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Keywords = psychedelic-assisted therapy (PAT)

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48 pages, 4777 KB  
Review
Predictors of the Effectiveness of Psychedelics in Treating Depression—A Scoping Review
by James Chmiel and Filip Rybakowski
Int. J. Mol. Sci. 2026, 27(5), 2202; https://doi.org/10.3390/ijms27052202 - 26 Feb 2026
Cited by 1 | Viewed by 2037
Abstract
Psychedelic-assisted therapies (PATs) can produce rapid and sustained antidepressant effects, yet variability in response remains substantial. Identifying predictors and moderators is essential for optimising patient selection, preparation, and delivery. To map and synthesise the evidence on the predictors of antidepressant response to classic/serotonergic [...] Read more.
Psychedelic-assisted therapies (PATs) can produce rapid and sustained antidepressant effects, yet variability in response remains substantial. Identifying predictors and moderators is essential for optimising patient selection, preparation, and delivery. To map and synthesise the evidence on the predictors of antidepressant response to classic/serotonergic psychedelics administered with psychotherapeutic support in adults with depressive disorders, including treatment-resistant depression. Following PRISMA-ScR principles, we conducted a scoping review of major biomedical and psychology databases (PubMed (MEDLINE), Embase, PsycINFO, and Web of Science) and trial registries (searches September–October 2025), supplemented by reference-list screening. We included randomised trials, open-label studies, and naturalistic cohorts reporting associations between candidate predictors (baseline traits/clinical features, set/setting variables, acute in-session phenomenology, and biological measures) and validated depression outcomes. We charted study characteristics, analytic approaches (including moderation/mediation where available), and indicators of robustness (e.g., adjustment for overall intensity, preregistration, external validation). A total of 48 studies were included in the review. Across study designs, process-level features during the dosing session were the most consistent correlates of antidepressant improvement. Greater emotional breakthrough, mystical/unitive experiences, and ego dissolution-linked reappraisal/insight generally predicted larger and more durable symptom reductions, whereas anxiety-dominant or dysphoric states tended to attenuate benefit, often independent of overall subjective intensity. Set and setting—particularly a stronger therapeutic alliance and music experienced as resonant—predicted both the emergence of therapeutically salient acute experiences and downstream clinical gains. Baseline moderators showed smaller and mixed effects: PTSD comorbidity sometimes weakened trajectories; extensive prior psychedelic exposure was associated with smaller incremental gains; demographics were typically uninformative. Converging biological findings associated better outcomes with markers consistent with increased neural flexibility and plasticity (e.g., less segregated network dynamics; EEG indices), alongside peripheral changes implicating neurotrophic, inflammatory, and HPA axis pathways. Current evidence suggests that antidepressant response in PATs is driven less by static patient characteristics and more by what occurs during dosing and how the context shapes that experience. Optimising preparation, alliance, and music; facilitating emotional breakthrough and meaning making; and mitigating anxious dysregulation are actionable levers. Future trials should harmonise measures, pre-specify and validate moderators/mediators, intensively sample in-session experience and physiology, and report benefits and harms more consistently. Full article
(This article belongs to the Special Issue Advances in the Pharmacology of Depression and Mood Disorders)
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19 pages, 699 KB  
Protocol
The CAnadian Network for Psychedelic-Assisted Cancer Therapy (CAN-PACT): A Multi-Phase Program Overview
by Linda E. Carlson, Harriet Richardson, Ron Shore, Christopher P. Albertyn, Lynda G. Balneaves, Alan Bates, Margot Burnell, Harvey Max Chochinov, David Clements, Julie Deleemans, Hilary Horlock, Jean Mathews, Michael McKenzie, Chantal Savard, Claudio N. Soares, Wei Tu and Monnica Williams
Curr. Oncol. 2026, 33(1), 7; https://doi.org/10.3390/curroncol33010007 - 22 Dec 2025
Cited by 1 | Viewed by 1894
Abstract
The CAnadian Network for Psychedelic-Assisted Cancer Therapy (CAN-PACT) was launched in 2025 to address urgent gaps in supportive care for Canadians with cancer experiencing demoralization syndrome (loss of meaning, dysphoria, disheartenment, helplessness, a sense of failure) and related psychosocial distress. CAN-PACT has six [...] Read more.
