Disruption as an opportunity or threat: A qualitative analysis of factors influencing the attitudes of experts in serious illness care toward psychedelic-assisted therapies.
Roxanne Sholevar, John R Peteet, Justin J. Sanders, Yvan Beaussant
Palliative & Supportive Care December 1, 2023 DOI: 10.1017/S1478951523001475 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 17 |
| Population | Experts in serious illness care and/or psychedelic-assisted therapy research from the United States and Canada |
| Topics | Psychedelic-assisted therapy |
| Keywords | Disruption Qualitative research Serious illness care |
| Citations | 9 |
| Key findings | Experts' attitudes toward psychedelic-assisted therapy in serious illness care are influenced by five factors and hinge on whether its disruptive potential is viewed as a therapeutic opportunity or an undue risk. |
Abstract
Psychedelic-assisted therapies (PAT) are emerging as a promising treatment for psycho-existential distress in patients with serious illness. A recent qualitative analysis of perspectives of 17 experts in serious illness care and/or PAT research identified divergent views on the therapeutic potential and safety of PAT in patients with serious illness. This paper further analyzes the factors that may influence these views. To identify factors underlying the attitudes of experts in serious illness care and/or PAT toward PAT and its potential role in serious illness care. Semi-structured interviews of 17 experts in serious illness care and/or PAT from the United States and Canada were analyzed to identify factors cited as influencing their views on PAT. Five factors were identified as influencing experts' attitudes toward PAT: perception of unmet need, knowledge of empirical studies of PAT, personal experience with psychedelics, professional background, and age/generation. In addition, an integrative theme emerged from the analysis, namely PAT's disruptive potential at 4 levels relevant to serious illness care: patient's experience of self, illness, and death; relationships with loved ones and health-care providers; existing clinical models of serious illness care; and societal attitudes toward death. Whether this disruptive potential was viewed as a therapeutic opportunity, or an undue risk, was central in influencing experts' level of support. Experts' perception of this disruptive potential was directly influenced by the 5 identified factors. Points of disruption potentially invoked by PAT in serious illness care highlight important practical and philosophical considerations when working to integrate PAT into serious illness care delivery in a safe and effective way.
Comparable studies
Other qualitative studies on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression enrolled in an open-label trial of psilocybin | 2017 | Qualitative study | n = 20 |
| LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects Patients with anxiety associated with life-threatening diseases | 2014 | Prospective follow-up with qualitative content analysis | n = 10 |
| Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis Adults aged 22 to 69 with clinically elevated anxiety associated with a cancer diagnosis | 2017 | Qualitative study | n = 13 |
| Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts Participants who completed a psilocybin-facilitated smoking cessation pilot study | 2018 | Qualitative follow-up study using semi-structured interviews and thematic analysis | n = 12 |
| The hidden therapist: evidence for a central role of music in psychedelic therapy Patients undergoing psychedelic therapy with psilocybin for treatment-resistant depression | 2018 | Qualitative study | n = 19 |
Citations in the library
Cited by 10
- Psychedelic-Assisted Therapies for Psychosocial Symptoms in Cancer: A Systematic Review and Meta-Analysis Current Oncology June 30, 2025
- Qualitative content analysis of expectations in participants with depression about to begin LSD microdosing treatment: Identifying the need for psychedelic expectancy measures. Neuropharmacology December 1, 2025
- Examining the Perspectives of Key Stakeholders on the Problems, Policies, and Politics Regarding Accessing Psychedelic Interventions to Alleviate End‐of‐Life Distress Politics & Policy January 24, 2026
- Health Care Workers' Attitudes Toward and Knowledge of the Clinical Application of Classic Psychedelics for People with Serious Illness: A Systematic Review. Journal of Palliative Medicine June 1, 2025
- Anything that helps: cancer patient and carer perspectives on psychedelic-assisted therapy Supportive Care in Cancer May 1, 2026
and 5 more in the library
Cites 14
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- 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
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
- Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases The Journal of Nervous and Mental Disease March 4, 2014
- Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential distress in patients with life-threatening cancer Journal of Psychopharmacology January 9, 2020
and 9 more in the library