Healing together: Results from a pilot trial of 3,4-Methylenedioxymethamphetamine-enhanced cognitive-behavioral conjoint therapy for posttraumatic stress disorder
In the first trial of MDMA-assisted cognitive-behavioral conjoint therapy for U.S. veterans with PTSD and their intimate partners, veterans and their partners experienced large improvements in relationship functioning.
This new study included 8 U.S. military veterans with PTSD and their 8 intimate partners (16 people total). It was a single-site, open-label, uncontrolled pilot study conducted through the Veterans Affairs San Diego Healthcare System. MDMA was administered only to the veteran with PTSD, while the veteran and their intimate partner participated together in cognitive-behavioral conjoint therapy and associated integration sessions.
MDMA-enhanced brief cognitive-behavioral conjoint therapy was feasible and acceptable. Veterans demonstrated substantial reductions in clinician-rated PTSD symptoms, with five of eight participants meeting the study's criterion for clinically significant treatment response, three no longer meeting PTSD diagnostic criteria, and two meeting remission criteria at post-treatment. Relationship satisfaction also increased substantially among both veterans and partners. However, some symptom and relationship-satisfaction gains diminished during follow-up. Given the absence of a control group, small sample size, and open-label design, the study cannot establish that MDMA caused these improvements or that MDMA provides additional benefit beyond the underlying conjoint psychotherapy.
Abstract
Posttraumatic stress disorder (PTSD) disrupts individual well-being and relationship health, particularly among veteran/military couples with heightened risks due to deployment, family reintegration, and traumatic stress. Although cognitive-behavioral conjoint therapy (CBCT) and brief CBCT (bCBCT) have demonstrated strong efficacy in reducing PTSD symptoms, their impact on relational outcomes is less compelling. Given the importance of relationship functioning for veterans' overall health, enhancing interpersonal outcomes of PTSD treatment remains a research priority. One promising approach is the integration of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy to augment the relational benefits of established PTSD interventions.
This single-site, open-label pilot study evaluated the preliminary benefit, safety, and acceptability of MDMA-assisted bCBCT in eight U.S. military veterans with PTSD and their intimate partners (N = 16). An eight-session MDMA-assisted bCBCT protocol with two MDMA administration sessions and dyadic integration sessions incorporating elements of integrative behavioral couples therapy was delivered. Outcomes included PTSD symptom severity, relationship functioning, and safety. Veterans exhibited large pre-post PTSD symptom reductions, d = 1.25, which were generally maintained during follow-up.
Both veterans and partners experienced large improvements in relationship functioning, ds = 1.83 and 1.29, respectively, with moderate rebound during follow-up. No serious adverse events were reported. This first trial of MDMA-assisted bCBCT in U.S. veterans and their partners provides preliminary evidence of potential improvements in PTSD and relational outcomes, with no identified serious safety concerns. This model has potential for future evaluation in large health care systems, leveraging the hypothesized therapeutic effects of MDMA for individuals with PTSD and their families
Morland, Leslie A., Khalifian, Chandra E., Perivoliotis, D., Chargin, B., Alam, A., Wachsman, Tamara R., Ramanathan, D., Bismark, Andrew W., Stauffer, C., Wagner, Anne C., Angkaw, Abigail C., & Knopp, Kayla C. (2026). Healing together: Results from a pilot trial of 3,4-Methylenedioxymethamphetamine-enhanced cognitive-behavioral conjoint therapy for posttraumatic stress disorder. Journal of Traumatic Stress, 1–13. Read Paper
For more psychedelic news and research, visit the psychedelic health professional network homepage.