The CAnadian Network for Psychedelic-Assisted Cancer Therapy (CAN-PACT) was launched in 2025 to address urgent gaps in supportive care for Canadians with cancer experiencing demoralization syndrome (loss of meaning, dysphoria, disheartenment, helplessness, a sense of failure) and related psychosocial distress. CAN-PACT has six major objectives: (1) to develop a national interdisciplinary research and practice network; (2) to set research priorities through structured stakeholder engagement; (3) to develop and provide PAT training and education for clinicians, researchers, and patients; (4) to pilot test the feasibility of intervention and assessment procedures; (5) to conduct a multi-center, randomized controlled trial of PAT for people with advanced cancer; and (6) to inform and influence healthcare policy on PAT in Canada. We discuss the background and need for PAT in cancer, describe challenges currently limiting its use, and outline CAN-PACT’s strategy for building capacity, generating Canadian evidence, and preparing the oncology healthcare environment for potential implementation. This manuscript presents a summary overview of CAN-PACT as a multi-objective research program; detailed protocols for each discrete study component will be published separately as the research program progresses. Through environmental scans, national engagement, targeted training, rigorous research, and ongoing collaboration with policymakers, CAN-PACT aims to enable equitable access to safe, evidence-based PAT for people with advanced cancer in Canada’s publicly funded cancer centers. Full article
(This article belongs to the Section Psychosocial Oncology)
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18 pages, 271 KB  
Article
Psychedelic-Assisted Therapy in Palliative Care—Insights from an International Workshop
by Anna Schuldt, Ian C. Clark, Yasmin Schmid, Michael Ljuslin, Christopher Boehlke, Sivan Schipper, Megan B. Sands and David Blum
Healthcare 2025, 13(18), 2275; https://doi.org/10.3390/healthcare13182275 - 12 Sep 2025
Viewed by 2464
Abstract
Background: Evidence is growing that psychedelic substances have positive effects in the setting of Palliative Care (PC), focusing on special needs in this patient population. After a scoping review of the literature, no published expert recommendations guiding best practice for psychedelic-assisted therapy (PAT) [...] Read more.
Background: Evidence is growing that psychedelic substances have positive effects in the setting of Palliative Care (PC), focusing on special needs in this patient population. After a scoping review of the literature, no published expert recommendations guiding best practice for psychedelic-assisted therapy (PAT) towards the end of life were identified. Objective: To draw conclusions from first-hand experienced professionals on PAT in PC (PATPC). Setting, Design, Participants: An international workshop with experts was held in Wasserfallen, Switzerland. A thematic analysis of a semi-structured, questionnaire-based qualitative study with 13 experts in PC, oncology, psychiatry/psychology, and PAT from Europe, the United States, and Oceania was made. Measurements: The questionnaire was designed to elicit the participant’s perspectives on (A) special considerations on PATPC, (B) specific characteristics of PATPC (versus mental illness), and (C) the relevance of these differences during preparation, substance dosing session, and integration in PATPC. Results: (A) Special Considerations included (non-medicalized) setting, potential need, and possibility to reduce preparation time. (B) Distinguishing characteristics included the patient’s intrinsic motivation for treatment success, the importance of anxiety, depression, and spiritual distress as indications for PATPC, and the importance of sufficient integration of the psychedelic experience into life in the face of limited time due to the life-limiting illness. (C) Flexibility in setting and timing of preparation, choosing the appropriate dosage of the psychedelic substance depending on the patient’s intended focus, low/medium (relational issues), higher for transcendental experiences, considering mental capacity and vulnerability for the individual. In addition, respondents noted that for therapists, knowledge about transcendental states, such as mystical experiences, existential aspects of life-threatening illness, and the role of therapists’ own self-experience/inner work, as well as good knowledge of the theoretical basis for treatment, was highlighted. Conclusions: This study highlights special considerations for PAT PC and could be a first step towards specific treatment recommendations (guidelines) for PATPC. Full article
(This article belongs to the Special Issue Psychedelic Therapy in Palliative Care)
31 pages, 1058 KB  
Systematic Review
Psychedelic-Assisted Therapies for Psychosocial Symptoms in Cancer: A Systematic Review and Meta-Analysis
by Haley D. M. Schuman, Chantal Savard, Raèf Mina, Sofia Barkova, Hanna S. W. Conradi, Julie M. Deleemans and Linda E. Carlson
Curr. Oncol. 2025, 32(7), 380; https://doi.org/10.3390/curroncol32070380 - 30 Jun 2025
Cited by 4 | Viewed by 5368
Abstract
This systematic review and meta-analysis evaluates (1) the effectiveness of psychedelic-assisted therapy (PAT) using psilocybin and ketamine for psychosocial symptoms in adults with cancer, (2) contextualizes findings with non-randomized and exploratory studies of other psychedelics, and (3) examines the role of therapeutic frameworks [...] Read more.
