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Synergies in psychedelic-assisted therapy: a qualitative interview study of psychotherapeutic processes

Jonathan Stellmacher, Christopher Schmidt, Helena Aicher, Kae Eichel, Eva‐lotta Brakemeier, Uwe Herwig

Frontiers in Psychiatry April 1, 2026 DOI: 10.3389/fpsyt.2026.1771726 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Qualitative study Peer reviewed
Sample size 7
Population Swiss therapists providing psychedelic-assisted therapy
Intervention Psychedelic-assisted therapy
Topics Psychedelic-assisted therapy
Keywords Theme computing Thematic analysis Therapeutic relationship Qualitative research Therapeutic modalities Psychotherapist Action physics Clinical practice Clinical psychology Therapeutic approach
Key findings Psychedelics act as unspecific catalysts for psychotherapeutic processes, amplifying general therapeutic factors such as trust and profundity, while psychotherapeutic techniques in PAT retain similarities to non-psychedelic practices.

Abstract

Research on the therapeutic effects of psychedelics in psychiatry, commonly referred to as Psychedelic-Assisted Therapy (PAT), has expanded substantially in recent years. The context-dependent nature of psychedelics has sparked discussion about the importance of the psychotherapeutic environment in achieving beneficial outcomes. This study explores the contribution of psychotherapeutic factors on PAT in Switzerland, where psychedelic treatments can be implemented within long-term clinical frameworks. Seven semi-structured interviews were conducted with Swiss therapists to explore how they frame psychedelic treatments and the role of the psychotherapeutic setting in facilitating therapeutic outcomes. Thereby, individual experiences of the patients as reported by the therapists, were particularly considered. Thematic analysis identified two main themes, each with several sub-themes. The first theme revealed that while psychotherapeutic techniques are adapted to PAT, they retain similarities to non-psychedelic psychotherapy practices, supporting patients in having meaningful therapeutic experiences. The second theme describes a synergistic relationship between psychedelics and psychotherapy, amplifying underlying general psychotherapeutic factors such as trust, a sense of profundity, and the emergence of therapeutic experiences. The interviewed therapists agreed that psychedelics work as unspecific catalysts for psychotherapeutic processes, while still acknowledging the potential for psychopharmacological effects or the interaction between psychedelics and psychotherapy to create unique psychotherapeutic processes. Findings from our sample suggest that, for specific indications, incorporating psychedelics into long-term psychotherapeutic treatment may strengthen therapeutic processes. Future research could investigate the efficacy of PAT within the framework of specific psychotherapeutic modalities or in different settings, including prospective quantitative assessments of outcomes. Ultimately, clarifying mechanisms of action of PAT may help to enhance its efficacy and potentially to integrate psychedelic treatments into mainstream mental health care.

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

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