{"rows":[{"id":3774,"title":"Altered States, Enhanced Potential: Psychedelics and Physical Performance","normalized_title":"altered states enhanced potential psychedelics and physical performance","authors":"Qarni Z, Richard J.","abstract":"Interest in psychedelics has expanded beyond clinical treatment contexts, yet little empirical work has examined how users describe psychedelic use in relation to sport and physical activity. This study conducted a qualitative content analysis of Reddit discussions involving psychedelics and physical performance. A Reddit search for “sports psychedelics” returned 253 threads. After screening, 39 threads and 290 comments met inclusion criteria. Analysis identified eight content categories: physical performance enhancement; flow state/automaticity; perceptual and cognitive enhancement; risks, limitations, and safety concerns; reduced fatigue/pain perception; microdosing as strategy; psychological and emotional benefits; and fairness, ethics, and governance. Psilocybin mushrooms and LSD were the most frequently mentioned substances. Across accounts, users most often described psychedelics as enhancing performance indirectly through altered attention, increased mind-body connection, flow-like absorption, and reduced pain or fatigue. Some users reported greater perceived strength, speed, endurance, coordination, or overall capability during activity, while others described effortless movement, reduced self-consciousness, sharper perception, and improved focus. Reports were predominantly positive or mixed, with concerns about overexertion, injury risk, impaired judgment, and fairness in competitive settings. These findings suggest that psychedelics may be understood less as traditional performance-enhancing drugs and more as potential-enhancing substances that alter the subjective conditions under which performance occurs. However, because all accounts were self-reported, it remains unclear whether perceived performance gains correspond to measurable physiological or behavioral improvement. Future controlled research using objective performance outcomes is needed to clarify the relationship between psychedelic use, subjective experience, and physical performance.","journal":"PsyArXiv","publication_date":"2026-06-11","publication_year":2026,"doi":"10.31234/osf.io/txgq2_v2","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/txgq2_v2","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:20","last_checked":"2026-07-01 11:22:03","raw_json":"{\"europe_pmc_id\":\"PPR1251202\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Chronic Pain,Consciousness,Microdosing,Emotional Processing,Safety","study_type":"Qualitative Study","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3242,"title":"Altered States, Enhanced Potential: Psychedelics and Physical Performance","normalized_title":"altered states enhanced potential psychedelics and physical performance","authors":"Qarni Z, Richard J.","abstract":"Interest in psychedelics has expanded beyond clinical treatment contexts, yet little empirical work has examined how users describe psychedelic use in relation to sport and physical activity. This study conducted a qualitative content analysis of Reddit discussions involving psychedelics and physical performance. A Reddit search for “sports psychedelics” returned 253 threads. After screening, 39 threads and 290 comments met inclusion criteria. Analysis identified eight content categories: physical performance enhancement; flow state/automaticity; perceptual and cognitive enhancement; risks, limitations, and safety concerns; reduced fatigue/pain perception; microdosing as strategy; psychological and emotional benefits; and fairness, ethics, and governance. Psilocybin mushrooms and LSD were the most frequently mentioned substances. Across accounts, users most often described psychedelics as enhancing performance indirectly through altered attention, increased mind-body connection, flow-like absorption, and reduced pain or fatigue. Some users reported greater perceived strength, speed, endurance, coordination, or overall capability during activity, while others described effortless movement, reduced self-consciousness, sharper perception, and improved focus. Reports were predominantly positive or mixed, with concerns about overexertion, injury risk, impaired judgment, and fairness in competitive settings. These findings suggest that psychedelics may be understood less as traditional performance-enhancing drugs and more as potential-enhancing substances that alter the subjective conditions under which performance occurs. However, because all accounts were self-reported, it remains unclear whether perceived performance gains correspond to measurable physiological or behavioral improvement. Future controlled research using objective performance outcomes is needed to clarify the relationship between psychedelic use, subjective experience, and physical performance.","journal":"PsyArXiv","publication_date":"2026-06-11","publication_year":2026,"doi":"10.31234/osf.io/txgq2_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/txgq2_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:49","last_checked":"2026-07-01 11:22:03","raw_json":"{\"europe_pmc_id\":\"PPR1251240\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Chronic Pain,Consciousness,Microdosing,Emotional Processing,Safety","study_type":"Qualitative Study","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3238,"title":"Altered States, Enhanced Potential: Psychedelics and Physical Performance","normalized_title":"altered states enhanced potential psychedelics and physical performance","authors":"","abstract":"Interest in psychedelics has expanded beyond clinical treatment contexts, yet little empirical work has examined how users describe psychedelic use in relation to sport and physical activity. This study conducted a qualitative content analysis of Reddit discussions involving psychedelics and physical performance. A Reddit search for “sports psychedelics” returned 253 threads. After screening, 39 threads and 290 comments met inclusion criteria. Analysis identified eight content categories: physical performance enhancement; flow state/automaticity; perceptual and cognitive enhancement; risks, limitations, and safety concerns; reduced fatigue/pain perception; microdosing as strategy; psychological and emotional benefits; and fairness, ethics, and governance. Psilocybin mushrooms and LSD were the most frequently mentioned substances. Across accounts, users most often described psychedelics as enhancing performance