Meaning-Centered Psychotherapy for Psilocybin-Assisted Therapy Among Patients with Advanced Cancer and Depression: Rationale and Preliminary Evaluation of MCP-PSIL.
William E Rosa, Stephanie Napolitano, Natalie Mcandrew, Betsy Jenkins, Wendy G Lichtenthal, Allison J Applebaum, William Breitbart, Manish Agrawal
Psychedelic medicine (New Rochelle, N.Y.) June 1, 2026 DOI: 10.1177/28314425251363983 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Open-label Peer reviewed |
|---|---|
| Sample size | 13 |
| Population | Patients with cancer and major depressive disorder who received psilocybin-assisted therapy and group meaning-centered psychotherapy, plus their therapists |
| Interventions | Meaning-centered psychotherapy Psilocybin-assisted therapy |
| Topics | Depression Psilocybin Psychedelic-assisted therapy |
| Keywords | Cancer Group therapy Meaning-centered psychotherapy |
| Key findings | Meaning-centered psychotherapy is a natural therapeutic partner to guide patients throughout the psilocybin-assisted therapy continuum, and a 5-session MCP-PSIL model was developed based on participant feedback. |
Abstract
Psilocybin shows encouraging outcomes for patients with cancer and major depressive disorder (MDD). However, there is insufficient evidence on the use of evidence-based psychotherapeutic interventions to consistently guide and standardize psilocybin preparation, dosing, and integration. Meaning-centered psychotherapy (MCP) is a manualized, brief psychotherapeutic intervention that enhances meaning and purpose among recipients. This article substantiates the rationale for using MCP as a psychotherapeutic intervention to accompany psychedelic-assisted therapy (PAT) with psilocybin for patients with cancer and MDD. We sampled seven patients with cancer and MDD who previously received PAT with psilocybin followed by group MCP in a phase 2 open-label trial, as well as six therapists who delivered the interventions. First, electronic open-ended response surveys were distributed to explore participant experiences during the phase 2 trial and elicit recommendations to adapt MCP for psilocybin. Second, the research team developed a 5-session model of MCP and psilocybin therapy (MCP-PSIL) based on survey responses. Finally, four focus groups were conducted (two with patients and two with therapists) to expand on patient experiences during the phase 2 trial and gather feedback on MCP-PSIL. Seven patients (ages 53-80 years) and six therapists (mental health professional experience ranging 9-44 years) participated in both surveys and focus groups. Focus groups underscored the value of experiences related to psilocybin, the group, and MCP, as distinct elements and in conjunction. Participants shared key recommendations to enhance combined psilocybin and MCP experiences and the 5-session MCP-PSIL model. The importance of the group format was also emphasized while noting that individual MCP may be indicated in certain circumstances. Findings suggest that MCP is a natural therapeutic partner to guide patients throughout the PAT continuum. As MCP-PSIL is tested in the future, we anticipate MCP will leverage the PAT experience by building therapist capacity to optimize care while reducing avoidable distress for patients and maximizing their meaning-making opportunities.