How to make psychedelic-assisted therapy safer
Cambridge Quarterly of Healthcare Ethics September 27, 2024 DOI: 10.1017/s0963180124000604 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Psychedelic-assisted therapy |
| Keywords | Psychedelics Entheogenic therapy Psychedelic medicine Patient safety Patient protection Therapeutic safety Risk mitigation Harm reduction Safeguards Well-being Therapeutic support Patient support Clinical support Session support Companion support Caregiving Patient autonomy Ethical considerations Patient rights Self-determination |
| Citations | 10 |
| Key points | Argues that bringing a close person to the psychedelic session is a highly effective and feasible safety measure overlooked in the literature. |
Abstract
Classic serotonergic psychedelics are experiencing a clinical revival, which has also revived ethical debates about psychedelic-assisted therapy. A particular issue here is how to prepare and protect patients from the vulnerability that the psychedelic state creates. This paper first examines how this vulnerability manifests itself, revealing that it results from an impairment of autonomy: psychedelics diminish decision-making capacity, reduce controllability, and limit resistance to external influences. It then analyzes the strengths and weaknesses of five safety measures proposed in the literature, what aspect of the patient’s vulnerability they seek to reduce, and how they can be optimized. The analysis shows that while preparatory sessions, advance directives, and specific training and oversight are useful, starting with a lower dosage and no therapy is less so. Finally, the paper presents a safety measure that has been overlooked in the literature but could be highly effective and feasible: bringing a close person to the psychedelic session
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 12
- Ethical issues with psychedelic-assisted treatments in psychiatry: A systematic scoping review Psychological Medicine 2025
- Same Same but Different: On Psychedelic Exceptionalism The American Journal of Bioethics 2025
- Clinical psychedelic research in adolescents: a scoping review and overview of ethical considerations The Lancet Child & Adolescent Health September 2, 2025
- Patient-therapist relationship in psychedelic-assisted therapy: Implications for future real-world settings. General Hospital Psychiatry June 6, 2025
- What motivates spiritual health practitioners in psychedelic-assisted therapy? A qualitative study and implications for facilitator training practices Psychedelics April 29, 2025
and 7 more in the library
Cites 33
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics Pharmacological Reviews June 20, 2019
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Psychedelics and the essential importance of context. Journal of Psychopharmacology February 15, 2018
- Single-Dose Psilocybin Treatment for Major Depressive Disorder JAMA August 31, 2023
and 28 more in the library