indirectly through altered attention, increased mind-body connection, flow-like absorption, and reduced pain or fatigue. Some users reported greater perceived strength, speed, endurance, coordination, or overall capability during activity, while others described effortless movement, reduced self-consciousness, sharper perception, and improved focus. Reports were predominantly positive or mixed, with concerns about overexertion, injury risk, impaired judgment, and fairness in competitive settings. These findings suggest that psychedelics may be understood less as traditional performance-enhancing drugs and more as potential-enhancing substances that alter the subjective conditions under which performance occurs. However, because all accounts were self-reported, it remains unclear whether perceived performance gains correspond to measurable physiological or behavioral improvement. Future controlled research using objective performance outcomes is needed to clarify the relationship between psychedelic use, subjective experience, and physical performance.","journal":"PsyArXiv","publication_date":"2026-06-11","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/txgq2_v2","keywords":"exercise, flow state, harm reduction, LSD, microdosing, pain perception, performance-enhancing drugs, physical performance, psilocybin, psychedelics, qualitative content analysis, qualitative research, Reddit, sport psychology, Neuroscience, Social and Behavioral Sciences, Sport Psychology","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:49","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"txgq2_v2\",\"version\":2,\"reviews_state\":\"accepted\"}","topic_tags":"Chronic Pain,Consciousness,Microdosing,Emotional Processing,Safety","study_type":"Qualitative Study","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3768,"title":"Aquahenosis: A non-pharmacological altered state of consciousness induced by Floatation-REST in individuals with anxiety and depression","normalized_title":"aquahenosis a non pharmacological altered state of consciousness induced by floatation rest in individuals with anxiety and depression","authors":"Tobel T, Cone A, Choquette E, Garland M, Johnson M, Mink K, Lynch C, Frohlich J, Feinstein J, Reggente N, Khalsa SS.","abstract":"Floatation-REST (Reduced Environmental Stimulation Therapy) systematically alters sensory and bodily input by combining neutral buoyancy, thermal and proprioceptive neutrality, attenuation of exteroceptive stimulation, and enhancement of cardiorespiratory signaling to the brain. Here we examined whether this non-pharmacological sensory perturbation induces altered states of consciousness and whether specific experiential dimensions are statistically related to changes in affect. In a secondary analysis of a randomized controlled feasibility trial, 75 treatment-seeking adults with anxiety and depression were assigned to six sessions of Floatation-REST with prescribed scheduling, Floatation-REST with preferred scheduling and duration, or a zero-gravity chair comparison condition. Altered states of consciousness were assessed using the 5-Dimensional Altered States of Consciousness Rating Scale, alongside measures of interoceptive awareness and affect. Compared to the chair condition, Floatation-REST was associated with increased interoceptive awareness of cardiorespiratory sensations and an altered state of consciousness characterized by Oceanic Boundlessness, Disembodiment, and Experience of Unity-a pattern we refer to as \"aquahenosis.\" Effects were strongest among participants who selected longer and more flexible float sessions. Experiential profiles selectively overlapped with those reported for psilocybin and ketamine along boundary-dissolution dimensions. These findings identify Floatation-REST as a tractable, non-pharmacological method for inducing specific altered states of consciousness and highlight oceanic boundlessness as an important mediator of the float-induced changes in positive affect.","journal":"PsyArXiv","publication_date":"2026-06-09","publication_year":2026,"doi":"10.31234/osf.io/6mj8n_v2","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/6mj8n_v2","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:19","last_checked":"2026-07-01 11:22:02","raw_json":"{\"europe_pmc_id\":\"PPR1249613\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Depression,Anxiety,Mechanism of Action,Consciousness,Randomized Controlled Trial","study_type":"Randomized Controlled Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3210,"title":"Aquahenosis: A non-pharmacological altered state of consciousness induced by Floatation-REST in individuals with anxiety and depression","normalized_title":"aquahenosis a non pharmacological altered state of consciousness induced by floatation rest in individuals with anxiety and depression","authors":"","abstract":"Floatation-REST (Reduced Environmental Stimulation Therapy) systematically alters sensory and bodily input by combining neutral buoyancy, thermal and proprioceptive neutrality, attenuation of exteroceptive stimulation, and enhancement of cardiorespiratory signaling to the brain. Here we examined whether this non-pharmacological sensory perturbation induces altered states of consciousness and whether specific experiential dimensions are statistically related to changes in affect. In a secondary analysis of a randomized controlled feasibility trial, 75 treatment-seeking adults with anxiety and depression were assigned to six sessions of Floatation-REST with prescribed scheduling, Floatation-REST with preferred scheduling and duration, or a zero-gravity chair comparison condition. Altered states of consciousness were assessed using the 5-Dimensional Altered States of Consciousness Rating Scale, alongside measures of interoceptive awareness and affect. Compared to the chair condition, Floatation-REST was associated with increased interoceptive awareness of cardiorespiratory sensations and an altered state of consciousness characterized by Oceanic Boundlessness, Disembodiment, and Experience of Unity-a pattern we refer to as \"aquahenosis.