Psychological Support in Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder: A Scoping Review Protocol

Abstract

Alcohol use disorder (AUD) is a prevalent and chronic psychiatric condition characterized by impaired control over alcohol use, compulsive consumption, and high rates of relapse (Grant et al., 2015; Kurihara, 2023). Despite the availability of pharmacological and psychosocial interventions, treatment outcomes remain suboptimal, with substantial rates of non-response and relapse (Lohoff, 2022; Nguyen et al., 2020). Psilocybin-assisted psychotherapy (PAP) has emerged as a promising intervention for AUD, with early clinical trials demonstrating reductions in heavy drinking and improvements in psychosocial functioning (Piper et al., 2025). PAP is typically delivered within a structured therapeutic model consisting of preparation, dosing, and integration phases, within which psychological support is considered essential to both safety and therapeutic change (Barber & Aaronson, 2022; Brennan & Belser, 2022). Psychological support in PAP aims to promote safety, facilitate meaning-making, and foster lasting therapeutic change (Brennan & Belser, 2022). However, the field lacks conceptual clarity regarding how psychological support is defined, differentiated, and operationalized across studies (Bender et al., 2025). Terms such as “psychological support,” “psychotherapy,” “counselling,” and “monitoring” are often used interchangeably, contributing to inconsistency in reporting and interpretation (Brennan, Kelman, and Belser, 2023). In this review, psychological support is conceptualized using two complementary frameworks. The Preparation–Support–Integration (PSI) model provides a temporal structure for therapeutic processes across treatment phases (Carhart-Harris et al., 2018). The microskills framework further differentiates levels of intervention, including Level 2 (listening), Level 3 (interviewing), and Level 4 (influencing/psychotherapy) skills (Richard & Levine, 2025). Integrating these frameworks allows for a structured examination of both when and how psychological support is delivered within PAP. Although PAP has demonstrated promising outcomes for AUD, most studies have focused on safety and efficacy, with limited and inconsistent reporting of the psychological support provided. As a result, it remains unclear how psychological support is structured across studies, what specific therapeutic processes are implemented, and how these components are described alongside reported outcomes. Existing variability in terminology, reporting practices, and intervention detail limits the ability to compare studies, identify patterns, and understand the role of psychological support within PAP protocols. This represents a critical gap, particularly as psychological support is consistently acknowledged as vital to both patient safety and sustained therapeutic change (Brennan et al., 2023; Richard & Levine, 2025; Bender et al., 2025). References: Grant, B. 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