Ethical Complexities and Best Practices in Informed Consent Processes for Psilocybin Services: A Qualitative Study
Christina Chwyl, Alissa Bazinet, Adrianne R Wilson-Poe, Kim Hoffman, Kellie Pertl, R. Cameron Wolf, Philip Todd Korthuis, Jason B. Luoma
Neuroethics May 13, 2026 DOI: 10.1007/s12152-026-09645-5 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 36 |
| Population | Psilocybin content experts and providers in clinical trial, underground, or ceremonial settings |
| Topics | Psilocybin |
| Keywords | Best practice Qualitative research Informed consent Neuropsychology Ethical issues Medline Psychotherapist Medical education Engineering ethics |
| Key findings | Informed consent in psilocybin services should be an ongoing process emphasizing therapeutic relationship, client empowerment, comprehensive risk-benefit disclosure, explicit boundaries around touch, and provider training in relational skills. |
Abstract
Informed consent in psychedelic-assisted services is ethically complex, difficult to implement, and remains largely unstudied and unstandardized. The current study sought expert recommendations on informed consent challenges, best practices and recommendations for supervised psilocybin experiences across various settings. Participants with psilocybin content expertise and psilocybin providers were recruited with purposive sampling. Qualitative interviews on informed consent best practices and recommendations were analyzed using Thematic Analysis. Participants (N = 36; 71% white; 53% female) reported providing psilocybin services (64%) for a mean of 15.2 (SD = 13.1) years in clinical trial, underground, or ceremonial settings. Participants viewed informed consent as a process (Theme 1), necessitating a strong therapeutic relationship, centering client empowerment, and occurring as an ongoing process. Potential risks and benefits should be comprehensively conveyed (Theme 2), including potential long-term psychological and social changes from psychedelic use, and the potential for disappointing experiences. Participants specifically recommended detailed consent processes around touch and boundaries (Theme 3), including explicitly establishing boundaries prior to psychedelic administration, maintaining those boundaries throughout, and recognizing subtle non-verbal cues that may indicate lack of true consent. For provider training (Theme 4), participants emphasized cultivating a deep respect for client agency, and experientially learning relational and boundary setting skills. Findings may inform provider training programs, consent practices in varied psychedelic service settings, and improved safety practices.
Comparable studies
Other qualitative studies on psilocybin, 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 |
| 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 |
| Response of cluster headache to psilocybin and LSD Cluster headache patients who used psilocybin or LSD | 2006 | Qualitative study | n = 53 |
| Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress Adult participants with clinically elevated anxiety associated with a cancer diagnosis | 2017 | Qualitative study using interpretative phenomenological analysis | n = 13 |
Citations in the library
Cited by 2
Cites 23
- Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects. Psychopharmacology December 1, 2011
- Towards an understanding of psychedelic-induced neuroplasticity. Neuropsychopharmacology 2023
- Psychedelics alter metaphysical beliefs. Scientific Reports November 23, 2021
- Ethics and ego dissolution: the case of psilocybin Journal of Medical Ethics May 27, 2020
- Pattern breaking: a complex systems approach to psychedelic medicine Neuroscience of Consciousness 2023
and 18 more in the library