This systematic review and meta-analysis evaluates (1) the effectiveness of psychedelic-assisted therapy (PAT) using psilocybin and ketamine for psychosocial symptoms in adults with cancer, (2) contextualizes findings with non-randomized and exploratory studies of other psychedelics, and (3) examines the role of therapeutic frameworks in shaping outcomes. We searched PubMed, Cochrane Library, PsycINFO, and EMBASE (2000–2024) for randomized controlled trials (RCTs) and non-randomized studies investigating psychedelic agents in cancer populations. Meta-analyses pooled RCTs of psilocybin or ketamine using random-effects models. Non-randomized studies were synthesized narratively. Risk of bias and evidence certainty were assessed via Cochrane ROB 2.0, NIH Before–After tool, and GRADE. Eleven placebo-controlled RCTs and four single open-label studies were included. Meta-analysis of four ketamine RCTs (n = 354) showed large, rapid effects on depression/anxiety (Hedges’ g = −1.37, 95% CI: −2.66 to −0.08; I2 = 92%). Three psilocybin RCTs (n = 101) showed a large effect of psilocybin on alleviating depression (Hedges’ g = −3.13, 95% CI: −10.04 to 3.77; I2 = 95%). MDMA and LSD trials suggested promise but lacked rigor. PAT may offer meaningful relief for cancer-related distress, though effects vary by therapeutic model and context. Oncology-specific trials are needed to standardize and scale for implementation. Full article
(This article belongs to the Section Psychosocial Oncology)
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14 pages, 536 KB  
Perspective
A Perspective for Enhancing the Supervision of Psychedelic-Assisted Therapy: Motivational-Interviewing-Enhanced Integration Supervision (MIE-IS)
by Mitch Earleywine and Alyssa B. Oliva
Psychoactives 2025, 4(2), 14; https://doi.org/10.3390/psychoactives4020014 - 17 May 2025
Viewed by 2274
Abstract
While research on psychedelic-assisted therapy (PAT) continues to show promise, challenges in its clinical application persist. One relevant domain includes how supervision might enhance both client and trainee outcomes. Current data suggest that, despite supervisor reports and the enthusiasm of trainees, supervision accounts [...] Read more.
While research on psychedelic-assisted therapy (PAT) continues to show promise, challenges in its clinical application persist. One relevant domain includes how supervision might enhance both client and trainee outcomes. Current data suggest that, despite supervisor reports and the enthusiasm of trainees, supervision accounts for extraordinarily little variance in treatment outcome. We propose that as supervisors model relevant skills, these skills can also improve in the therapist, which should lead to enhanced alliances and improved self-care for the client, trainee, and supervisor. Thus, we propose a model of supervision that rests on key Motivational Interviewing (MI) principles and supports the integration process—a pivotal phase of PAT where clients translate psychedelic-induced insights into meaningful behavioral change. This Motivational-Interviewing-Enhanced Integration Supervision (MIE-IS) model bridges the gap between psychedelic experiences and personal growth by ensuring supervisors can effectively encourage trainees to support their clients through this crucial integration process. Supervisors would model the use of MI with trainees in supervision, who would, in turn, apply those same MI technical and relational skills to support clients’ integration experiences. Beyond enhancing client outcomes, this supervisory model could also increase each trainee’s motivation to personally engage with wellness-promoting integration behaviors, potentially enhancing professional development and minimizing burnout. By reinforcing a culture of self-care and reflective practice, this model might inspire better self-care in supervisors as well. By fostering an MI-informed supervisory relationship, the model promotes a culture of continuous learning and skill development, benefiting clients through the effective and meaningful integration of their psychedelic experiences. Full article
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10 pages, 550 KB  
Protocol
The Use, Role, and Function of Music During Psychedelic-Assisted Therapy (PAT) with Ayahuasca: A Scoping Review Protocol
by Guillermo Escobar-Cornejo, Fernando P. Cardenas, Diego Torres, Mario Valderrama and Mark Ettenberger
Psychoactives 2025, 4(2), 9; https://doi.org/10.3390/psychoactives4020009 - 1 Apr 2025
Viewed by 3273
Abstract
Objective: To provide a state of the art on the use, role, and function of music during psychedelic-assisted therapy (PAT) with ayahuasca. Introduction: Ayahuasca is a medicinal brew with psychoactive qualities used by indigenous communities throughout the Amazon region, and music is deemed [...] Read more.