\" Effects were strongest among participants who selected longer and more flexible float sessions. Experiential profiles selectively overlapped with those reported for psilocybin and ketamine along boundary-dissolution dimensions. These findings identify Floatation-REST as a tractable, non-pharmacological method for inducing specific altered states of consciousness and highlight oceanic boundlessness as an important mediator of the float-induced changes in positive affect.","journal":"PsyArXiv","publication_date":"2026-06-09","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/6mj8n_v2","keywords":"Neuroscience, Social and Behavioral Sciences, Clinical Psychology","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:48","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"6mj8n_v2\",\"version\":2,\"reviews_state\":\"accepted\"}","topic_tags":"Depression,Anxiety,Mechanism of Action,Consciousness,Randomized Controlled Trial","study_type":"Randomized Controlled Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3757,"title":"Serotonergic Psychedelics as a Potential Therapeutic Strategy for Anxiety, A Systematic Review","normalized_title":"serotonergic psychedelics as a potential therapeutic strategy for anxiety a systematic review","authors":"Bralic N, Bragagnolo E, Palner M.","abstract":"Background and objective: Anxiety disorders are among the most prevalent psychiatric disorders worldwide and affect all age groups. Current pharmacological treatments, such as selective serotonergic reuptake inhibitors (SSRI’s) and benzodiazepines, have limitations in terms of adverse effects and efficacy, which highlights the need for alternative therapies. Serotonergic psychedelics have demonstrated promising anxiolytic-like behaviors in preclinical studies, primarily thought to be mediated through agonism of the 5-HT2A receptor. This systematic review aimed to investigate the preclinical evidence of anxiolytic-like potential of serotonergic psychedelics in animal models, and to evaluate the validity and limitations of the included behavioral tests. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A systematic search was conducted in PubMed and Embase. Inclusion and exclusion criteria were defined prior to screening to ensure a transparent inclusion of studies and minimize bias. The title, abstract and full-text screening were conducted independently by two reviewers, with conflicts being resolved through discussion. In total, 18 studies were included after the final screening. Results: Overall, the results demonstrate that serotonergic psychedelics, such as psilocybin and DOI, exerted anxiolytic-like effects across several behavioral tests. However, anxiogenic and null effects were also reported. This suggests that the effects are context-dependent, influenced by dosage, administration pattern, biological variables, as well as the experimental conditions. The predictive and face validity of the included behavioral models was generally acceptable. However, the construct validity had some limitations, and inconsistencies in the experimental conditions create a need for more standardization to ensure more transparent and reproducible data, and further the research field. Conclusions: The preclinical studies included in this review indicate that the serotonergic psychedelics have therapeutic potential in the treatment of anxiety, especially psilocybin elicited consistent anxiolytic-like effects, possibly due to 5-HT2A receptor agonism. However, future studies should focus on understanding mechanisms, sex-specific effects, and further the combinations of behavioral tests to ensure better interpretation of behavioral outcomes.","journal":"PsyArXiv","publication_date":"2026-05-23","publication_year":2026,"doi":"10.31234/osf.io/gf7bq_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/gf7bq_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:19","last_checked":"2026-07-01 11:22:01","raw_json":"{\"europe_pmc_id\":\"PPR1237570\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Anxiety,Mechanism of Action,Receptor Pharmacology,Systematic Review,Review Article,Animal Study","study_type":"Systematic Review","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3172,"title":"Serotonergic Psychedelics as a Potential Therapeutic Strategy for Anxiety, A Systematic Review","normalized_title":"serotonergic psychedelics as a potential therapeutic strategy for anxiety a systematic review","authors":"","abstract":"Background and objective: Anxiety disorders are among the most prevalent psychiatric disorders worldwide and affect all age groups. Current pharmacological treatments, such as selective serotonergic reuptake inhibitors (SSRI’s) and benzodiazepines, have limitations in terms of adverse effects and efficacy, which highlights the need for alternative therapies. Serotonergic psychedelics have demonstrated promising anxiolytic-like behaviors in preclinical studies, primarily thought to be mediated through agonism of the 5-HT2A receptor. This systematic review aimed to investigate the preclinical evidence of anxiolytic-like potential of serotonergic psychedelics in animal models, and to evaluate the validity and limitations of the included behavioral tests. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A systematic search was conducted in PubMed and Embase. Inclusion and exclusion criteria were defined prior to screening to ensure a transparent inclusion of studies and minimize bias. The title, abstract and full-text screening were conducted independently by two reviewers, with conflicts being resolved through discussion. In total, 18 studies were included after the final screening. Results: Overall, the results demonstrate that serotonergic psychedelics, such as psilocybin and DOI, exerted anxiolytic-like effects across several behavioral tests. However, anxiogenic and null effects were also reported. This suggests that the effects are context-dependent, influenced by dosage, administration pattern, biological variables, as well as the experimental conditions. The predictive and face validity of the included behavioral models was generally acceptable. However, the construct validity had some limitations, and inconsistencies in the experimental conditions create a need for more standardization to ensure more transparent and reproducible data, and further the research field. Conclusions: The preclinical studies included in this review indicate that the serotonergic psychedelics have therapeutic potential in the treatment of anxiety, especially psilocybin elicited consistent anxiolytic-like effects, possibly due to 5-HT2A receptor agonism. However, future studies should focus on understanding mechanisms, sex-specific effects, and further the combinations of behavioral tests to ensure better interpretation of behavioral outcomes.","journal":"PsyArXiv","publication_date":"2026-05-23","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/gf7bq_v1","keywords":"Anxiety, Preclinical, Psychedelics, Systematic Review, Psychiatry, Social and Behavioral