Protocols and practices in psilocybin assisted psychotherapy for depression: A systematic review.
Noah Chisamore, Danica E. Johnson, Margery J.q. Chen, Hilary Offman, David C J Chen-Li, Erica Kaczmarek, Zoe Doyle, Roger S McIntyre, Joshua D. Rosenblat
Journal of Psychiatric Research August 1, 2024 DOI: 10.1016/j.jpsychires.2024.05.051 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Peer reviewed |
|---|---|
| Population | Published clinical trial protocols on psilocybin-assisted psychotherapy for depression and distress in life-threatening illnesses |
| Topics | Depression Psilocybin Psychedelic-assisted therapy |
| Keywords | Mood disorders Psychedelics Psychological treatment Antidepressant therapy Psychotherapy talk therapy Counsel |
| Citations | 21 |
| Key findings | Published psilocybin-assisted psychotherapy protocols consistently include preparation, supportive dosing, and integration sessions, but beyond this basic framework there is significant heterogeneity and lack of clarity, with no validated or universally agreed-upon protocol existing. |
Abstract
Psilocybin-assisted psychotherapy (PAP) is a promising treatment option for depression, with randomized controlled trials (RCTs) providing preliminary support for its safety and efficacy. However, there is a lack of consistency across existing treatment protocols and psychotherapeutic approaches. The objective of this review is to summarize and compare current psychotherapy methods of PAP in treating depression and distress in life-threatening illnesses. We sought to comprehensively summarize published psychotherapy protocols from clinical trials to provide insights for future practices. A systematic search of four databases (Embase, MEDLINE, PsycINFO, CINAHL) for data relating to psychotherapy protocols was conducted by two independent reviewers. In total, our search identified 1869 articles; after removing duplicates, we screened 1107 articles. We included 70 articles in the full-text review and determined that 28 were eligible for the final review. All protocols include sessions before (preparatory) and after (integration) the psychedelic dosing session with supportive monitoring. However, there was substantial variability and inconsistencies in all other aspects of therapy protocols (e.g., duration and number of sessions, model of therapy). Additionally, significant limitations were identified in the frequent need for more clarity in the description of therapeutic approaches. In published clinical trials, PAP has consisted of preparation, supportive dosing, and integration sessions. Beyond this basic framework, significant heterogeneity and lack of clarity were identified in reported psychotherapy protocols, meaning a validated and universally agreed upon protocol for PAP currently does not exist. Future studies should more clearly define and report psychotherapeutic components to identify the safest and most efficacious approaches to PAP.
Comparable studies
Other systematic reviews and meta-analyses on psilocybin and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy | 2020 | Systematic review | |
| Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. Participants in studies of psychedelic therapy for depressive symptoms (Major... | 2023 | Systematic review with meta-analysis | n = 14 |
| Psilocybin-assisted therapy for depression: A systematic review and meta-analysis. Patients diagnosed with life-threatening illnesses or major depressive disorder | 2023 | Systematic review and meta-analysis | n = 686 |
| United States National Institutes of Health grant funding for psychedelic-assisted therapy clinical trials from 2006-2020. | 2022 | Systematic review | |
| Safety and risk assessment of psychedelic psychotherapy: A meta-analysis and systematic review. Human subjects in studies of psychedelic-assisted psychotherapy | 2024 | Systematic review and meta-analysis | n = 30 |
Citations in the library
Cited by 22
- Quality of reporting on psychological interventions in psychedelic treatments: a systematic review. The Lancet Psychiatry 2025
- Mapping psilocybin therapy: A systematic review of therapeutic frameworks, adaptations, and standardization across contemporary clinical trials Journal of Affective Disorders July 18, 2025
- Psilocybin-Assisted Psychotherapy for Treatment-Resistant Depression in Bipolar II Disorder Psychedelic Medicine November 18, 2024
- Synaptic priming: A framework for pharmacotherapy in depression. Neuron November 19, 2025
- Psilocybin-assisted psychotherapy for Parkinson's disease without depression: A case-report. Journal of Parkinson's disease March 1, 2025
and 17 more in the library
Cites 37
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
and 32 more in the library