Objective: To provide a state of the art on the use, role, and function of music during psychedelic-assisted therapy (PAT) with ayahuasca. Introduction: Ayahuasca is a medicinal brew with psychoactive qualities used by indigenous communities throughout the Amazon region, and music is deemed crucial during ayahuasca experiences. In PAT, music forms part of the set and setting, but it lacks systematization and is poorly explored in the scientific literature. Inclusion criteria: Published literature in English, Spanish, and Portuguese, focusing on conceptualizing, defining, or describing the use, role, and/or function of music in PAT sessions with ayahuasca. Methods: This review follows the JBI methodology for scoping reviews. We will search Web of Science, Scopus, Google Scholar, and PubMed databases without year restrictions, and a hand search of articles will be performed. Two reviewers will assess titles/abstracts, followed by independent reviews of included full texts. An Excel data extraction sheet will be used to tabulate the information. The findings will be presented narratively, including respective tables or figures. If feasible, a potential theoretical framework for the use, role, and function of music during PAT with ayahuasca will be outlined, including implications for future research and clinical practice. Full article
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19 pages, 688 KB  
Systematic Review
The Therapeutic Potential of Psychedelics in Treating Substance Use Disorders: A Review of Clinical Trials
by Lavinia Hogea, Dana Cătălina Tabugan, Iuliana Costea, Oana Albai, Laura Nussbaum, Adriana Cojocaru, Leonardo Corsaro and Teodora Anghel
Medicina 2025, 61(2), 278; https://doi.org/10.3390/medicina61020278 - 6 Feb 2025
Cited by 11 | Viewed by 22123
Abstract
Background and Objectives: Substance use disorders (SUDs) affect millions worldwide. Despite increasing drug use, treatment options remain limited. Psychedelic-assisted therapy (PAT), integrating psychedelic substances with psychotherapy, offers a promising alternative by addressing underlying neural mechanisms. Materials and Methods: This review’s purpose [...] Read more.
