Journal of Contextual Behavioral Science
December 14, 2019
Rosalind Watts, Jason B. Luoma
261 citations
Psilocybin, a hallucinogen, significantly reduces anxiety in patients undergoing psychological therapy. In a sample of 60 individuals with anxiety disorders, 70% reported decreased symptoms after treatment combined with psilocybin and acceptance and commitment therapy. This approach enhances experiential learning, allowing patients to confront and manage their fears more effectively. The intervention showed an effect size of 0.8, indicating strong benefits. By influencing neurotransmitter receptors, psilocybin may promote greater psychological flexibility, a key factor in successful counseling outcomes in clinical psychology and psychiatry.
Journal of Psychoactive Drugs
June 12, 2020
Jason B. Luoma, Christina Chwyl, Geoff J. Bathje et al.
206 citations
Placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have resumed after a two-decade pause. Nine randomized, placebo-controlled trials published since 1994 examined psilocybin, LSD, ayahuasca, and MDMA. A significant mean between-groups effect size of 1.21 (Hedges g) was found, larger than typical effects for psychopharmacological or psychotherapy interventions. Effects were generally maintained at follow-up in the three studies that maintained a placebo control. Analyses support efficacy across post-traumatic stress disorder, anxiety/depression associated with a life-threatening illness, unipolar depression, and social anxiety among autistic adults. Larger trials with more diverse samples are needed to examine moderators and mediators and long-term effects.
Harm Reduction Journal
April 11, 2021
Brian Pilecki, Jason B. Luoma, Geoff J. Bathje et al.
135 citations
As clinical trials show strong evidence for psychedelic-assisted therapy's benefits, many people are using psychedelics on their own rather than waiting for legal medical access. Therapists have an ethical duty to support these clients, but incorporating psychedelics into traditional psychotherapy poses risks given their prohibited status. This paper explicates these risks and describes ways therapists can mitigate them while practicing within legal and ethical boundaries. A harm reduction approach is emphasized as a useful framework for conducting therapy around clients' psychedelic use. Therapists can meet with clients before and after personal psychedelic experiences to help minimize risk and maximize benefit. Common clinical scenarios in this growing area are discussed.
Frontiers in Psychology
May 23, 2022
David B. Yaden, Dylan Earp, Marianna Graziosi et al.
106 citations
The acute effects of psychedelics depend on users' expectations and surroundings (set and setting). Current clinical psychedelic administration draws on indigenous practices, 1960s new age spirituality, psychodynamic approaches, and cognitive-behavioral therapies. Cognitive-behavioral therapies, including acceptance and commitment therapy (ACT), have the strongest rationale for psychedelic-assisted psychotherapy because they avoid cultural insensitivity, make minimal speculative assumptions about the mind and reality, and have the largest empirical support for safety and effectiveness outside psychedelic therapy. Concepts from CBT, DBT, and ACT can usefully inform preparation, session, and integration phases. Evidence-based psychotherapeutic paradigms provide the best starting point for safety and efficacy.
Journal of Psychoactive Drugs
September 1, 2021
Alan K. Davis, Gabrielle Agin-Liebes, Megan España et al.
103 citations
Clinical psychologists in the United States hold cautiously favorable attitudes toward psychedelic-assisted therapy but express concerns about psychiatric and neurocognitive risks. Most surveyed psychologists report lacking a full understanding of psychedelics' effects and indicate a need for additional consultation. They endorse positive beliefs about the potential of psychedelic treatment and the need for further research. The findings highlight the need to increase education and training about psychedelics for psychologists to enhance knowledge and reduce stigma.
Journal of Psychopharmacology
March 1, 2022
Gabrielle Agin-Liebes, Richard J. Zeifman, Jason B. Luoma et al.
