Beyond neuroplasticity: Mapping the therapist variable in psychedelic-assisted therapy literature
Alexi Mary Theofanous
Open Mind 2026 preprint DOI: 10.17605/osf.io/ygs2r (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper |
|---|---|
| Topics | Neuroplasticity Psychedelic-assisted therapy |
| Key points | Argues that psychedelic-assisted therapy research underemphasizes relational processes, and that poorly defined therapist roles hinder replication, mechanism identification, training standardization, and regulatory approval. |
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.
Comparable studies
Other theoretical and historical papers on neuroplasticity, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A Dendrite-Focused Framework for Understanding the Actions of Ketamine and Psychedelics | 2020 | Theoretical or philosophical paper | |
| Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential? | 2021 | Theoretical or philosophical paper | |
| A complex systems perspective on psychedelic brain action. | 2023 | Theoretical or philosophical paper | |
| Critical Period Plasticity as a Framework for Psychedelic-Assisted Psychotherapy | 2021 | Theoretical or philosophical paper | |
| Therapeutic mechanisms of psychedelics and entactogens. | 2023 | Theoretical or philosophical paper |