Set and setting in psilocybin-assisted therapy: A qualitative study of patients with cancer and depression.
Yvan Beaussant, Elise C. Tarbi, Kabir Nigam, Skye A. Miner, Zachary Sager, Justin J. Sanders, Michael Ljuslin, Benjamin Guérin, Roxanne Sholevar, Kimberly Roddy, James A. Tulsky, Manish Agrawal
General Hospital Psychiatry 2025 DOI: 10.1016/j.genhosppsych.2025.10.010 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Peer reviewed |
|---|---|
| Sample size | 28 |
| Population | Patients with cancer and depression |
| Intervention | Psilocybin-assisted therapy |
| Topics | Depression End-of-life distress Psilocybin |
| Keywords | Cancer Psilocybin-assisted therapy |
| Citations | 3 |
| Key findings | The acceptability of psilocybin-assisted therapy for patients with cancer and depression depends on their ability to surrender to the intense experience, supported by a safe and ethical therapeutic environment, preparation, and integration. |
Abstract
Psilocybin-assisted therapy (PAT) shows promise for cancer-related depression, yet little research has examined how therapeutic context shapes patient experiences. While set (mindset) and setting (environment) are considered central to psychedelic treatment, empirical evidence on their role in PAT acceptability remains limited. This study explores factors influencing the acceptability of PAT from the perspective of patients with cancer and depression. We conducted semi-structured interviews with participants in a clinical trial of psilocybin-assisted therapy. Using template analysis, we examined themes related to the acceptability of the experience and the surrounding therapeutic environment. Participants (n = 28) described the psilocybin experience as intense and demanding, with therapeutic benefits closely tied to their ability to "surrender"-a term used to describe accepting and remaining open to the experience's intensity and unpredictability. A safe, supportive, and ethical environment was critical in fostering trust and engagement. Preparation and integration were key to maximizing benefit. Music played a significant but variable role, sometimes enhancing and other times distracting. While the clinical setting provided safety, ceremonial elements added meaning for many. Findings highlight how therapeutic structure, preparation, and setting shape PAT acceptability, supporting the need for patient-centered approaches to optimize care and outcomes.
Comparable studies
Other qualitative studies on psilocybin for end-of-life distress, most cited first.
Citations in the library
Cites 30
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
- REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics Pharmacological Reviews June 20, 2019
- Constructing drug effects: A history of set and setting Drug Science, Policy and Law 2017
- Predicting Responses to Psychedelics: A Prospective Study Frontiers in Pharmacology November 2, 2018
- Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory. Journal of Psychopharmacology July 11, 2019
and 25 more in the library