Sciences, Emotion, Neuroscience, Behavioral Neuroscience, Animal Learning and Behavior","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:47","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"gf7bq_v1\",\"version\":1,\"reviews_state\":\"accepted\"}","topic_tags":"Anxiety,Mechanism of Action,Receptor Pharmacology,Emotional Processing,Systematic Review,Review Article,Animal Study","study_type":"Systematic Review","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3733,"title":"Strong alliance, weak conclusions: Comment on Goodwin et al. (2026) “The role of therapeutic alliance in psilocybin treatment for treatment-resistant depression”","normalized_title":"strong alliance weak conclusions comment on goodwin et al 2026 the role of therapeutic alliance in psilocybin treatment for treatment resistant depression","authors":"","abstract":"This commentary critically examines the interpretation and analytic choices in Goodwin and colleagues’ recent analysis of therapeutic alliance in psilocybin treatment for treatment-resistant depression. While the authors conclude that alliance did not meaningfully contribute to treatment efficacy, we argue that this interpretation is not supported by the reported results, which are, in addition, shaped by methodological decisions that obscure relevant effects. By contextualizing the observed associations, clarifying the logic of mediation analysis, and pointing out methodological weaknesses, we show that the available evidence is more consistent with a meaningful role of therapeutic alliance in shaping both the psychedelic experience and clinical outcomes. Furthermore, we highlight unexplained deviations from the study protocol that warrant scrutiny. These concerns underscore the importance of accurately characterizing psychological and contextual factors in psychedelic treatment research and calls for more comprehensive and transparent analyses of psychotherapeutic processes.","journal":"PsyArXiv","publication_date":"2026-05-14","publication_year":2026,"doi":"10.1177/28314425261461057","pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/8s7xk_v2","keywords":"depression, psilocybin, psychedelic therapy, psychotherapy, therapeutic alliance, Psychiatry, Social and Behavioral Sciences, Clinical Psychology, Psychotherapy, Psychopharmacology","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:09:45","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"8s7xk_v2\",\"version\":2,\"reviews_state\":\"accepted\"}","topic_tags":"Depression,Pharmacology,Treatment-Resistant Depression","study_type":"Other","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3073,"title":"Strong alliance, weak conclusions: Comment on Goodwin et al. (2026) “The role of therapeutic alliance in psilocybin treatment for treatment-resistant depression”","normalized_title":"strong alliance weak conclusions comment on goodwin et al 2026 the role of therapeutic alliance in psilocybin treatment for treatment resistant depression","authors":"Wolff M, Kangaslampi S, Zeifman R, Spangemacher M.","abstract":"This commentary critically examines the interpretation and analytic choices in Goodwin and colleagues’ recent analysis of therapeutic alliance in psilocybin treatment for treatment-resistant depression. While the authors conclude that alliance did not meaningfully contribute to treatment efficacy, we argue that this interpretation is not supported by the reported results, which are, in addition, shaped by methodological decisions that obscure relevant effects. By contextualizing the observed associations, clarifying the logic of mediation analysis, and pointing out methodological weaknesses, we show that the available evidence is more consistent with a meaningful role of therapeutic alliance in shaping both the psychedelic experience and clinical outcomes. Furthermore, we highlight unexplained deviations from the study protocol that warrant scrutiny. These concerns underscore the importance of accurately characterizing psychological and contextual factors in psychedelic treatment research and calls for more comprehensive and transparent analyses of psychotherapeutic processes.","journal":"PsyArXiv","publication_date":"2026-05-14","publication_year":2026,"doi":"10.31234/osf.io/8s7xk_v2","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/8s7xk_v2","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:46","last_checked":"2026-07-01 11:22:00","raw_json":"{\"europe_pmc_id\":\"PPR1208581\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Depression,Treatment-Resistant Depression","study_type":"Other","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3741,"title":"Low doses of psilocybin as adjunct pharmacological treatment to virtual reality exposure therapy for social anxiety disorder: A study protocol for a double-blind randomized controlled trial.","normalized_title":"low doses of psilocybin as adjunct pharmacological treatment to virtual reality exposure therapy for social anxiety disorder a study protocol for a double blind randomized controlled trial","authors":"Cohen J, Parbo P, Ørskov PT, Wildgruber D, Kreifelts B, kirk u, Gerke O, Madsen MK, Palner M.","abstract":"Background: Social anxiety disorder is a chronic and disabling condition with limited response to standard therapies. Low-dose psilocybin may enhance the effectiveness of exposure-based treatments by modulating neural circuits associated with fear and avoidance. Virtual reality exposure therapy offers a controlled and individualized platform for intervention. Objective: This phase 2b, double-blind clinical trial (n = 32) investigates feasibility and tolerability of low-dose psilocybin as an adjunct to virtual reality exposure therapy in individuals with social anxiety disorder.Design and Methods: Participants will be randomized to receive either low-dose psilocybin or placebo alongside virtual reality exposure therapy. The primary outcome is the change in social anxiety symptoms, measured by the Liebowitz Social Anxiety Scale (LSAS). The primary endpoint is a Cohen’s d ≥ 0.5 for LSAS reduction in the psilocybin group versus placebo. Secondary outcomes include identification of multimodal biomarkers predictive of treatment response. Neuroimaging (e.g., amygdala reactivity, thalamo-cortical connectivity), psychophysiological (e.g., heart rate variability, galvanic skin response, sleep quality), and behavioral task measures (e.g., Affective Shift Task, Emotional Go/No-Go Task) will be analyzed to stratify participants and predict therapeutic response. Successful biomarker stratification is defined as a significant correlation with