Systematic review · 2026
How cognitive behavioural therapy is combined with psychedelics: a review of 9 trials
- Original title
- Mapping cognitive-behavioral approach in psychedelic-assisted treatment: a systematic review across phases with classic and non-classic psychedelics.
- Authors
- Varela YM, de O Tavares VD, Delgado LM, et al.
- Journal
- European archives of psychiatry and clinical neuroscience, 2026
- Molecules
- Ketamine, Psilocybin, MDMA
- Conditions
- Other
- Participants
- 283
- Evidence grade
- Low
- Source
- Read the original paper
The question
Do clinical trials of psychedelic-assisted therapy actually use cognitive-behavioural methods, and if so, when and how are they delivered?
What they did
The authors searched four research databases (Embase, PsycArticles, PubMed and Web of Science) for studies published up to May 2025, following PRISMA reporting standards. They included 9 clinical trials with a combined total of 283 patients. The trials used ketamine (5 studies), psilocybin (3 studies) and MDMA (1 study). The authors then catalogued which type of cognitive-behavioural therapy was used and at what point in treatment it was delivered.
What they found
Traditional cognitive behavioural therapy, which focuses on changing unhelpful thought and behaviour patterns, was the most common approach (6 studies). Mindfulness-Based Cognitive Therapy was used in 2 studies and Acceptance and Commitment Therapy in 1. The timing varied widely: therapy was given before, during or after the drug session, sometimes with support during the session and sometimes without. The authors concluded that practice is highly heterogeneous across studies, making it hard to compare them.
The fine print
This is a review of how therapy was structured, not a pooled analysis of whether patients got better, so it reports no effectiveness numbers. Only nine trials and 283 people in total were included, across three different drugs and several different conditions. The abstract does not state which mental health conditions were treated or how the trials were designed and controlled. This summary is based on the abstract alone.
What it means
Psychedelic-assisted treatment is often paired with cognitive-behavioural therapy, but the trials so far do it in very different ways, which makes it difficult to know which parts of the therapy matter.
Evidence grade: Low. A descriptive systematic review of only nine clinical trials with highly varied designs and no pooled statistical analysis of outcomes.
This summary is based on the study’s published abstract.