51 citations
People who participated in ayahuasca retreats in Central and South America reported reduced negative mood and increased positive mood and psychological flexibility three months later. Acute experiences of cognitive reappraisal during the ceremony were the strongest predictor of improvements in positive mood and flexibility. Increases in psychological flexibility statistically accounted for the link between acute psychological factors, including reappraisal, and later mood improvements. The findings suggest that acute reappraisal and subsequent gains in psychological flexibility are key mechanisms behind psychedelic-assisted therapy's benefits, supporting the integration of mindfulness-based and third-wave therapy approaches with such interventions.
Journal of Contextual Behavioral Science
October 1, 2019
Jason B. Luoma, Pablo Sabucedo, Johan Eriksson et al.
51 citations
No Summary
Human Psychopharmacology
May 1, 2022
Jason B. Luoma, Ben Shahar, M Kati Lear et al.
26 citations
Adding MDMA to psychotherapy may help treat social anxiety disorder by triggering three key processes of change. MDMA can enhance memory reconsolidation, allowing patients to reprocess painful social memories. It can also induce self-transcendent emotions like compassion, love, and awe, which counteract shame and social disconnection. Finally, MDMA may strengthen the therapeutic relationship, a robust predictor of positive outcomes. These effects likely extend beyond the drug sessions themselves.
Journal of Psychopharmacology
June 18, 2024
Kim Hoffman, Alissa Bazinet, Kellie Pertl et al.
14 citations
Experts with extensive experience facilitating psilocybin experiences, including in ceremonial settings, indigenous practices, and clinical trials, developed a set of core measures to monitor the safety, quality, and outcomes of supervised psilocybin services. Through a three-phase e-Delphi process with 36 experts, 55 candidate measures were identified and then prioritized to a core set of 11 process measures (e.g., preparatory hours with client, documentation of touch/sexual boundaries), 11 outcome measures (e.g., adverse events, well-being), and 17 structure measures (e.g., facilitator training in trauma informed care). The findings suggest that service providers and policy makers should consider standardizing these measures for community-based psilocybin services.
Psychedelic medicine (New Rochelle, N.Y.)
March 1, 2024
Jason B. Luoma, Luke R Allen, Veronika Gold et al.
14 citations
MDMA-assisted therapy (MDMA-AT) is nearing regulatory approval, but the role of therapeutic touch within it remains understudied and raises ethical concerns about power dynamics. A review of existing literature on touch in psychotherapy found little empirical evidence specifically for MDMA-AT. To address this gap, the authors developed the Touch Outcomes Measurement Inventory (TOMI), a tool for assessing clients' perceptions of touch during MDMA-AT. The creation of TOMI is the main outcome, intended to help researchers and evaluators study touch's impact and inform evidence-based, ethical guidelines for its use in MDMA-AT and other psychedelic-assisted therapies.
Frontiers in Psychiatry
July 15, 2023
M. Kati Lear, Sarah M. Smith, Brian Pilecki et al.
14 citations
An open-label pilot study will test MDMA-assisted therapy for social anxiety disorder. Twenty participants with moderate-to-severe generalized social anxiety will be randomly assigned to immediate or delayed treatment. The immediate group receives three preparation sessions, two MDMA medicine sessions, and six integration sessions over about 16 weeks. The primary outcome is symptom reduction measured by the Liebowitz Social Anxiety Scale at post-treatment and 6-month follow-up. Secondary outcomes include changes in functional impairment, safety, and processes like shame, belongingness, self-concealment, and self-compassion. Results will inform the design of larger randomized controlled trials.
Drugs Education Prevention and Policy
September 4, 2022
Jason B. Luoma, Brian Pilecki, Alan K. Davis et al.
13 citations
Psychologists' attitudes toward psychedelics vary with individual characteristics. Men, younger psychologists, those living in the West or Northeast US, those with greater knowledge of risks and benefits, those who are religiously unaffiliated, and those with direct or indirect experience with psychedelics report more positive attitudes. Previous addiction treatment training was not associated with more positive attitudes. These findings can help inform efforts to improve attitudes, such as using case studies in public education.
Journal of Psychedelic Studies
August 21, 2023
Stacey B. Armstrong, Adam W. Levin, Yitong Xin et al.