LSAS change and classification accuracy >70%. Conclusion: This study will provide proof-of-concept evidence for low-dose psilocybin as an adjunct to virtual reality exposure therapy in social anxiety disorder and evaluate multimodal biomarkers for patient stratification. Positive results will support progression to a larger phase 3 trial and inform precision-based approaches for treatment of social anxiety disorder.","journal":"PsyArXiv","publication_date":"2026-05-13","publication_year":2026,"doi":"10.31234/osf.io/3b9fx_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/3b9fx_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:17","last_checked":"2026-07-01 11:22:00","raw_json":"{\"europe_pmc_id\":\"PPR1208061\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Anxiety,Brain Imaging,Biomarkers,Aging,Emotional Processing,Clinical Trial,Randomized Controlled Trial,Safety","study_type":"Randomized Controlled Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3035,"title":"Low doses of psilocybin as adjunct pharmacological treatment to virtual reality exposure therapy for social anxiety disorder: A study protocol for a double-blind randomized controlled trial.","normalized_title":"low doses of psilocybin as adjunct pharmacological treatment to virtual reality exposure therapy for social anxiety disorder a study protocol for a double blind randomized controlled trial","authors":"","abstract":"Background: Social anxiety disorder is a chronic and disabling condition with limited response to standard therapies. Low-dose psilocybin may enhance the effectiveness of exposure-based treatments by modulating neural circuits associated with fear and avoidance. Virtual reality exposure therapy offers a controlled and individualized platform for intervention. Objective: This phase 2b, double-blind clinical trial (n = 32) investigates feasibility and tolerability of low-dose psilocybin as an adjunct to virtual reality exposure therapy in individuals with social anxiety disorder. Design and Methods: Participants will be randomized to receive either low-dose psilocybin or placebo alongside virtual reality exposure therapy. The primary outcome is the change in social anxiety symptoms, measured by the Liebowitz Social Anxiety Scale (LSAS). The primary endpoint is a Cohen’s d ≥ 0.5 for LSAS reduction in the psilocybin group versus placebo. Secondary outcomes include identification of multimodal biomarkers predictive of treatment response. Neuroimaging (e.g., amygdala reactivity, thalamo-cortical connectivity), psychophysiological (e.g., heart rate variability, galvanic skin response, sleep quality), and behavioral task measures (e.g., Affective Shift Task, Emotional Go/No-Go Task) will be analyzed to stratify participants and predict therapeutic response. Successful biomarker stratification is defined as a significant correlation with LSAS change and classification accuracy >70%. Conclusion: This study will provide proof-of-concept evidence for low-dose psilocybin as an adjunct to virtual reality exposure therapy in social anxiety disorder and evaluate multimodal biomarkers for patient stratification. Positive results will support progression to a larger phase 3 trial and inform precision-based approaches for treatment of social anxiety disorder.","journal":"PsyArXiv","publication_date":"2026-05-13","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/3b9fx_v1","keywords":"microdosing, psilocybin, social anxiety, Psychiatry","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:46","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"3b9fx_v1\",\"version\":1,\"reviews_state\":\"accepted\"}","topic_tags":"Anxiety,Brain Imaging,Biomarkers,Aging,Microdosing,Emotional Processing,Clinical Trial,Randomized Controlled Trial,Safety","study_type":"Randomized Controlled Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3085,"title":"Strong alliance, weak conclusions: Comment on Goodwin et al. (2026) “The role of therapeutic alliance in psilocybin treatment for treatment-resistant depression”","normalized_title":"strong alliance weak conclusions comment on goodwin et al 2026 the role of therapeutic alliance in psilocybin treatment for treatment resistant depression","authors":"Wolff M, Kangaslampi S, Zeifman R, Spangemacher M.","abstract":"This commentary critically examines the interpretation and analytic choices in Goodwin et al.’s (2026) analysis of therapeutic alliance in psilocybin treatment for treatment-resistant depression. While the authors conclude that alliance did not meaningfully contribute to treatment efficacy, we argue that this interpretation is not supported by the reported results, which are, in addition, shaped by methodological decisions that obscure relevant effects. By contextualizing the observed associations, clarifying the logic of mediation analysis, and pointing out methodological weaknesses, we show that the available evidence is more consistent with a meaningful role of therapeutic alliance in shaping both the psychedelic experience and clinical outcomes. Furthermore, we highlight unexplained deviations from the study protocol that warrant scrutiny. The commentary underscores the importance of accurately characterizing psychological and contextual factors in psychedelic treatment research and calls for more comprehensive and transparent analyses of psychotherapeutic processes.","journal":"PsyArXiv","publication_date":"2026-03-29","publication_year":2026,"doi":"10.31234/osf.io/8s7xk_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/8s7xk_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:46","last_checked":"2026-07-01 11:22:00","raw_json":"{\"europe_pmc_id\":\"PPR1171795\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Depression,Treatment-Resistant Depression","study_type":"Other","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":1942,"title":"Strong alliance, weak conclusions: Comment on Goodwin et al. (2026) “The role of therapeutic alliance in psilocybin treatment for treatment-resistant depression”","normalized_title":"strong alliance weak conclusions comment on goodwin et al 2026 the role of therapeutic alliance in psilocybin treatment for treatment resistant depression","authors":"","abstract":"This commentary critically examines the interpretation and analytic choices in Goodwin et al.’s (2026) analysis of therapeutic alliance in psilocybin treatment for treatment-resistant depression. While the authors conclude that alliance did not meaningfully contribute to treatment efficacy, we argue that this interpretation is not supported by the reported results, which