Psychotherapy as an Indispensable Component of Real-World Psychedelic-Assisted Therapy in Switzerland: A Qualitative Interview Study With Patients
Eva Gallacher, Maria Arnold, Uwe Herwig, Helena Aicher
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study |
|---|---|
| Sample size | 16 |
| Population | Patients treated under the Swiss Limited Medical Use regulation who had received at least two doses of LSD or psilocybin (MDMA sessions analyzed but not counted toward eligibility); eight female, eight male, aged 29–71 |
| Interventions | LSD Psilocybin MDMA Psychotherapy |
| Duration | Two to 27 dosing sessions over six months to five years; interviews conducted December 2024–April 2025 |
| Topics | Psychedelic-assisted therapy |
| Key findings | Participants described psychotherapy as an interpersonal, indispensable component of psychedelic-assisted therapy that operated synergistically with the substance. Four themes were generated: the substance as catalyst rather than singular cause of change; the therapist and frame as a holding container for safety and meaning-making; the group as a source of connection, normalization, and potential overwhelm; and lasting psychotherapeutic benefits including new skills, agency, and personally meaningful values. |
Abstract
Background: The role, necessity, and relevance of psychotherapy within psychedelic-assisted therapy (PAT) remain contested: some view it principally as safety support, whereas others regard it as essential to safety and efficacy. Patient-centred evidence on how psychotherapy is experienced within real-world PAT is scarce. We examined how patients understood the role of psychotherapy in their treatment.
Methods: We conducted semi-structured interviews with patients treated under the Swiss Limited Medical Use regulation. Participants had received at least two doses of lysergic acid diethylamide (LSD) or psilocybin; 3,4-methylenedioxymethamphetamine (MDMA) sessions were analysed but did not count toward eligibility. Interviews (December 2024–April 2025) were analysed using reflexive thematic analysis.
Findings: The 16 interviewed participants (eight female, eight male; aged 29–71) had undergone two to 27 dosing sessions over six months to five years. Four themes were generated: the substance as catalyst rather than singular cause of change; the therapist and frame as a holding container for safety and meaning-making; the group as a source of connection, normalisation, but also potential overwhelm; and lasting psychotherapeutic treasures, including new skills, agency, and personally meaningful values.
Interpretation: Participants experienced psychotherapy as an interpersonal, indispensable component of PAT, operating synergistically with the substance. Findings support structurally integrating psychotherapy into PAT design, training, and regulation; group settings may represent a distinct therapeutic factor.
Comparable studies
Other qualitative studies on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression Patients with treatment-resistant depression enrolled in an open-label trial of psilocybin | 2017 | Qualitative study | n = 20 |
| LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects Patients with anxiety associated with life-threatening diseases | 2014 | Prospective follow-up with qualitative content analysis | n = 10 |
| Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis Adults aged 22 to 69 with clinically elevated anxiety associated with a cancer diagnosis | 2017 | Qualitative study | n = 13 |
| Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts Participants who completed a psilocybin-facilitated smoking cessation pilot study | 2018 | Qualitative follow-up study using semi-structured interviews and thematic analysis | n = 12 |
| The hidden therapist: evidence for a central role of music in psychedelic therapy Patients undergoing psychedelic therapy with psilocybin for treatment-resistant depression | 2018 | Qualitative study | n = 19 |