R., & Fonzo, G. A. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.006 · Cited by 18 · see citing works
Rudin, D., McCorvy, J. D., Glatfelter, G. C., Luethi, D., Szöllősi, D., Ljubišić, T., Kavanagh, P. V., Dowling, G., Holy, M., Jäntsch, K., et al. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-01221-0 · Cited by 17 · see citing works
Price, C. M., Feduccia, A. A., & DeBonis, K. (2022) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001595 · Cited by 17 · see citing works
Self-citationMDMA-assisted psychotherapy for post-traumatic stress disorder: The devil is in the detail
Bedi, G., Cotton, S. M., Guerin, A. A., & Jackson, H. J. (2022) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674221127186 · Cited by 18 · see citing works
Couple Therapy With MDMA—Proposed Pathways of Action
Wagner, A. C. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.733456 · Cited by 15 · see citing works
“Findings from the study include improved PTSD scores, relationship satisfaction, posttraumatic growth, and improved social intimacy for the partner with PTSD (Monson et al., 2020; Wagner et al., 2021).”
BackgroundMethodSelf-citationMDMA-assisted psychotherapy for borderline personality disorder
Traynor, J. M., Roberts, D. E., Ross, S., Zeifman, R., & Choi-Kain, L. (2022) · Focus · doi:10.1176/appi.focus.20220056 · Cited by 15 · see citing works
Brain Networks, Neurotransmitters and Psychedelics: Towards a Neurochemistry of Self-Awareness
Mograbi, D. C., Rodrigues, R. F. S., Bienemann, B., & Huntley, J. D. (2024) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-024-01353-y · Cited by 16 · see citing works
“In an uncontrolled trial conducted by Monson et al. [161], MDMA was combined with Cognitive-Behavioural Conjoint Therapy (CBCT) for post-traumatic stress disorder (PTSD) and produced significant improvements in depressive symptoms and emotion regulation abilities.”
MethodPsychotherapy-supported MDMA treatment for PTSD
Krystal, J. H., Kelmendi, B., & Petrakis, I. L. (2021) · Cell Reports Medicine · doi:10.1016/j.xcrm.2021.100378 · Cited by 11 · see citing works
Therapeutic role of psilocybin and 3,4-methylenedioxymethamphetamine in trauma: A literature review
Fonseka, L. N., & Woo, B. K. P. (2023) · World Journal of Psychiatry · doi:10.5498/wjp.v13.i5.182 · Cited by 13 · see citing works
Expert recommendations for Germany’s integration of psychedelic-assisted therapy
Rosal, S. P., Torre, J. T. L., Birnkammer, S., Chernoloz, O., Williams, M. T., & Faber, S. C. (2024) · BMC Medical Education · doi:10.1186/s12909-024-06141-3 · Cited by 13 · see citing works
“…in approval and access of pharmaceuticals in Germany antidepressants such as SSRIs, or serotonin-norepineph-rine reuptake inhibitors (SNRIs) [34–37]. the IQWiG may face challenges in evaluating a new therapy such as MDMA if there are insufficient comparisons with standard therapies in the…”
BackgroundA Review of MDMA-Assisted Therapy for Posttraumatic Stress Disorder
Lewis, B. R., & Byrne, K. (2023) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20220088 · Cited by 14 · see citing works
Developmental couple therapy for complex trauma: Results of an implementation pilot study.