are, in addition, shaped by methodological decisions that obscure relevant effects. By contextualizing the observed associations, clarifying the logic of mediation analysis, and pointing out methodological weaknesses, we show that the available evidence is more consistent with a meaningful role of therapeutic alliance in shaping both the psychedelic experience and clinical outcomes. Furthermore, we highlight unexplained deviations from the study protocol that warrant scrutiny. The commentary underscores the importance of accurately characterizing psychological and contextual factors in psychedelic treatment research and calls for more comprehensive and transparent analyses of psychotherapeutic processes.","journal":"PsyArXiv","publication_date":"2026-03-29","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/8s7xk_v1","keywords":"depression, psilocybin, psychedelic therapy, psychotherapy, therapeutic alliance, Psychiatry, Social and Behavioral Sciences, Clinical Psychology, Psychotherapy, Psychopharmacology","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 06:52:05","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"8s7xk_v1\",\"version\":1,\"reviews_state\":\"accepted\"}","topic_tags":"Depression,Pharmacology,Treatment-Resistant Depression","study_type":"Other","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3742,"title":"Safety and Efficacy of Psilocybin-Assisted Therapy for Alcohol Use Disorder: Open-Label Extension of a Phase II Randomized Controlled Trial","normalized_title":"safety and efficacy of psilocybin assisted therapy for alcohol use disorder open label extension of a phase ii randomized controlled trial","authors":"Pagni BA, Ross S, Mennenga S, Bhatt SR, Zeifman R, Petridis P, Carrithers B, Worth L, Podrebarac S, Owens L, O'Donnell K, Roberts DE, Kim Y, Bogenschutz M.","abstract":"Background: Psilocybin-assisted therapy (PAT) has shown promise for alcohol use disorder (AUD) in randomized controlled trials (RCTs). However, the effects of open-label administration following blinded treatment are unclear. Here, we present safety and efficacy data from an open-label extension of a Phase II RCT (NCT02061293) examining PAT for AUD. Methods: Adults with AUD (N = 59) received a single administration of psilocybin (25-40mg/70kg) along with four total hours of therapy. Of this cohort, 30 participants had originally received psilocybin during the blinded phase of the RCT and 29 received active placebo (diphenhydramine). Mixed-Effects Models for Repeated Measures examined the effects of PAT on (a) alcohol consumption (percent heavy drinking [PHDD], drinks per day [DpD], and percent drinking days [PDD]), (b) alcohol craving, (c) abstinence self-efficacy, (d) and treatment readiness across a four-month follow-up. Results: Psilocybin was well tolerated, with no serious adverse events. Across participants, PDD decreased at 1-month but returned to baseline by Months 2-4. Among those with higher baseline drinking, PHDD, DpD, and PDD showed similar transient reductions. Participants from both double-blind groups demonstrated improvements in craving, self-efficacy, and treatment readiness one week after psilocybin with variable trajectories over follow-up. Discussion: Results suggest that a single administration of psilocybin in an open-label context may produce short-term improvements in alcohol use and core predictors of clinical change. Given long-lasting efficacy in the double-blind phase, it remains unclear if the short-term durability in the open-label extension is due to baseline floor effects, treatment resistance, lower treatment readiness and motivation, or fewer medication/therapy sessions.","journal":"PsyArXiv","publication_date":"2026-03-25","publication_year":2026,"doi":"10.31234/osf.io/7xfek_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/7xfek_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:17","last_checked":"2026-07-01 11:22:00","raw_json":"{\"europe_pmc_id\":\"PPR1170889\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Addiction,Clinical Trial,Randomized Controlled Trial,Observational Study,Safety,Adverse Events","study_type":"Randomized Controlled Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3037,"title":"Safety and Efficacy of Psilocybin-Assisted Therapy for Alcohol Use Disorder: Open-Label Extension of a Phase II Randomized Controlled Trial","normalized_title":"safety and efficacy of psilocybin assisted therapy for alcohol use disorder open label extension of a phase ii randomized controlled trial","authors":"","abstract":"Background: Psilocybin-assisted therapy (PAT) has shown promise for alcohol use disorder (AUD) in randomized controlled trials (RCTs). However, the effects of open-label administration following blinded treatment are unclear. Here, we present safety and efficacy data from an open-label extension of a Phase II RCT (NCT02061293) examining PAT for AUD. Methods: Adults with AUD (N = 59) received a single administration of psilocybin (25-40mg/70kg) along with four total hours of therapy. Of this cohort, 30 participants had originally received psilocybin during the blinded phase of the RCT and 29 received active placebo (diphenhydramine). Mixed-Effects Models for Repeated Measures examined the effects of PAT on (a) alcohol consumption (percent heavy drinking [PHDD], drinks per day [DpD], and percent drinking days [PDD]), (b) alcohol craving, (c) abstinence self-efficacy, (d) and treatment readiness across a four-month follow-up. Results: Psilocybin was well tolerated, with no serious adverse events. Across participants, PDD decreased at 1-month but returned to baseline by Months 2-4. Among those with higher baseline drinking, PHDD, DpD, and PDD showed similar transient reductions. Participants from both double-blind groups demonstrated improvements in craving, self-efficacy, and treatment readiness one week after psilocybin with variable trajectories over follow-up. Discussion: Results suggest that a single administration of psilocybin in an open-label context may produce short-term improvements in alcohol use and core predictors of clinical change. Given long-lasting efficacy in the double-blind phase, it remains unclear if the short-term durability in the open-label extension is due to baseline floor effects, treatment resistance, lower treatment readiness and motivation, or fewer medication/therapy sessions.","journal":"PsyArXiv","publication_date":"2026-03-25","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/7xfek_v1","keywords":"alcohol use disorder, clinical trial, craving, psilocybin, psychedelic, short