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How Important Is a Guide Who Has Taken Psilocybin in Psilocybin-Assisted Therapy for Depression?

Mitch Earleywine, Fiona Low, Brianna R. Altman, Joseph A. de Leo

Journal of Psychoactive Drugs March 23, 2022 DOI: 10.1080/02791072.2022.2047842 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional survey Peer reviewed
Sample size 800
Population MTurk respondents with depressive symptoms
Topics Psilocybin Depression
Keywords Cognition Clinical psychology Psychotherapist Hallucinogen Depression economics Demographics
Citations 31
Key findings Potential clients with depressive symptoms rated a guide who had used psilocybin as more than somewhat important, and this preference was stronger among people of color and those with prior therapy.

Abstract

Promising outcomes of Psilocybin-Assisted Therapy (PAT) for depression have generated concerted efforts to replicate, extend, and refine protocols to maximize efficacy. Psychotherapy research reveals that clients benefit most when important components of treatment align with their personal preferences. One open question related to PAT concerns the importance of the psilocybin experience of the guides (trained professionals present during acute effects). We sought to assess the importance of a guide who had used psilocybin to potential clients with depressive symptoms. Over 800 MTurk respondents with depressive symptoms rated the import of a guide who had used psilocybin relative to alternative characteristics in guides and cognitive behavioral (CBT) therapists. Importance ratings for guides who had used psilocybin significantly exceeded the "somewhat important" level (50 on a 0-100 scale), other guide-related qualities, and comparable ratings for a cognitive behavioral therapist who shared demographics, had experience with depression and received cognitive therapy personally. People of color (those who are not Caucasian) and those who had previous therapy gave significantly higher importance ratings for guides who had used psilocybin. Participants who chose to list other qualities important for guides listed very similar ones for CBT therapists, often emphasizing proper training and an empathic demeanor. Guides who have used psilocybin, who inform clients of the fact, might have advantages for facilitating PAT's antidepressant effects, as least in a subset of clients.

Comparable studies

Other cross-sectional and survey studies on psilocybin for depression, most cited first.

Study Year Design Participants
Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non-microdosers Self-selected microdosers and non-microdosers recruited via a mobile application 2021 Cross-sectional survey n = 8,703
Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being: Associations With Patterns of Use, Reported Harms, and Transformative Mental States. Adults with at least one lifetime psychedelic experience 2022 Cross-sectional survey n = 2,510
Attitudes toward psychedelics and psychedelic-assisted therapy among potential mental health service users and the general population in Australia. Australians, including individuals with and without self-identified mental illness 2024 Cross-sectional survey n = 502
Psychedelic Use Among Psychiatric Medication Prescribers: Effects on Well-Being, Depression, Anxiety, and Associations with Patterns of Use, Reported Harms, and Transformative Mental States. Healthcare providers who treat psychiatric disorders with medications and have at least... 2023 Secondary analysis of a cross-sectional online survey n = 228
Characteristics and mental health of psychedelic mushroom and multi-psychedelic users relative to non-psychedelic users in American adults, 2020-2021. American adults 2025 Cross-sectional survey n = 6,869

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Psilocybin Depression Psychedelic-assisted therapy

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Psilocybin for depression