Therapists’ Perspectives on the Psychotherapeutic Support in Psilocybin Treatment for Major Depressive Disorder: Insights from a Randomized Controlled Trial
Anette Kjellgren, Johan Lundberg, Hampus Yngwe, Carl Johan Ekman, Mikael Tiger, Tomas Ljunglöf, Frida Stridh, Maria Beckman
Research Square October 5, 2026 preprint DOI: 10.21203/rs.3.rs-10879308/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study Randomized Placebo-controlled Double-blind |
|---|---|
| Sample size | 9 |
| Population | Therapists providing psychotherapeutic support during a randomized, double-blind, placebo-controlled phase II psilocybin trial for major depressive disorder |
| Intervention | Psilocybin |
| Topics | Depression Psilocybin |
| Key findings | Therapists described psilocybin treatment as beneficial for psychotherapy and the psychedelic experience as facilitating therapeutic processes, and they reported using specialized psychotherapeutic skills during sessions. The authors note that current research has yet to determine whether psychotherapeutic support is an essential component of psilocybin treatment and call for future research to clarify its role and optimal structure. |
Abstract
Abstract Psilocybin treatment has emerged as a promising intervention for Major Depressive Disorder (MDD). However, the contribution of psychotherapeutic support to treatment outcomes remains unclear. This study explored therapists' descriptions of their work during a randomized, double-blind, placebo-controlled psilocybin treatment phase II trial for MDD. Nine therapists participated in semi-structured interviews focusing on (a) specific psychotherapeutic activity, (b) treatment structure and content, and (c) treatment active components and outcome. Data were analyzed using thematic analysis. The analysis resulted in four themes. The first involves the therapists’ reflections on the role of the psychotherapeutic support. The second includes their functions and specific approaches and techniques used. The third describes how the therapists experienced providing psychotherapeutic support within a clinical trial. The final theme describes various aspects of the therapists’ experiences with the double-blind study design. Therapists considered psilocybin treatment beneficial for psychotherapy and described the psychedelic experience as facilitating therapeutic processes. They also described how they used specialized psychotherapeutic skills during sessions. Current research has yet to determine whether psychotherapeutic support is an essential component of psilocybin treatments. Future research should clarify the role and optimal structure of psychotherapeutic support.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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State of the evidence: Depression Supports
Therapists described psilocybin treatment as beneficial for psychotherapy and the psychedelic experience as facilitating therapeutic processes, while noting it remains undetermined whether psychotherapeutic support is essential.
Synthesized
Comparable studies
Other qualitative studies on psilocybin for depression, most cited first.
Citations in the library
Cites 23
- Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Journal of Humanistic Psychology June 19, 2017
- The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects. ACS Pharmacology & Translational Science December 10, 2020
- The Subjective Effects of Psychedelics May Not Be Necessary for Their Enduring Therapeutic Effects ACS Pharmacology & Translational Science December 10, 2020
- Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis Journal of Humanistic Psychology April 28, 2017
- Developing Guidelines and Competencies for the Training of Psychedelic Therapists Journal of Humanistic Psychology June 29, 2017
and 18 more in the library