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      Therapeutic potential of ayahuasca in grief: a prospective, observational study

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          Abstract

          Rationale

          Recent studies have assessed the therapeutic potential of ayahuasca for the treatment of depression with promising preliminary results .

          Objectives

          Here, we examine the course of grief over 1 year of follow-up in a bereaved sample that attended a center in Peru to participate in indigenous Shipibo ayahuasca ceremonies. We also explore the roles of experiential avoidance and decentering as mechanisms of change.

          Methods

          Bereaved participants who attended the ayahuasca center responded to an online survey that included the Texas Revised Inventory of Grief, Symptom Assessment-45, WHO Quality of Life-Bref, Acceptance and Action Questionnaire, and Decentering. Baseline assessment was completed by 50 individuals (T0). Of these, 39 completed the post-assessment at 15 days (T1), 31 at 3 months (T2), 29 at 6 months (T3), and 27 at 12 months (T4) after leaving the retreat. Pearson’s analysis was performed to examine the relationship between the severity of grief and mechanisms of change during the period of T0 and T1.

          Results

          A significant decrease in Texas Revised Inventory was observed at all time points (T1: Cohen’s d = 0.84; T2: Cohen’s d = 1.38; T3: Cohen’s d = 1.16; T4: Cohen’s d = 1.39). We found a relationship between experiential avoidance ( r = 0.55; p < .01), decentering ( r = − 0.47; p < .01), and a reduction in the severity of grief.

          Conclusions

          Our results suggest that the ceremonial use of ayahuasca has therapeutic value by reducing the severity of grief. Acceptance and decentering are both psychological processes that mediate the improvement of grief symptoms.

          Electronic supplementary material

          The online version of this article (10.1007/s00213-019-05446-2) contains supplementary material, which is available to authorized users.

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          Most cited references30

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          Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis.

          Prolonged grief disorder (PGD) is a bereavement-specific syndrome expected to be included in the forthcoming ICD-11. Defining the prevalence of PGD will have important nosological, clinical, and therapeutic implications. The present systematic review and meta-analysis aimed to estimate the prevalence rate of PGD in the adult bereaved population, identify possible moderators, and explore methodological quality of studies in this area.
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            Treatment of complicated grief: a comparison between cognitive-behavioral therapy and supportive counseling.

            Few studies have examined treatments for complicated grief--a debilitating condition that can develop after the loss of a loved one. This study compared the effectiveness of cognitive-behavioral therapy with a nonspecific treatment with supportive counseling (SC). Using a minimization method, 54 mourners with clinically significant levels of complicated grief were allocated to 1 of 3 treatment conditions: (a) a condition of 6 sessions of cognitive restructuring (CR) and 6 sessions of exposure therapy (ET; CR + ET), (b) a condition in which these interventions were applied in reversed order (ET + CR), and (c) 12 sessions of SC. Outcomes showed that the 2 cognitive-behavioral therapy conditions produced more improvement in complicated grief and general psychopathology than SC in the completers and intention-to-treat groups. Comparison of the cognitive-behavioral conditions showed that "pure" exposure was more effective than "pure" cognitive restructuring, that adding ET to CR led to more additional improvement than adding CR to ET, and that ET + CR was more efficacious than CR + ET. Effect sizes of ET + CR were encouraging and compare favorably with those found in earlier bereavement intervention studies. Copyright 2007 APA, all rights reserved.
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              The prevention and treatment of complicated grief: a meta-analysis.

              Bereaved individuals are at increased risk of mental and physical disorders, and prevention and treatment of complicated grief is indicated. Earlier quantitative reviews have not focused on the effect of bereavement interventions on (complicated) grief. Therefore the main objective of this meta-analysis was to determine the short-term and long-term effect of both preventive and treatment interventions on complicated grief. Randomized controlled trials for prevention or treatment of complicated grief were identified through a systematic literature search. Electronic databases and reference lists of earlier review articles served as data sources. Data were analyzed with REVMAN 5.0.14. Fourteen randomized controlled trials met the inclusion criteria. Study quality differed among the trials. Contrary to preventive interventions, treatment interventions yielded significant pooled standardized mean differences in favor of the (specific) grief intervention at post-test and follow-up. During the follow-up period, the positive effect of treatment interventions for complicated grief even increased. Treatment interventions can effectively diminish complicated grief symptoms. Preventive interventions, on the other hand, do not appear to be effective. Limitations of the meta-analysis and future research options are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                deboragonzalez@iceers.org
                Journal
                Psychopharmacology (Berl)
                Psychopharmacology (Berl.)
                Psychopharmacology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0033-3158
                1432-2072
                14 January 2020
                14 January 2020
                2020
                : 237
                : 4
                : 1171-1182
                Affiliations
                [1 ]International Center for Ethnobotanical Education, Research and Services (ICEERS), Carrer de Sepúlveda, 65, Office 2, 08015 Barcelona, Spain
                [2 ]PHI Asociation, Passeig del Calvell 35-37, 08005 Barcelona, Spain
                [3 ]GRID grid.411438.b, ISNI 0000 0004 1767 6330, Clinical Pharmacology Unit, , Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (IGTP), ; Ctra. de Can Ruti s/n, 08916 Badalona, Spain
                [4 ]GRID grid.7080.f, Department of Pharmacology, Therapeutics and Toxicoloy, , Universitat, Autònoma de Barcelona, ; Avinguda de Can Doménech, 08193 Cerdanyola del Vallés, Spain
                [5 ]GRID grid.490720.8, The Beckley Foundation, ; Beckley Park, Oxford, OX3 9SY UK
                [6 ]GRID grid.7080.f, Department of Clinical and Health Psychology, , Universitat Autònoma de Barcelona, ; Bellaterra Campus, Building B, Office B5/016b, 08193 Cerdanyola del Vallés, Spain
                Author information
                http://orcid.org/0000-0002-5353-4351
                Article
                5446
                10.1007/s00213-019-05446-2
                7113212
                31938878
                abac4046-7d1f-406f-9729-2a769afc19c6
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 24 July 2019
                : 27 December 2019
                Categories
                Original Investigation
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2020

                Pharmacology & Pharmaceutical medicine
                ayahuasca,shipibo,death,bereavement,grief,psychopathology,quality of life,experiential avoidance,acceptance,decentering

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