Beyond neuroplasticity: Mapping the therapist variable in psychedelic-assisted therapy literature

Abstract

Recent research into psychedelic-assisted psychotherapy has largely emphasised pharmacological mechanism such as neuroplasticity and symptom reduction, with less attention to the relational processes through which therapeutic change is supported and integrated. Given that such experiences are central to therapeutic change, this introduces a significant limitation: variability in therapist factors and relational dynamics remains difficult to operationalise, replicate and evaluate, thereby constraining the ability to identify mechanisms of change, standardise training and advance the field. This project will explore how the therapist variable and relational processes are conceptualised within psychedelic-assisted therapy literature. Alongside implicating research rigour, the lack of clarity described makes it difficult to determine how therapy contributes to subjective experience and which therapist qualities or relational factors are important for therapeutic outcomes. Without a well-defined, clearly theorised therapeutic component, it is difficult to understand mechanisms that support therapeutic benefit, which limits wider implementation. In identifying gaps in how therapist roles and relational processes are conceptualised, this project aims to support both improved therapeutic practice and the development of treatments that meet regulatory standards for safety, consistency and effectiveness. Additionally, findings my help inform areas of future research and support development of more coherent, evidence-based training approaches in order to deliver replicable treatment safely and consistently.