What is it about?

Psilocybin is emerging as a novel and effective treatment for a variety of mental illnesses when administered in a psychologically supportive clinical setting. This systematized review sought to determine the role of therapists in psilocybin-assisted psychotherapy (PAP), a term used in the literature to describe the administration of psilocybin in the context of treating mental illness. The role of therapists was determined through an investigation of the structure and content of PAP. Briefly, the review found substantial homogeneity in the structure of PAP across the collected studies, but substantial heterogeneity in PAP's content. Psychotherapy modalities and techniques implemented in PAP are reviewed and discussed, as well as implications for therapists interested in PAP.

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Why is it important?

To our knowledge, this is the first review of modern clinical trials that investigates similarities and differences between the psychotherapeutic structure(s) surrounding and embodying modern clinical trials of psilocybin-assisted psychotherapy. Findings will have implications for future research designs of psilocybin clinical trials.


As expected, the trials included in this review shared the same general template for psilocybin-assisted psychotherapy (PAP), differing in the number of sessions at each stage and the content in each stage. Notably, the research design seems to most effectively benefit higher doses of psilocybin through facilitation of a "complete mystical experience." Set and setting have been identified as crucial factors in psilocybin outcomes; coupled with the myriad conceptual papers exploring potential avenues of modifying the templated structure of PAP to enhance outcomes, future research might build upon and/or modify this template to tailor treatment designs for a number of variables, including clinical population, personality type, client/participant preference, and dosage.

David Horton

Read the Original

This page is a summary of: Systematized Review of Psychotherapeutic Components of Psilocybin-Assisted Psychotherapy, American Journal of Psychotherapy, December 2021, American Psychiatric Association,
DOI: 10.1176/appi.psychotherapy.20200055.
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