Does the "therapy" in psychedelic-assisted therapy trials count as real psychotherapy?

The question

In clinical trials of psilocybin, MDMA and LSD, does the psychological support given alongside the drug actually meet accepted definitions of psychotherapy?

What they did

The authors searched two research databases (PubMed and PsycINFO) in January 2024 for clinical trials of psilocybin, MDMA or LSD that reported any form of psychological support. They screened 224 records, read 52 full-text documents, and included 29 trials covering 449 patients. Each trial’s support was rated against a four-item “common factors” checklist, a standard way of defining what makes something psychotherapy.

What they found

Of the 29 included trials, 69% met all four psychotherapy criteria. Among the 19 trials that described their support as psychotherapy, 84% met all four. Among the 10 trials that did not call their support psychotherapy, 40% still met all four criteria, suggesting therapeutic elements are often present even when they are not labelled as such.

The fine print

This review looked at how trials described their psychological support, not at whether that support improved patient outcomes. Only 29 trials and 449 patients were included, and the search covered two databases up to January 2024. Judging psychotherapy from published trial reports depends on how thoroughly authors wrote up their methods. This summary is based on the abstract only.

What it means

Most psychedelic trials appear to include a genuine psychotherapy component, even when they do not label it that way, which matters for how these treatments would be trained for, regulated and delivered.

Evidence grade: Low. A systematic review that describes and classifies what trials did, rather than pooling outcome data from randomized comparisons.

This summary is based on the study’s published abstract.