MacIntosh, H. B. (2024) · Journal of Marital & Family Therapy · doi:10.1111/jmft.12711 · Cited by 6 · see citing works
Bhagavan, C., Glue, P., Evans, W., Reynolds, L., Turner, T., King, C., Russell, B. R., Morunga, E., Mills, J. L., Layton, G., et al. (2024) · Trials · doi:10.1186/s13063-024-08174-x · Cited by 8 · see citing works
A novel framework for ketamine-assisted couple therapy
Khalifian, C. E., Rashkovsky, K. T., Mitchell, E., Bismark, A. W., Wagner, A. C., & Knopp, K. C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1376646 · Cited by 10 · see citing works
Self-citationBeaussant, Y., & Nigam, K. B. (2022) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2022.09.017 · Cited by 8 · see citing works
Sexual assault as a public health problem and other developments in psychotraumatology
Olff, M. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008198.2022.2045130 · Cited by 8 · see citing works
“(1) Greene et al. (2021), (2) De Jongh et al. (2020), (3) Thoresen, Aakvaag, Wentzel-Larsen, Dyb, and Hjemdal (2012), (4) Monson et al. (2020), (5) Kessler et al. (2017).”
EMBARK Psychedelic Therapy for Depression
Brennan, B., & Belser, A. (2024) · doi:10.1093/9780197762622.001.0001 · Cited by 8 · see citing works
Sippel, L. M., Khalifian, C. E., Knopp, K. C., Webster, K., Maglione, J., Holcomb, J., Flanagan, J. C., Monson, C. M., Holtzheimer, P. E., & Morland, L. A. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.03.001 · Cited by 6 · see citing works
Self-citationExploring effects and experiences of ketamine in group couples therapy
Cornfield, M., McBride, S., Torre, J. T. L., Zalewa, D., Gallo, J., Mahammadli, M., & Williams, M. T. (2024) · Journal of Psychedelic Studies · doi:10.1556/2054.2024.00302 · Cited by 8 · see citing works
“…of MDMA alongside an already empirically accepted therapy, cognitive behavioral conjoint therapy (CBCT) for treatment of PTSD and found that MDMA can accelerate trauma recovery and improve overall relational satisfaction when both partners are involved in the process (Monson et al., 2020).”
BackgroundMDMA-assisted brief cognitive behavioral conjoint therapy for PTSD: Study protocol for a pilot study
Morland, L. A., Perivoliotis, D., Wachsman, T. R., Alam, M. A., Knopp, K. C., Khalifian, C. E., Ramanathan, D., Chargin, B. E., Bismark, A. W., Glynn, S. M., et al. (2024) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2024.101314 · Cited by 6 · see citing works
“In 2020, results were published from the first preliminary open trial of MDMA-assisted CBCT [17], providing insight regarding the dyadic approach.”
BackgroundMethodResultInfluentialSelf-citationMDMA for the treatment of misophonia, a proposal
Webb, J., & Keane, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.983285 · Cited by 6 · see citing works
“MDMA thus appears to be a promising pharmacological treatment for couples undergoing therapy (Cognitive Behavioral Conjoint Therapy) when one partner has PTSD, with high overall satisfaction rates for both partners (72).”
BackgroundCaraccio, M., Cheung, K., Mann, S. P., Bruce, L., Jacobs, E., Villiger, D., Sandbrink, J. D., Register, C., Hannikainen, I. R., Høeg, M. L., et al. (2025) · Philosophical Psychology · doi:10.1080/09515089.2025.2532761 · Cited by 8 · see citing works
“…has demonstrated the potential of using MDMA for enhancing relational bonds – in addition to treating PTSD symptoms – in the context of couple’s therapy (Monson et al., 2020; for discussion of secondary outcomes of the trial, see Wagner et al., 2021; for a critical commentary on such research, see…”
Chao, Y., & Horton, J. (2021) · Canadian Journal of Health Technologies · doi:10.51731/cjht.2021.90 · Cited by 5 · see citing works
Maples‐Keller, J. L., & ROTHBAUM, B. O. (2025) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2025.02.001 · Cited by 4 · see citing works
Psychedelics for military and Veteran communities? Research, practice, and policy considerations
Shore, R. (2023) · Journal of Military Veteran and Family Health · doi:10.3138/jmvfh.9.5.ed01 · Cited by 4 · see citing works
Morland, L., Knopp, K., Chargin, B., Wachsman, T., Khalifian, C., Perivoliotis, D., & Wagner, A. (2025) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2025.01.002 · Cited by 4 · see citing works
Self-citationBuyukbabani, M. B., Earp, B. D., Hannikainen, I. R., et al. (2024) · AJOB Neuroscience · doi:10.1080/21507740.2024.2402221 · Cited by 4 · see citing works
“…patients or participants undergoing drug-assisted therapy, there is now a small but growing literature on “MDMA-facilitated cognitive-behavioral conjoint therapy” for romantic couples dealing with varying levels of relational dissatisfaction or distress (Monson et al. 2020, 1, emphasis added).”
