Notes on the standards of psilocybin-assisted psychotherapy Original paper

Research on the psychotherapeutic potential of psilocybin, the bioactive psychedelic substance found in magic mushrooms, has focused on proving efficacy in a safe and controlled setting. The term psilocybin-assisted psychotherapy (PAP) describes the standards for safety and structure (“set and setting”) used in clinical intervention.

This systematic review of 11 studies evaluated commonalities in the structure and format of PAP across studies on psilocybin published in the past 25 years.

Most studies investigated depression and anxiety, while others monitored substance abuse, obsessive compulsive disorder, and mood and behavior. Sample sizes ranged from 9 to 75 participants.

PAP consists of three stages:

i) Pretreatment: Psilocybin effects, participant experiences in life and with the presenting problem, and intentions or goals for treatment are discussed.

The number of sessions provided ranged from 1 to 5 and lasted 4 to 10 hours.

ii) Treatment: After psilocybin administration, the participants are asked to lie down, wear eyeshades, and listen to a standardized playlist of music.

All studies included at least two therapists (trained specifically for PAP) who conduct treatment in a nondirective and supportive setting. This means that they are present to provide psychological support (e.g., reality orientation, physical reassurance, and nonjudgemental and empathic listening). Generally, 2 sessions were provided, and each lasted 7 to 8 hours.

iii) Posttreatment: The participant’s experiences of the previous psilocybin administration and integration of the experience into the participant’s life are discussed.

The number of sessions conducted ranged from 1 to 18, each lasted 1 to 22 hours, and the therapy content ranged from cognitive behavioral therapy to journaling.

Although PAP has been shown to improve symptoms of depression and anxiety, demoralization, substance use, and attitude and mood, the impact of different psychotherapeutic methods (e.g., cognitive behavioral therapy and meditation) and their potential effects on the different quantitative and qualitative measurement methods may affect the final result.