Integration in classic psychedelic-assisted therapies for mental health conditions: a scoping review

Psychedelic integration—the process of making sense of and incorporating a psychedelic experience into daily life—is a core component of psychedelic-assisted therapy but is poorly defined and reported in clinical research. A scoping review of 44 articles (30 clinical trials, 8 protocols, 6 manuals) found psilocybin was the most studied classic psychedelic. Among trials reporting integration, 1–4 sessions were provided per dose (median 2), each lasting 1–3 hours (median 1.5). The first session typically occurred 24–48 hours post-dose, with a second about a week later. Reporting of session content, therapeutic conduct, and facilitator training was minimal, especially outside psilocybin trials. The authors argue that standardized, transparent reporting is needed to improve safety and enable cross-trial comparisons.

Study at a glance

Abstract

Background Integration — the ongoing process of revisiting, making sense of, and incorporating the content of a psychedelic experience into daily life — is a core component of psychedelic-assisted therapy (PAT), but is variably operationalised and poorly reported in clinical research. Objective To map how integration is described, delivered, and reported in clinical studies of classic psychedelics and to identify common practices and research gaps. Methods A PRISMA-ScR scoping review was conducted searching PubMed, Scopus, and CENTRAL for English-language studies between 1990 and January 2025. Data was extracted on integration session structure (number, timing, duration), therapeutic frame, and facilitator training and conduct. Results Forty-four articles met inclusion, comprising 30 clinical trials, eight prospective trial protocols, and six therapeutic manuals. Psilocybin was the most studied classic psychedelic (k = 37 publications). In clinical trials that reported integration (k = 24), 1-4 integration sessions were provided per dose (median = 2); reported session duration was between 1-3hrs (median = 1.5hrs). Typically, clinical trials provided an initial integration session 24-48hrs post-dose and a second session approximately 1 week later. Reporting of integration content, therapeutic conduct, and facilitator training was minimal, particularly outside psilocybin-assisted therapy trials. Conclusion Psychedelic integration is central to PAT, yet its delivery remains vaguely operationalised in clinical research. Future trials should routinely publish comprehensive protocols specifying integration session goals and timing, facilitator roles, therapist qualifications, and fidelity monitoring. Standardised, transparent reporting will improve participant safety and continuity of care, enable cross-trial comparisons, and support safe progression to phase III trials.