BackgroundState of the Science: MDMA‐assisted psychotherapy for the treatment of posttraumatic stress disorder
Morland, L. A., Rothbaum, B. O., Sippel, L. M., Maples‐Keller, J. L., & Schnurr, P. P. (2026) · Journal of Traumatic Stress · doi:10.1002/jts.70060 · Cited by 2 · see citing works
Varela, Y. M., Tavares, V. D. D. O., Delgado, L. M., de Faria, H. A. T., Menezes, L. Q., Almeida, R. M., Agrícola, P. M. D., de Carvalho, B. S., Bienemann, B., Falchi-Carvalho, M., et al. (2026) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-025-02188-5 · Cited by 2 · see citing works
“[ 43].”
InfluentialCouple Treatment for Posttraumatic Stress Disorder
Monson, C. M., Wagner, A. C., Macdonald, A., & Brown‐Bowers, A. (2022) · Springer eBooks · doi:10.1007/978-3-030-97802-0_25 · Cited by 2 · see citing works
Self-citationMaples‐Keller, J. L., Hyatt, C. S., Phillips, N. L., Sharpe, B. M., Sherrill, A. M., Yasinski, C. W., Reiff, C. M., Rakofsky, J. J., Rauch, S. A. M., Dunlop, B. W., et al. (2024) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2024.2420044 · Cited by 2 · see citing works
“These findings have been replicated in subsequent Phase III trials (Mitchell et al. 2023), and similar trials have been conducted for couples therapy with individuals with PTSD (Monson et al. 2020) and cancer-related distress (Wolfson et al. 2020).”
InfluentialMorland, L. A., Knopp, K. C., Khalifian, C. E., & Stauffer, C. S. (2025) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2025.04.001 · Cited by 2 · see citing works
The Use of Psychedelics in Couples Therapy
Groveman, A. M. (2025) · Springer eBooks · doi:10.1007/978-3-031-90006-8_2 · Cited by 1 · see citing works
Psychedelic Use and Intimacy: A Systematic Review of Experimental and Naturalistic Research.
Bradford, A., Freedman, E., & Dinero, R. E. (2025) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2025.2577311 · Cited by 1 · see citing works
Koning, E., Gamberg, S., & Keshen, A. R. (2026) · Behavioral Sciences · doi:10.3390/bs16030376 · Cited by 1 · see citing works
“…often occurs with general psychological support, there is growing scientific interest for its utility as a tool to enhance structured psychotherapies, supported by theoretical and empirical lines of evidence (Goodwin et al., 2024; Monson et al., 2020; Sloshower et al., 2023; Wolff et al., 2025).”
