Common factors in altered states: Understanding psychedelic therapy through the lens of Grawe's general change mechanisms.
Max Wolff, Hans Rutrecht, Lea J. Mertens, Andy Meijer, Jessica Beck, Sergio Pérez, Gerhard Gründer, Isabel Dziobek, Henrik Jungaberle
Psychological Review November 1, 2025 DOI: 10.1037/rev0000589 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Psychedelic-assisted therapy |
| Key points | Argues that the efficacy of psychedelic therapy is mediated by five general change mechanisms common to all effective psychotherapies. |
Abstract
Psychedelic therapy is commonly understood as a form of psychotherapy. However, despite promising results from clinical trials, scientific progress has been hindered by a lack of theoretical integration between the fields of psychedelic and psychotherapy research. This article seeks to bridge this divide by outlining a transtheoretical understanding of psychedelic-occasioned psychological change based on Klaus Grawe's model of general change mechanisms-an empirically grounded framework of psychotherapeutic "common factors" that emphasizes therapeutic experiences and change processes. Drawing on extensive evidence from psychedelic research, we argue that the efficacy of psychedelic therapy is ultimately mediated by the same five general change mechanisms that underlie all effective psychotherapies: (1) resource activation, (2) therapeutic relationship, (3) problem actuation, (4) clarification, and (5) mastery. Implications for clinical practice, training, and future research are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Comparable studies
Other theoretical and historical papers on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. | 2024 | Theoretical or philosophical paper | |
| Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance | 2020 | Theoretical or philosophical paper | |
| Awe: a putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy | 2018 | Theoretical or philosophical paper | |
| Ethical and legal issues in psychedelic harm reduction and integration therapy | 2021 | Theoretical or philosophical paper | |
| Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations. | 2022 | Theoretical or philosophical paper |
Citations in the library
Cited by 11
- Psychological Therapy Quantity and Depressive Symptom Reduction in Psychedelic-Assisted Therapy: A Systematic Review and Meta-Analysis. JAMA Network Open January 2, 2026
- Efficacy and safety of psilocybin-assisted therapy for alcohol use disorder: A systematic review and meta-analysis Journal of Psychopharmacology October 8, 2026
- Retreat from Racism: A Psychedelic Group Experience for Racial Stress and Trauma Psychedelics July 1, 2026
- Strong Alliance, Weak Conclusions: Comment on Goodwin et al. (2026) “The Role of Therapeutic Alliance in Psilocybin Treatment for Treatment-Resistant Depression” Psychedelic Medicine June 16, 2026
- Changes in anxiety, quality of life, and functioning following psilocybin-assisted therapy in veterans with treatment-resistant depression. Journal of Affective Disorders June 4, 2026
and 6 more in the library