Background and aims: Interest in psychedelic research has grown significantly in recent years and the naturally derived substance psilocybin, in combination with therapy, has shown promising results as a treatment for a range of psychiatric conditions. However, the negative effects and risks of psilocybin-assisted treatment are not well-established. The purpose of this study was to investigate the potential negative effects of psilocybin-assisted psychological interventions in both the short and long term.

Method: Semi-structured interviews were conducted with eight psychedelic treatment providers and facilitators. Their content was thematically interpreted.

Results: Three themes of short-term negative effects were identified. They included negative reactions to psilocybin dosing sessions, undesirable processes in the therapeutic relationship, and difficult self-experiences. Four themes of long-term negative effects were identified. They included destabilization of the client, difficulties adapting to life post-treatment, complications in the treatment relationship, and undesirable outcomes.

Conclusions: These results highlight the multifaceted challenges clients may face, emphasizing the need for thorough pre-intervention assessment and post-intervention support. The findings both confirm previous research and highlight new aspects that can contribute to increased safety and be relevant for clinical implementation. Further rigorous research is needed to ensure safety, establish ethical guidelines, and optimize the positive effects of these experimental medicines. Integrating various research approaches and types of measurements will be vital to further our understanding of negative effects of psychedelic-assisted therapy.

INNGANGUR: Nýverið hafa hugvíkkandi efni rutt sér til rúms í samfélagslegri umræðu. Til að mynda hefur eftirspurn eftir sálfræðilegri meðferð með hugvíkkandi efnum, einkum ofskynjunarefna á borð við psilocybin, aukist samhliða fréttum af mögulegum meðferðarávinningi þeirra. Hins vegar skortir rannsóknir á neikvæðum afleiðingum slíkra efna í meðferðarsamhengi. Þetta erindi greinir frá niðurstöðum eigindlegrar rannsóknar sem lagði mat á skammtíma- og langtímaafleiðingar sálrænnar meðferðar með ofskynjunarefninu psilocybin. EFNIVIÐUR OG AÐFERÐIR: Viðtöl voru tekin við átta aðila sem veita sálræna meðferð með ofskynjunarefninu psilocybin. Innihald viðtalanna var þemagreint. NIÐURSTÖÐUR: Niðurstöður þemagreiningar leiddu í ljós þrjú þemu neikvæðra skammtímaafleiðinga sálrænnar meðferðar með psilocybin: 1) Neikvæð viðbrögð við meðferð, 2) óæskileg ferli í meðferðarsambandi, og 3) þungbær sjálfsreynsla. Þá greindust fjögur þemu langtímaafleiðinga sálrænnar meðferðar með psilocybin: 1) Sálrænn óstöðugleiki, 2) aðlögunarörðugleikar að meðferð lokinni, 3) flækjur og fylgikvillar í meðferðarsambandinu, og 4) óæskilegar afleiðingar meðferðar. ÁLYKTANIR: Niðurstöðurnar útlista þær fjölþættu áskoranir sem skjólstæðingar geta staðið frammi fyrir vegna notkunar ofskynjunarefna í meðferðartilgangi. Til að mynda undirstrika niðurstöðurnar þörfina á ítarlegu mati, sögutöku og geðskoðun áður en psilocybin inngripi er beitt. Aukinheldur renna niðurstöðurnar stoðum undir mikilvægi sálræns stuðnings að inngripi loknu. Niðurstöðurnar vekja athygli á þáttum sem geta stuðlað að auknu öryggi í sálrænni meðferð með ofskynjunarefnum og upplýst klíníska framkvæmd slíka meðferða. Ljóst er að frekari rannsókna er þörf svo unnt sé að tryggja öryggi skjólstæðinga. Að auki er brýnt að setja siðferðilegar viðmiðunarreglur fyrir beitingu meðferða af þessum toga ef hámarka á möguleg jákvæð áhrif ofskynunaefna í meðferðartilgangi.

Objective: Telephone health services is an increasing and integral part of health care in several countries. Callers who call repeatedly, in the current study “frequent callers” are present in all kinds of healthcare services, often constitute a considerable proportion of the total amount of calls and are complicated to help. The aim was to provide a comprehensive overview of research on frequent callers at a variety of telephone health services.

Methods: An integrative literature review. Literature was searched for the period 2011–2020 in CINAHL Plus, MEDLINE, APA PsycArticles, APA PsycInfo, and PubMed, and resulted in the inclusion of 20 articles.

Results: Studies on frequent callers (FCs) were found in the context of emergency medical services, telephone helplines, primary healthcare, and specialist medicine clinics. Frequent calling was associated with psychiatric comorbidity, and the reasons for calling were often multifaceted.

Conclusion: The strategies suggested for handling calls involved an individual approach, which could be enabled through multidisciplinary work.

Innovation: The main findings indicate a need for a systematic approach and guidelines to enable optimal help for FCs. Cooperation among healthcare instances seems to contribute to a more individual care for FCs.

Aim: To examine telephone nurses' perceived stress, self-efficacy and empathy in their work with answering calls from frequent callers.

Design: The study is a quantitative questionnaire survey study with a comparative design.

Methods: Telephone nurses (N = 199) answered a survey containing three instruments: Perceived Stress Scale, General Self-Efficacy Scale and Jefferson's Scale of Empathy. Correlation analysis, multiple regression analysis and analysis of variance were performed to test the research questions.

Results: Significant negative correlations were found between stress involving calls from FCs and self-efficacy (r = −.238), and significant negative correlations between stress involving calls from frequent callers and empathy (r = −.185). It was further revealed that telephone nurses who had worked less than 30 years scored higher on Jefferson's Scale of empathy than those who had worked more than 30 years, F(1, 183) = 4.98, η² = 0.027.

Objective: The objective was to provide a synthesis of already synthesized literature on empathy in order to identify similarities and differences among conceptualizations.

Methods: A review of reviews was conducted to locate synthesized literature published between January 1980 and December 2019. Two authors screened and extracted data, and quality-appraised the sources. A total of 52 articles deemed relevant to this overview were synthesized using thematic analysis.

Results: The analysis resulted in four themes found in most empathy conceptualizations. In empathy, the empathizer (1) understands, (2) feels, and (3) shares another person’s world (4) with self-other differentiation.

Conclusions: Most writings about empathy begin by claiming that there is far from a consensus on how empathy should be defined. This article shows a developing consensus among neuroscientists, psychologists, medical scientists, nursing scientists, philosophers, and others that empathy involves understanding, feeling, sharing, and self-other differentiation.

Practice implications: A clarification of the content of empathy may assist practitioners and researchers in avoiding confusion regarding the meaning of the concept, as well as in developing and measuring the relevant aspects of the concept.