A Needs Assessment of Older Hispanics in Omaha, Nebraska
DiMartino, D. R. (1979) · DigitalCommons@UNO · Cited by 1 · see citing works
Mithoefer, M. C., & Presti, D. E. (2023) · doi:10.1093/med/9780192863607.003.0004
Self-citationBreeksema, J. J. (2024) · doi:10.33612/diss.912040905
Introduction to the EMBARK Approach
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0003
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0006
Bringing It Home and Carrying It Forward
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0009
Considerations Prior to Meeting With a Participant
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0005
INTRODUCTION: A New Approach for the Whole Person
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0001
Choosing Suggested Integration Goals
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0004
Working Within the EMBARK Domains Cheat Sheet
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0003
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0007
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0002
An Overview of Psychedelic-Assisted Therapy
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0002
Personal Care for the Therapist
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0001
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0008
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.002.0004
EMBARK Mechanisms of Change in the Treatment of Depression
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0004
Psychedelic Drugs as Treatment Agents
Yehuda, R., Lepow, L., Bonnano, P. A., Zaretsky, T. G., Antonio, J. H., & Jagodnik, K. M. (2025) · doi:10.1093/med/9780197640654.003.0074
Ahari, N. J., & Fonzo, G. A. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1665770 · Cited by 1 · see citing works
Wongpaiboon, M., Shelton, J. L., Rendon, E. D., & Vail, M. (2025) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-025-00373-w
Psychological support in psychedelic-assisted therapy clinical trials: A systematic review
Brusky, B., M’Baïlara, K., Alla, F., & Barrault, M. (2026) · Journal of Psychopharmacology · doi:10.1177/02698811261424204 · Cited by 1 · see citing works
“Most of these studies also use music—only one did not (Danforth et al., 2018) or did not specify (Bouso et al., 2008; Monson et al., 2020)—but the intention is not explicitly linked to emotional arousal.”
InfluentialApproaches to ketamine-assisted couple therapy
Avruch, D. O. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1843151
“Monson et al. (2020) conducted research into the use of MDMA-assisted Cognitive-Behavioral Conjoint Therapy in the context of treating PTSD, which led to significant improvements in traumatic stress symptomatology.”
The purpose of the psychosocial protocol in the psychedelic-assisted therapy: A scoping review
Ferreira, F. G. D. P., Fernandes, J. A. B., Filev, R., da Silveira, D. X., & Fidalgo, T. M. (2026) · Journal of Psychopharmacology · doi:10.1177/02698811261453850
Morley, K. C., Arunogiri, S., Mills, K. L., Watt, J., Teesson, M., Baillie, A., Lee, Y. Y., Morse, A. R., Back, S. E., Lubman, D. I., et al. (2026) · BMJ Open · doi:10.1136/bmjopen-2025-114896
Kasiviswanathan, K., Nilaweera, D., Morando, M., Rao, S., Lee, J., Fettling, J., & Broadbear, J. H. (2026) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253251408626
Morland, L. A., Khalifian, C. E., Perivoliotis, D., Chargin, B. E., Alam, A., Wachsman, T. R., Ramanathan, D., Bismark, A. W., Stauffer, C., Wagner, A. C., et al. (2026) · Journal of Traumatic Stress · doi:10.1002/jts.70126
Self-citation
- Authors
- Monson, C. M., Wagner, A. C., Mithoefer, A. T., Liebman, R. E., Feduccia, A. A., Jerome, L., Yazar-Klosinski, B., Emerson, A., Doblin, R., & Mithoefer, M. C.
- Affiliations
- Toronto Metropolitan University (CA)
- Private Practice, Asheville, NC, USA
- Multidisciplinary Association for Psychedelic Studies (US)
- Multidisciplinary Association for Psychedelic Studies and MAPS Public Benefit Corporation, Santa Cruz, CA, USA
- Corresponding author
- Monson, Candice M.
- ORCID
- Venue
- European Journal of Psychotraumatology
- Publisher
- Informa UK Limited
- Published
- 2020-12-07
- Volume
- 11
- Issue
- 1
- Pages
- 1840123-1840123
- ISSN
- 2000-8066 (ISSN-L)
- PMC
- PMC7748057
- OpenAlex
- W3111512601
- Cited by
- 91
- References
- 13
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 36 · 2023: 9 · 2022: 14 · 2021: 9
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Psychotraumatology (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Multidisciplinary Association for Psychedelic Studies (MPVA-1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- MDMA-assisted psychotherapy, post-traumatic stress disorder, couples, relationship adjustment, depression, sleep, emotion regulation, safety and tolerability
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