Psychedelic-Assisted Psychotherapy

The following article on psychedelic-assisted psychotherapy is by guest contributor Olivia Horge.

Enthusiastic research into the use of psychedelics in therapy began in the 1940s. Triggered by Albert Hoffman’s discovery of lysergic acid diethylamide (LSD) and its mind altering properties, research began to explore if psychiatry could make use of the substance in treating mental illness (Richards, 2017). Over the centuries, humans have used a multitude of entheogens, such as ayahuasca and peyote, to induce periods of altered state of consciousness for sacred ceremonies and spiritual growth. As research into these psychoactive substances began, the field of psychedelic-assisted psychotherapy developed. In the 1950s, Humphry Osmond and Aldous Huxley conducted experiments that blended science and humanism which ultimately shifted approaches to defining and treating mental illnesses (Dyck & Farrell, 2018). Together, they discovered that the “psychedelic reaction created a period of reflection, or insight, which allowed one to gain perspective on one’s self” (Dyck & Farrell, 2018, p. 249). The motivation behind the creation of this approach was to use psychedelic drugs as catalysts deepening one’s understanding of themselves and their struggles by opening the doors into the unconscious.

Currently, research is still taking place to explore how psychedelic-assisted therapy can be used to help individuals improve their lives. The results have been promising so far. Methylenedioxymethamphetamine (MDMA) has been used to aid in the recovery of those suffering from post-traumatic stress disorder. LSD and psilocybin can be used in the treatment of substance addictions, major depressive disorders and end-of-life distress (Richards, 2017).

Major Assumptions

When considering the nature of change, psychedelics have the potential to catalyze transformative paradigm shifts for the individual. The psychedelic substance aids in expanding one’s perception of the world and their place within it. The mind-altering trip brings unconscious material to the surface. Addiction therapy breakthroughs consider the recovery to be due to individuals gaining a broader collective mindset, to “see beyond themselves” (p. 252), which aids them in altering their unhealthy patterns of behaviour that affect themselves and their close relationships (Dyck & Farrell, 2018). Clients were able to look at themselves in a new light which also gave them a different lens in which to consider their actions. It induces an empathetic, reflective and open state of mind that is sustained for long periods of time after the experience. The majority of participants in MDMA research view the experience of one of the most profound, personally meaningful and healing experiences of their lives (Pixler, 2017).

Psychedelic experiences also altered the relationship between therapist and client. As therapists usually undergo the psychedelic experience prior to guiding their clients through it, it enhances their ability to empathize and support the client (Dyck & Farrell, 2018). With a knowledgeable and skilled counselor, the therapy is more likely to be a successful process.

Role of the Counselor

During the sessions involving the use of psychedelic substances, the role of the therapist is three-fold. When facilitating the psychedelic experience, the counselor is continuously playing the role of sitter, guide and therapist (Phelps, 2017). As a sitter, the counselor must have a broad understanding of how the drug could affect the client and be able to help the client through any potential feelings of anxiety or paranoia. As a guide, the counselor uses their skills to help the client navigate the experience and inform them about the direction of the trip. As therapist, the role is to show empathy and use techniques that help the client reach insights on themselves and their lived reality. Six competencies have been outlined by Phelps as necessary for success in this approach; “empathetic abiding presence, trust enhancement, spiritual intelligence, knowledge of the physical and psychological effect of psychedelics, therapist self-awareness and ethical integrity, and proficiency in complementary techniques” (2017, p. 460). While the psychedelic substance facilitates the process of uncovering one’s truth, the therapeutic relationship is the supporting factor that makes this approach effective.

Major Techniques

There are three phases of therapy in this approach. First, the counselor must prepare the client for the psychedelic-assisted session which, in this context, is often referred to as “set and setting” (Phelps, 2017, p. 460). Set involves outlining the client’s expectations, motivations and intentions, the therapist’s techniques and understanding of the psychedelic experience, and the mutually agreed-upon goals. Setting refers to the environment in which the sessions take place and the interpersonal relationship between the counselor and client. A trusting relationship needs to be established between the individuals with a mutual understanding of goals. Once the client is ready, the psychedelic experience takes place. Lastly, the counselor aids the client in integrating their revealed insights during subsequent therapy sessions. Further exploration is often needed to uncover the full effect of the trip. The counselor’s approach and relationship with the client are crucial as they navigate this new ground and reach for desired outcomes (Richards, 2017).

Psychedelic experiences are complex phenomenons. The manner in which it is taken as well as set and setting greatly influence whether the experience will be life-enhancing, damaging or ineffective. By exploring their lives in a mind-altering state, individuals can encounter their consciousness in new ways. With the help of a counselor in the therapy sessions, this approach has the potential for enormous breakthroughs in treating mental illness as well as opening anyone’s mind to reshaping their perspectives on life and their interpersonal connections.


Dyck, E. & Farrell, P. (2018). Psychedelics and psychotherapy in Canada: Humphry Osmond and Aldous Huxley. History of psychology, 21(3), 240-253.
Phelps, J. (2017) Developing guidelines and competencies for the training of psychedelic therapists. Journal of humanistic psychology, 57(5), 450-487.
Pixler, L. (2017). Psychedelic movement: Healing trauma through MDMA-assisted authentic movement psychotherapy. Journal of transpersonal psychology, 49(2), 121-135.
Richards, W. A. (2017). Psychedelic psychotherapy: Insights from 25 years of research. Journal of humanistic psychology, 57(4), 323-337.

Olivia Horge is a social innovation practitioner who supports individuals and teams to connect with their purpose and strategically address complex issues. Inspired by human-centred change, she designs emergent processes that foster authenticity, build community and harness collective energy for a more creative, collaborative and conscious world.