A qualitative analysis of participant expectations and experiences of psilocybin‐assisted psychotherapy for methamphetamine use disorder
Jonathan Brett, Toby Lea, Elizabeth Knock, Steven M. Albert, Liam Acheson, Krista J. Siefried, Sebastian Job
Addiction December 22, 2025 DOI: 10.1111/add.70284 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Pilot study Peer reviewed |
|---|---|
| Sample size | 12 |
| Population | People enrolled in an open-label pilot study of psilocybin-assisted psychotherapy for methamphetamine use disorder in an outpatient stimulant treatment program in Sydney, Australia |
| Duration | Interviews before starting PAT and again one month following PAT |
| Topics | Psilocybin Psychedelic-assisted therapy |
| Keywords | Qualitative research Qualitative analysis Interpersonal communication Focus group Psychotherapist Clinical psychology Interpersonal psychotherapy Interpersonal relationship Stimulant Narrative inquiry Content analysis |
| Key findings | Participants perceived psilocybin-assisted psychotherapy as acceptable, and transformation in self-understanding and reduced salience of methamphetamine use often occurred through confronting psychic obstacles with high levels of therapeutic support. |
Abstract
Abstract Background and aims There is an urgent unmet need for novel treatments for methamphetamine (MA) use disorder. We explored the qualitative experiences of people participating in a study of psilocybin‐assisted psychotherapy (PAT) to treat MA use disorder. Design and setting Qualitative study of participants enrolled in a single arm, open‐label pilot study of PAT for MA use disorder delivered in an outpatient stimulant treatment program setting in Sydney, Australia.
Participants: Twelve participants were interviewed before starting PAT and then again one month following PAT.
Measurements: Pre‐PAT interviews explored participants' experiences of MA use and expectations of receiving PAT. Post‐PAT interviews explored participants' experiences of PAT, with a focus on phenomena related to the acute subjective effects of psilocybin, the perceived effects of PAT on MA use, self‐perception, beliefs, values, behaviours, interpersonal relationships and spirituality, and acceptability of the intervention. Interviews were audio recorded, transcribed verbatim and analysed using an inductive qualitative approach.
Findings: While participants generally hoped to have positive outcomes from study participation, their expectations were generally tempered and realistic. Their trial experiences of PAT were often characterised by new understandings of themselves, their narrative histories and interpersonal relationships, all of which were frequently prompted by leaning into vividly presented challenging experiences within the psychedelic experience. This volitional attitude of ‘leaning into the obstacle’ emerged as a key theme, meriting exploration for its potential to expose the subjective dimension of the psychedelic mechanism of effect. Resolution of this obstacle was associated with a reduction in the salience of methamphetamine. Therapeutic alliance was seen as critical to positive outcomes and was achieved through high levels of concentrated therapeutic attention and intersubjective intimacy between participant and therapist.
Conclusions: Interviewed participants in a study of psilocybin‐assisted psychotherapy (PAT) for methamphetamine use disorder perceived PAT as an acceptable intervention. Transformation in understandings of self and interpersonal relationships and subsequent reduced salience of methamphetamine use often occurred through confronting psychic obstacles in the context of high levels of therapeutic support from study therapists.