12 citations
Among 856 U.S. mental health professionals—social workers, psychiatrists, and psychologists—there were no differences in confidence that psychedelic-assisted therapy (PAT) would be effective. However, psychiatrists showed a better understanding of PAT than social workers. Psychologists rated PAT as more acceptable than social workers did, and psychologists also rated it as a more reasonable treatment approach than both social workers and psychiatrists. Social workers perceived greater disadvantages of PAT than psychologists and psychiatrists, and they were less likely than both other groups to believe PAT could permanently improve clients' lives. The findings indicate a need for education and training across professions as PAT moves toward approval.
Frontiers in Psychiatry
September 27, 2021
Jason B. Luoma, M. Kati Lear
11 citations
Social anxiety disorder (SAD) often persists despite treatment, prompting interest in MDMA-assisted therapy (MDMA-AT) as an adjunct. A small randomized placebo-controlled trial in autistic adults showed encouraging results, but more research is needed. This review proposes how MDMA-AT may alter four disrupted systems in SAD: social anhedonia and reduced reward sensitivity, heightened threat perception, shame regulation, and dysfunctional interpersonal behaviors. The authors suggest MDMA-AT could enhance social motivation, increase feelings of safety and affiliation, reduce shame through self-transcendent emotions, and improve social skills, potentially boosting extinction learning and relationship quality.
Journal of Psychedelic Studies
April 5, 2024
Brian Pilecki, Jason B. Luoma, Kati M. Lear
9 citations
Psychological flexibility may be a core process behind the therapeutic benefits of psilocybin. In a pilot study, nine participants attended a 7-day psilocybin retreat and completed measures at baseline, 2 months, and 6 months. They showed significant improvements in cognitive defusion, valued living, and self-compassion, along with a trend toward increased overall psychological flexibility. Other measures included acute drug effects, belief in oneness, social safeness, mental health, burnout, and emotion expressivity. These results offer preliminary evidence that psilocybin experiences may improve psychological flexibility.
Am J Bioeth
January 13, 2025
Jason B. Luoma, Jenna Lejeune
6 citations
Clear ethical guidelines for touch in psychedelic-assisted therapy are needed but often remain theoretical. This paper argues that to ensure patient safety and therapeutic integrity, abstract ethical principles must be translated into concrete, measurable practices. It proposes an operational framework that defines specific behaviors, boundaries, and assessment tools for ethical touch, allowing therapists to consistently apply and evaluate these standards. By moving from theory to practice, the framework aims to reduce risks, enhance patient care, and support professional conduct in a field where touch can be both healing and potentially harmful.
The International journal on drug policy
January 1, 2026
Christina Chwyl, Adrianne R Wilson-Poe, Kim Hoffman et al.
3 citations
Experts in psychedelic care and harm reduction identified five key areas for improving standards of care: strengthening provider accountability and credibility, advancing culturally responsive and inclusive practices, emphasizing community-based support and integration, ensuring safety through preparation and screening, and navigating legal and informational gray areas. The findings highlight the need for clearer guidelines, robust safety protocols, and accessible support systems to optimize outcomes across diverse populations and settings.
Journal of Psychoactive Drugs
January 29, 2025
Jason B. Luoma, Kim Hoffman, Adrianne R Wilson-Poe et al.
3 citations
Oregon's early psilocybin facilitator workforce is relatively diverse, with many holding existing healthcare licenses. Among 16 active training programs, mean tuition was $9,359 and half offered diversity scholarships. Survey respondents (n=106) reported that training expenses were a moderate-to-severe financial strain, though most were satisfied with their training. The mean planned price for a session was $1,388, and common specializations included trauma, mental disorders, consciousness exploration, and spirituality. Facilitators requested ongoing training opportunities. These findings are crucial for informing future policy and training program development to support a diverse and effective workforce.
Research Square
August 5, 2025
Christina Chwyl, Odin S. Elvenes, Andrew S. R. Kleven et al.
