Meaning-Centered Psychotherapy for Psilocybin-Assisted Therapy Among Patients with Advanced Cancer and Depression: Rationale and Preliminary Evaluation of MCP-PSIL.
William E Rosa, Stephanie Napolitano, Natalie Mcandrew, Betsy Jenkins, Wendy G Lichtenthal, Allison J Applebaum, William Breitbart, Manish Agrawal
Psychedelic medicine (New Rochelle, N.Y.) June 1, 2026 Peer reviewed DOI: 10.1177/28314425251363983 via PubMed
Summary
Psilocybin therapy shows promise for patients with cancer and major depressive disorder, but there's a lack of standardized psychotherapeutic support. Meaning-centered psychotherapy (MCP) is proposed as a beneficial accompaniment to psilocybin-assisted therapy. In a phase 2 open-label trial, seven patients and six therapists provided feedback through surveys and focus groups, leading to the development of a 5-session MCP-PSIL model. Participants highlighted the importance of group dynamics in enhancing therapeutic experiences.
Study at a glance
| Design | phase 2 open-label trial |
|---|---|
| Sample size | 13 |
| Population | seven patients with cancer and major depressive disorder and six therapists |
| Key finding | MCP is suggested as a valuable therapeutic partner to enhance the experience of psilocybin-assisted therapy. |
Abstract
Psilocybin shows encouraging outcomes for patients with cancer and major depressive disorder (MDD). However, there is insufficient evidence on the use of evidence-based psychotherapeutic interventions to consistently guide and standardize psilocybin preparation, dosing, and integration. Meaning-centered psychotherapy (MCP) is a manualized, brief psychotherapeutic intervention that enhances meaning and purpose among recipients. This article substantiates the rationale for using MCP as a psychotherapeutic intervention to accompany psychedelic-assisted therapy (PAT) with psilocybin for patients with cancer and MDD. We sampled seven patients with cancer and MDD who previously received PAT with psilocybin followed by group MCP in a phase 2 open-label trial, as well as six therapists who delivered the interventions. First, electronic open-ended response surveys were distributed to explore participant experiences during the phase 2 trial and elicit recommendations to adapt MCP for psilocybin. Second, the research team developed a 5-session model of MCP and psilocybin therapy (MCP-PSIL) based on survey responses. Finally, four focus groups were conducted (two with patients and two with therapists) to expand on patient experiences during the phase 2 trial and gather feedback on MCP-PSIL. Seven patients (ages 53-80 years) and six therapists (mental health professional experience ranging 9-44 years) participated in both surveys and focus groups. Focus groups underscored the value of experiences related to psilocybin, the group, and MCP, as distinct elements and in conjunction. Participants shared key recommendations to enhance combined psilocybin and MCP experiences and the 5-session MCP-PSIL model. The importance of the group format was also emphasized while noting that individual MCP may be indicated in certain circumstances. Findings suggest that MCP is a natural therapeutic partner to guide patients throughout the PAT continuum. As MCP-PSIL is tested in the future, we anticipate MCP will leverage the PAT experience by building therapist capacity to optimize care while reducing avoidable distress for patients and maximizing their meaning-making opportunities.