inventory of problems, treatment readiness, Psychiatry","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:46","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"7xfek_v1\",\"version\":1,\"reviews_state\":\"accepted\"}","topic_tags":"Addiction,Clinical Trial,Randomized Controlled Trial,Observational Study,Safety,Adverse Events","study_type":"Randomized Controlled Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3419,"title":"Oregon's Emerging Psilocybin Services Workforce: A Survey of the First Legal Psilocybin Facilitators and Their Training Programs","normalized_title":"oregon s emerging psilocybin services workforce a survey of the first legal psilocybin facilitators and their training programs","authors":"","abstract":"BACKGROUND: New legal frameworks for supervised psychedelic services are emerging, with Oregon and Colorado implementing programs to train and license psilocybin facilitators. This study describes Oregon's early psilocybin facilitator workforce and assesses state-approved training programs. METHODS: The Open Psychedelic Evaluation Nexus (OPEN) reviewed Oregon Health Authority-approved training programs and surveyed facilitators who had completed or were enrolled in these programs between July and November 2023. Data collection included a review of public listings, contact with training programs, and facilitator survey. RESULTS: In the 16 active training programs, the mean tuition was $9,359 and half offered diversity scholarships. Survey respondents (n=106) were relatively diverse; many had an existing healthcare license. The majority reported that training expenses were a moderate-to-severe financial strain. Most were satisfied with training. The mean planned price for a session was $1,388 and the most common areas of specialization were trauma, mental disorders, consciousness exploration, and spirituality. Facilitators requested ongoing training opportunities. CONCLUSION: Oregon's emerging psilocybin facilitator workforce and training programs are in early development These findings are crucial for informing future policy and training program development to support a diverse and effective workforce.","journal":"PsyArXiv","publication_date":"2026-03-10","publication_year":2026,"doi":"10.1080/02791072.2025.2454474.","pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/4jm2n_v1","keywords":"certification, licensure, Oregon, psilocybin, psychedelics, workforce survey, Social and Behavioral Sciences","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:04:23","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"4jm2n_v1\",\"version\":1,\"reviews_state\":\"accepted\"}","topic_tags":"Consciousness,Spirituality,Review Article,Observational Study","study_type":"Review Article","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3025,"title":"Oregon's Emerging Psilocybin Services Workforce: A Survey of the First Legal Psilocybin Facilitators and Their Training Programs","normalized_title":"oregon s emerging psilocybin services workforce a survey of the first legal psilocybin facilitators and their training programs","authors":"Luoma JB, Hoffman K, Wilson-Poe A, Levander X, Bazinet A, Cook R, McCarty D, Pertl K, Bielavitz S, Gregoire D, Wolf C, Jarlais DD, Harrison HV, Stauffer C, Korthuis P.","abstract":"BACKGROUND: New legal frameworks for supervised psychedelic services are emerging, with Oregon and Colorado implementing programs to train and license psilocybin facilitators. This study describes Oregon's early psilocybin facilitator workforce and assesses state-approved training programs. METHODS: The Open Psychedelic Evaluation Nexus (OPEN) reviewed Oregon Health Authority-approved training programs and surveyed facilitators who had completed or were enrolled in these programs between July and November 2023. Data collection included a review of public listings, contact with training programs, and facilitator survey. RESULTS: In the 16 active training programs, the mean tuition was $9,359 and half offered diversity scholarships. Survey respondents (n=106) were relatively diverse; many had an existing healthcare license. The majority reported that training expenses were a moderate-to-severe financial strain. Most were satisfied with training. The mean planned price for a session was $1,388 and the most common areas of specialization were trauma, mental disorders, consciousness exploration, and spirituality. Facilitators requested ongoing training opportunities. CONCLUSION: Oregon's emerging psilocybin facilitator workforce and training programs are in early development These findings are crucial for informing future policy and training program development to support a diverse and effective workforce.","journal":"PsyArXiv","publication_date":"2026-03-10","publication_year":2026,"doi":"10.31234/osf.io/4jm2n_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/4jm2n_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:45","last_checked":"2026-07-01 11:22:00","raw_json":"{\"europe_pmc_id\":\"PPR1165131\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Consciousness,Spirituality,Review Article,Observational Study","study_type":"Review Article","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3759,"title":"Multidimensional Ego-Dissolution Assessment (MEDA): Scale Development and Substance-Specific Comparisons","normalized_title":"multidimensional ego dissolution assessment meda scale development and substance specific comparisons","authors":"Senānāyaka R.","abstract":"Rationale: Ego-dissolution represents a key therapeutic mechanism in psychedelic-assisted therapy, yet current measurement approaches may inadequately capture its multidimensional nature. Objective: To develop and validate the Multidimensional Ego-Dissolution Assessment (MEDA) and examine substance-specific patterns across classical psychedelics. Methods: Items from three validated scales (Ego-Dissolution Inventory, Mystical Experience Questionnaire, 5D-Altered States of Consciousness) were compiled into a 34-item measure. Exploratory factor analysis was conducted on responses from 207 participants reporting profound experiences with ayahuasca (n=51), DMT (n=28), LSD (n=52), or psilocybin (n=76). Results: Factor analysis revealed a robust 6-factor structure: Dissolving of Identity (α=.94), Experiences of Eternity (α=.89), Dissolving of Physical Body (α=.80), Dissolving into Environment (α=.85), Clarity about Life and Purpose (α=.78), and Pleasure (α=.78). Two distinct substance clusters emerged: ayahuasca/DMT produced significantly higher dissolution scores than LSD/psilocybin across four