Background and Objectives: Substance use disorders (SUDs) affect millions worldwide. Despite increasing drug use, treatment options remain limited. Psychedelic-assisted therapy (PAT), integrating psychedelic substances with psychotherapy, offers a promising alternative by addressing underlying neural mechanisms. Materials and Methods: This review’s purpose is to investigate the current understanding of psychedelic therapy for treating SUDs, including tobacco, alcohol, and drug addiction. The systematic review approach focused on clinical trials and randomized controlled trials conducted from 2013 to 2023. The search was performed using PubMed, Google Scholar, and Consensus AI, following PRISMA guidelines. Studies involving psychedelics like LSD, psilocybin, ibogaine, and ayahuasca for treating various addictions were included, excluding naturalistic studies and reviews. Results: Our results highlight the key findings from 16 clinical trials investigating psychedelic therapy for SUDs. Psychedelics like psilocybin and ayahuasca showed promise in reducing alcohol and tobacco dependence, with psilocybin being particularly effective in decreasing cravings and promoting long-term abstinence. The studies revealed significant improvements in substance use reduction, especially when combined with psychotherapy. However, the variability in dosages and study design calls for more standardized approaches. These findings emphasize the potential of psychedelics in SUD treatment, though further large-scale research is needed to validate these results and develop consistent protocols. Conclusions: This research reviewed the past decade’s international experience, emphasizing the growing potential of psychedelic therapy in treating SUDs pertaining to alcohol, tobacco, and cocaine dependence. Psychedelics such as psilocybin and ketamine can reduce cravings and promote psychological well-being, especially when combined with psychotherapy. However, regulatory barriers and specialized clinical training are necessary to integrate these therapies into mainstream addiction treatment safely. Psychedelics offer a promising alternative for those unresponsive to conventional methods. Full article
(This article belongs to the Section Psychiatry)
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15 pages, 241 KB  
Article
Psychedelics, the Bible, and the Divine
by Jaime Clark-Soles
Religions 2024, 15(5), 582; https://doi.org/10.3390/rel15050582 - 7 May 2024
Cited by 5 | Viewed by 20249
Abstract
The current psychedelic renaissance intersects with Christian practices in two key ways. First, as psychedelic-assisted therapy (PAT) becomes more common, Christians undergoing therapeutic medical treatment may seek outside support for integrating into their religious lives mystical experiences that occur during psychedelic sessions. Second, [...] Read more.
The current psychedelic renaissance intersects with Christian practices in two key ways. First, as psychedelic-assisted therapy (PAT) becomes more common, Christians undergoing therapeutic medical treatment may seek outside support for integrating into their religious lives mystical experiences that occur during psychedelic sessions. Second, with increasing legal access to psychedelics, more Christians may explore their spiritual potential outside of a medical context, either individually with spiritual guides or collectively in organized retreats. Many will have mystical encounters related to the Divine. Whether the experience involves the overwhelming presence or absence of the Divine, these Christians, too, will seek integration support. This essay argues that the Bible can serve as a rich source for such integration, because it contains significant material about mystical experiences marked by altered states of consciousness. First, I summarize the importance of the psychedelic renaissance, especially the scientific studies being conducted, as it relates to Christian practices of spiritual formation. Second, I explore new work being conducted by biblical scholars regarding embodied religious experiences with the Divine (and others), including mystical experiences. Third, I consider the Apostle Paul’s embodied mystical experience, with special attention to 2 Corinthians 12:1–10, as one example of biblical material that might intersect with or inform psychedelic mystical encounters that contemporary Christians might experience (whether in a medical therapeutic or non-medical spiritual formation setting). Finally, I indicate directions for further research and discussion. Full article
(This article belongs to the Special Issue Theology and Science: Loving Science, Discovering the Divine)
9 pages, 220 KB  
Article
Christian Responses to Psilocybin-Assisted Therapy and Potential Religious and Spiritual Experiences
by Brian Claude Macallan
Religions 2023, 14(10), 1312; https://doi.org/10.3390/rel14101312 - 19 Oct 2023
Cited by 2 | Viewed by 13600
Abstract
This paper explores Christian responses to religious and spiritual experiences (RSEs) associated with psilocybin-assisted therapy (PAT). It addresses the challenges of defining and understanding spiritual and religious experiences and examines the theological implications of PAT-induced RSEs. It highlights the growing acceptance of PAT [...] Read more.
This paper explores Christian responses to religious and spiritual experiences (RSEs) associated with psilocybin-assisted therapy (PAT). It addresses the challenges of defining and understanding spiritual and religious experiences and examines the theological implications of PAT-induced RSEs. It highlights the growing acceptance of PAT as a therapeutic approach and its potential benefits for mental health. It also discusses the occurrence of RSEs in individuals undergoing such therapy. In response to these experiences, I propose four possible Christian perspectives: viewing RSEs as illusions, perceiving them as inherently evil, considering them as encounters with the Christian God, or acknowledging their reality while recognizing their broader occurrence beyond the Christian tradition. The paper emphasizes the importance of active dialog and collective responses within the Christian community to avoid hindering individuals seeking mental health relief through PAT. By engaging with these theological questions, Christians can navigate the complexities and potential benefits of RSEs in the context of psychedelic-assisted therapy. Full article
(This article belongs to the Special Issue The Meaning of Religiosity in Life)
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