2 citations
Therapists who support clients after psychedelic experiences report ten key challenges, including unearthing trauma, destabilization or psychological crisis, re-adjusting to daily life with new insights and heightened sensitivity, relational harms from boundary violations, confusion about chaotic experiences, identity and worldview crises, feeling overwhelmed by needed changes, relationship disruption, disappointment after high hopes, and using psychedelics as escape. Based on interviews with 20 licensed mental health professionals (90% white, 70% cisgender women, modal integration clients 25–30), findings suggest that effective integration begins in preparation, involves setting realistic expectations, creating safe therapeutic environments, bolstering coping and social support, using trauma processing techniques, facilitating client-led meaning-making, and supporting gradual, values-guided life changes.
February 19, 2026
Christina Chwyl, Alissa Bazinet, Adie Wilson-Poe et al.
1 citation
preprint
Informed consent for psychedelic-assisted services should be treated as an ongoing process rather than a one-time form, according to 36 experienced facilitators. They emphasized building a strong therapeutic relationship, centering client empowerment, and comprehensively conveying potential long-term psychological and social changes, including the possibility of disappointing experiences. Detailed consent around touch and boundaries is needed, with explicit pre-session agreements, maintained boundaries, and attention to subtle non-verbal cues. Facilitator training should cultivate deep respect for client agency and provide experiential learning in relational and boundary-setting skills. These recommendations aim to improve practitioner training, consent practices, and policy for regulated psychedelic services.
Drug and Alcohol Dependence
July 1, 2024
P. Todd Korthuis, Kim Hoffman, Adrianne R Wilson-Poe et al.
1 citation
No Summary
Jason B. Luoma, Luke Roy Allen, Veronika Gold et al.
1 citation
preprint
MDMA is being tested as an adjunct to psychotherapy in controlled trials, including two completed Phase 3 trials, and could become a legally available medicine for MDMA-assisted therapy (MDMA-AT) within a few years. The treatment manual for MDMA-AT research considers touch an important part of therapy, but no empirical evaluation has examined how touch functions in MDMA-AT, and research on touch in psychotherapy generally is scarce. Concerns exist that touch combined with MDMA could intensify power imbalances or contribute to boundary crossings and unethical behavior.
Open MIND
July 14, 2026
Christina Chwyl, Jason B. Luoma, Stephanie R. Rodriguez et al.
Among individuals with PTSD symptoms, preferences for MDMA-assisted therapies and standard psychotherapies vary, with many favoring less directive approaches. In an online survey, participants rated MDMA-Assisted Inner-Directed Psychotherapy as more appealing than Prolonged Exposure or Present-Centred Therapy, citing perceived efficacy and lower fear. Treatment appraisals and clinical factors shaped these preferences, highlighting the importance of aligning emerging interventions with patient expectations.
June 4, 2026
Jason B. Luoma, M. Kati Lear, Brian Pilecki et al.
preprint
MDMA-Assisted Therapy (MDMA-AT) produced a large reduction in social anxiety symptoms compared to a waitlist condition in adults with social anxiety disorder. In a randomized open-label trial of 20 participants, those receiving MDMA-AT showed an average decrease of 43.3 points on the Liebowitz Social Anxiety Scale after 16 weeks, while the waitlist group did not. Improvements also occurred in functioning, shame, acceptance, belongingness, self-concealment, and self-compassion. Adverse events were mild to moderate and temporary; no serious adverse events occurred. These preliminary findings suggest MDMA-AT is safe and feasible for social anxiety disorder and warrant further research.
World Psychiatry
June 1, 2026
Christina Chwyl, Michael S. Ladka, Joshua C. Black et al.
In a US population-based study, about 1 in 20 people who used psychedelics reported experiencing sexual or physical violence during their use. Younger age, female gender, and use of certain psychedelics like MDMA were associated with higher risk. The findings suggest that while most psychedelic experiences are safe, a minority involve violence, highlighting the need for harm reduction strategies.