Objectives: Self-compassion may benefit individuals with social anxiety disorder and serve as a mechanism of change within 3,4-Methylenedioxymethamphetamine (MDMA)-assisted therapy (MDMA-AT). Methods: In this secondary analysis of 20 adults with social anxiety disorder who underwent MDMA-AT for social anxiety disorder (NCT05138068), we examined whether both trait self-compassion changes across...
By fostering certain self-transcendent experiences (STE)—those characterized by interconnectedness and other-oriented emotions—3,4-Methylenedioxymethamphetamine (MDMA)-assisted therapy (MDMA-AT) has been hypothesized to disrupt social anxiety disorder maintenance processes, including negative self-focus, self-criticism, and isolation, thereby enhancing wellbeing. This secondary analysis used...
Background Real-world psilocybin use outpaces evidence-based guidance and accessible professional support; understanding psilocybin safety strategy and resource utilization is important for informing education and dissemination initiatives. Methods This qualitative study explored the perspectives of Oregon residents ( N = 31) who plan to/have used psilocybin, employing thematic analysis of...
September 11, 2026Joseph M. Diehl, Christina Chwyl, Liliana Kennedy et al.
preprint
The therapeutic relationship is considered central to psychedelic-assisted therapy, yet little empirical research has examined how it changes during 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) or relates to acute MDMA experiences and clinical outcomes, particularly for social anxiety disorder (SAD). This preregistered secondary analysis examined therapeutic alliance and...
PTSD is a prevalent and debilitating condition, for which many individuals do not seek or complete treatment. As new PTSD treatments are being evaluated, such as psychedelic-assisted therapies, it’s important to understand the preferences of individuals for whom these treatments are being developed. To date, no research has directly compared preferences for psychedelic-assisted therapies...
Background: ±3,4-methylenedioxymethamphetamine (MDMA) has positive effects on socio-emotional processing and MDMA-Assisted Therapy (MDMA-AT) showed promise for treating SAD in a previous placebo-controlled trial. Aims: Develop a preliminary estimate of clinical response and safety for MDMA-AT versus waitlist in adults with SAD. Secondary aims included refinement of a standardized psychotherapy...
Informed consent in psychedelic-assisted services is ethically complex, difficult to implement, and remains largely unstudied and unstandardized. The current study sought expert recommendations on informed consent challenges, best practices and recommendations for supervised psilocybin experiences across various settings. Participants with psilocybin content expertise and psilocybin providers...
Background: Informed consent in psychedelic-assisted services is ethically complex, difficult to implement, and remains largely unstudied and unstandardized. Objective: The current study sought expert recommendations from experienced psychedelic facilitators on what constitutes informed consent best practices for supervised psychedelic experiences across various settings. Methods: Participants...
Findings indicate a "mindset-over-molecule" pattern wherein psychological context ("set") is more strongly associated with psychedelic outcomes than substance type alone.
The use of supportive touch in psychedelic-assisted therapy (PAT) and MDMA-assisted therapy (MDMA-AT) presents unique ethical challenges and opportunities. While touch can be a valuable component of treatment, its implementation requires careful consideration due to the altered states of consciousness induced by psychedelics and the potential for boundary violations. This paper addresses a...
There remain significant gaps in knowledge about best practices for facilitated psychedelic care and psychedelic-assisted therapy. To inform the development of service models that support safe and beneficial experiences, this qualitative study explored expert perspectives on current and ideal standards of care, including key practices (e.g., screening, adapting care to diverse contexts) and...
Self-compassion is theorized to play a central role in promoting mental health and wellbeing, including for individuals with social anxiety disorder (SAD). One proposed mechanism of MDMA-assisted therapy (MDMA-AT) for SAD is the cultivation of self-compassion. Across five aims, we will characterize self-compassion experiences during MDMA-AT and evaluate its role as a potential mechanism of...
