Definition
Preparation is the phase of MDMA-assisted therapy that occurs before any medication is administered. It includes informed consent, history-taking, expectation setting, coping-skills training, and building the therapeutic relationship.
Why it matters
Preparation is not a preliminary step. It is the foundation on which every subsequent phase depends. Trials that skip or shorten preparation report worse outcomes.
The Science
Protocols in Phase 2 and Phase 3 trials include multiple weeks of preparation before the first medication session. This structure appears essential to the treatment as studied.
The NSI Perspective
What happens before the medicine is often what makes the medicine safe. NSI treats preparation as part of the treatment, not a rehearsal.
Clinical Implications
Any clinic that offers this care without a defined preparation phase is not offering the treatment as researched.
Practical Application
Ask what preparation involves at any clinic offering this care. Specific answers are a good sign; vague ones are not.
References
- 1.Mithoefer MC. A Manual for MDMA-Assisted Psychotherapy in the Treatment of PTSD. MAPS; 2017.