Disengaged: A systematic review of community engagement in psychedelic-assisted therapy research.
Mallet R Reid, Jonathan Song, Kevin F Boehnke, Nicole T Buchanan, Jacob S Aday
Neuroscience and biobehavioral reviews February 1, 2026 Peer reviewed DOI: 10.1016/j.neubiorev.2025.106516 via PubMed
Summary
Psychedelic-assisted therapy (PAT) research has significantly underincluded people of color, who often face more severe symptoms. A systematic review of 27 clinical trials over the past decade found that only 3 studies (11.11%) used community-engaged research (CEnR) practices. The limited engagement primarily involved community consultation rather than deeper involvement. To enhance diversity in PAT trials, recommendations include engaging local stakeholders and co-designing research initiatives.
Study at a glance
| Design | systematic review |
|---|---|
| Sample size | 27 |
| Population | clinical trials of psilocybin, MDMA, and LSD in the United States |
| Key finding | Only 3 out of 27 studies incorporated community-engaged research practices. |
Abstract
People of color have been significantly underincluded in psychedelic-assisted therapy (PAT) research, despite facing challenges commonly addressed in PAT and often more severe symptoms. It may be the case that people of color are underincluded because PAT researchers have not used approaches designed to promote sample diversity. Community-engaged research (CEnR) is a research paradigm that has demonstrated success in promoting participant diversity. We hypothesize that the absence of CEnR in psychedelic science may be a contributing factor to the lack of diversity in psychedelic studies. To examine the prevalence of CEnR practices in PAT research, we conducted a systematic review of the past 10 years of psilocybin, MDMA, and LSD clinical trials in the United States. We reviewed each study (N = 27) to assess whether researchers incorporated CEnR using the Continuum of Community Engagement and reached out to each individual study team to ensure comprehensiveness. Our analysis revealed that only 3/27 (11.11 %) studies incorporated CEnR. In the rare instances CEnR was integrated, PAT researchers used community consultation, which involves relatively little engagement with community members. To improve representation in PAT trials, we recommending incorporating the CEnR principles of 1) mapping and engaging local stakeholders, 2) leveraging existing university-hospital infrastructures, 3) co-designing research and outreach initiatives, 4) securing dedicated CEnR resources, and 5) establishing mechanisms for ongoing evaluation. This systematic review supports that there has been a paucity of community-engaged practices in PAT research, which can be addressed by incorporating our recommendations for implementing CEnR in PAT studies.