Abstract Background Self-transcendent and mystical experiences may be key mechanisms underlying psychedelics’ therapeutic effects, yet how these experiences differ across substances remains unclear. This study compared mystical and self-transcendent experiences across psilocybin, 3,4-Methylenedioxymethamphetamine (MDMA), and cannabis in a diverse, community-based sample, while accounting for...
September 7, 2025Mathew Herbert, Brian H. Blanco, Dimitri Perivoliotis et al.
preprint
There is promise for 3,4-Methylenedioxymethamphetamine (MDMA)-assistedpsychotherapy as a highly effective and durable treatment for posttraumatic stress disorder(PTSD). However, the Food and Drug Administration rejected MDMA-assisted psychotherapy inits current form, expressing concerns about the lack of standardization and empirical basis ofpsychotherapy methods. This highlights the need to...
Abstract Background Psychedelic integration is widely acknowledged as essential, yet limited empirical data exists on challenges faced during integration. Objective To explore therapists' perspectives on post-psychedelic integration challenges and their approaches to supporting clients. Methods Online interviews were conducted with a purposive sample of licensed mental health professionals who...
New legal frameworks for supervised psychedelic services are emerging, with Oregon and Colorado implementing programs to train and license psilocybin facilitators. This study describes Oregon's early psilocybin facilitator workforce and assesses state-approved training programs. The Open Psychedelic Evaluation Nexus (OPEN) reviewed Oregon Health Authority-approved training programs and surveyed...
Neitzke-Spruill et al. (2025) offer an important overview of the ethical considerations around the use of touch within psychedelic assisted therapies (PAT) and MDMA-assisted therapy (MDMA-AT). Thei...
Background: Voter initiatives in Oregon and Colorado authorize legal frameworks for supervised psilocybin services, but no measures monitor safety or outcomes. Aims: To develop core measures of best practices. Methods: A three-phase e-Delphi process recruited 36 experts with 5 or more years’ experience facilitating psilocybin experiences in various contexts (e.g., ceremonial settings,...
Abstract Psychological flexibility has been proposed as a core process of change when psychedelics are used for therapeutic purposes, but to date empirical outcomes have only documented changes on the Acceptance and Action Questionnaire (AAQ-II), a very general measure of psychological flexibility. This pilot study measured outcomes from psilocybin administered in a retreat setting across a...
MDMA-assisted therapy (MDMA-AT) is an emerging treatment modality, with recent phase 3 trials indicating its potential for regulatory approval. Central to this therapy is the role of touch, yet its empirical evaluation in MDMA-AT, and psychotherapy in general, remains limited. The use of touch in combination with MDMA raises concerns about power imbalances and ethical boundaries. This article...
Abstract Background and aims Because psychedelic-assisted therapy (PAT) is likely to be provided by interdisciplinary professional teams comprised of social workers, psychologists, and psychiatrists, understanding the acceptability of this treatment approach among these professional disciplines is essential as the treatment advances through approval processes at the Food and Drug...
BackgroundSocial anxiety disorder (SAD) is a serious and prevalent psychiatric condition that heavily impacts social functioning and quality of life. Though efficacious treatments exist for SAD, remission rates remain elevated and a significant portion of those affected do not access effective treatment, suggesting the need for additional evidence-based treatment options. This paper presents a...
As evidence for psychedelic-assisted therapy accumulates, legalization becomes more likely. As a result, there is an increasing need for psychologists to become educated about psychedelics and their therapeutic effects as they will play an important role in disseminating this treatment. Therefore, understanding psychologists’ current attitudes toward psychedelics is integral in informing...
The acute subjective effects of psychedelics are responsive to users’ expectations and surroundings (i.e., “set and setting”). Accordingly, a great deal of thought has gone into designing the psychosocial context of psychedelic administration in clinical settings. But what theoretical paradigms inform these considerations about set and setting? Here, we describe several historical, sociological...
Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated during sessions involving MDMA administration in the...