factors, while all substances showed equivalent high scores on insight and pleasure dimensions. Dosage showed no significant effects. Conclusion: The MEDA provides preliminary evidence for multidimensional ego-dissolution assessment. Substance-specific clustering patterns might inform therapeutic selection, while universal insight and pleasure effects suggest core psychedelic benefits achievable across substances.","journal":"PsyArXiv","publication_date":"2026-03-01","publication_year":2026,"doi":"10.31234/osf.io/9c6xg_v1","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/9c6xg_v1","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:19","last_checked":"2026-07-01 11:22:02","raw_json":"{\"europe_pmc_id\":\"PPR1161047\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Consciousness,Mystical Experience","study_type":"Other","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3175,"title":"Multidimensional Ego-Dissolution Assessment (MEDA): Scale Development and Substance-Specific Comparisons","normalized_title":"multidimensional ego dissolution assessment meda scale development and substance specific comparisons","authors":"","abstract":"Rationale: Ego-dissolution represents a key therapeutic mechanism in psychedelic-assisted therapy, yet current measurement approaches may inadequately capture its multidimensional nature. Objective: To develop and validate the Multidimensional Ego-Dissolution Assessment (MEDA) and examine substance-specific patterns across classical psychedelics. Methods: Items from three validated scales (Ego-Dissolution Inventory, Mystical Experience Questionnaire, 5D-Altered States of Consciousness) were compiled into a 34-item measure. Exploratory factor analysis was conducted on responses from 207 participants reporting profound experiences with ayahuasca (n=51), DMT (n=28), LSD (n=52), or psilocybin (n=76). Results: Factor analysis revealed a robust 6-factor structure: Dissolving of Identity (α=.94), Experiences of Eternity (α=.89), Dissolving of Physical Body (α=.80), Dissolving into Environment (α=.85), Clarity about Life and Purpose (α=.78), and Pleasure (α=.78). Two distinct substance clusters emerged: ayahuasca/DMT produced significantly higher dissolution scores than LSD/psilocybin across four factors, while all substances showed equivalent high scores on insight and pleasure dimensions. Dosage showed no significant effects. Conclusion: The MEDA provides preliminary evidence for multidimensional ego-dissolution assessment. Substance-specific clustering patterns might inform therapeutic selection, while universal insight and pleasure effects suggest core psychedelic benefits achievable across substances.","journal":"PsyArXiv","publication_date":"2026-03-01","publication_year":2026,"doi":null,"pubmed_id":null,"source_url":"https://osf.io/preprints/psyarxiv/9c6xg_v1","keywords":"ego-dissolution, factor analysis, psychedelics, psychometric scale, scale development, Social and Behavioral Sciences, Cultural Psychology, Cross-cultural Psychology","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:03:47","last_checked":"2026-07-01 11:22:30","raw_json":"{\"osf_id\":\"9c6xg_v1\",\"version\":1,\"reviews_state\":\"accepted\"}","topic_tags":"Consciousness,Mystical Experience","study_type":"Other","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"},{"id":3761,"title":"Ethical Complexities and Best Practices in Informed Consent for Psychedelic Services: A Qualitative Study on Expert Perspectives","normalized_title":"ethical complexities and best practices in informed consent for psychedelic services a qualitative study on expert perspectives","authors":"Chwyl C, Bazinet A, Wilson-Poe A, Hoffman K, Pertl K, McCrimmon S, Korthuis P, Luoma JB.","abstract":"Background: Informed consent in psychedelic-assisted services is ethically complex, difficult to implement, and remains largely unstudied and unstandardized. Objective: The current study sought expert recommendations from experienced psychedelic facilitators on what constitutes informed consent best practices for supervised psychedelic experiences across various settings. Methods: Participants with expertise in facilitating psilocybin-assisted experiences or other expertise in the psychedelic field were recruited with purposive sampling. Qualitative interviews on informed consent best practices and recommendations were analyzed using Thematic Analysis. Results: Participants (N = 36; 71% white; 56% heterosexual; 53% female) reported facilitating psilocybin services (64%) for a mean of 15.2 (SD = 13.1) years in clinical trial, licensed service center, underground, or ceremonial settings. Participants viewed informed consent as a process (Theme 1), necessitating a strong therapeutic relationship, centering client empowerment, and occurring as an ongoing process. Potential risks and benefits should be comprehensively conveyed (Theme 2), including potential long-term psychological and social changes, and the potential for disappointing experiences. Participants recommended detailed consent processes around touch and boundaries (Theme 3), including explicitly establishing boundaries prior to psychedelic administration, maintaining those boundaries throughout, and recognizing subtle non-verbal cues that may indicate lack of true consent. Within facilitator trainings (Theme 4), participants emphasized cultivating a deep respect for client agency, and experientially learning relational and boundary setting skills. Conclusions: Findings may inform practitioner training, consent practices in varied settings, and policy development for state-regulated psychedelic services.","journal":"PsyArXiv","publication_date":"2026-02-18","publication_year":2026,"doi":"10.31234/osf.io/mdz73_v2","pubmed_id":null,"source_url":"https://doi.org/10.31234/osf.io/mdz73_v2","keywords":"","substance_tags":"psilocybin","source_name":"PsyArXiv","date_added":"2026-07-01 11:10:19","last_checked":"2026-07-01 11:22:02","raw_json":"{\"europe_pmc_id\":\"PPR1157026\",\"source\":\"PPR\",\"pub_type\":null,\"publisher\":\"PsyArXiv\",\"importer\":\"Europe PMC\"}","topic_tags":"Clinical Trial,Safety","study_type":"Clinical Trial","hidden":0,"false_positive":0,"curation_notes":null,"merged_into_id":null,"curation_locked":0,"publication_status":"preprint"}],"total":216,"page":1,"per_page":20,"pages":11,"resource":"papers","filters":{"q":null,"author":null,"substances":["psilocybin","psilocin"],"topic":null,"study_type":null,"sources":[],"publication_statuses":[],"year":null,"journal":"PsyArXiv","from":null,"to":null,"sort":"newest","page":1,"per_page":"20"}}