Trends in psychiatry and psychotherapy
April 25, 2026
Alberto Barbieri
Personality disorders involve rigid, maladaptive patterns of thinking and relating to others, which are hard to treat. Schema therapy, which targets early maladaptive schemas formed from unmet emotional needs, shows moderate effectiveness mainly for borderline personality disorder. Psilocybin, a psychedelic, may relax deeply held beliefs and increase cognitive flexibility, according to predictive coding models. This theoretical article proposes combining psilocybin with schema therapy—called Psilocybin-Assisted Schema Therapy (PAST)—to help patients revise maladaptive self-beliefs and improve treatment outcomes for Cluster B and C personality disorders. The framework awaits empirical testing.
Human Arenas
April 25, 2026
Shannon Dames, Grace Scharf, Vivian W.l. Tsang et al.
Ritual functions as a relational organizing container that stabilizes psychedelic therapy by regulating the nervous system, orienting attention, and anchoring meaning through predictable sequencing and symbolic framing. Without clear frameworks, ritual applications risk becoming prescriptive or ethically problematic, especially when borrowing from Indigenous traditions without relational accountability. A principle-informed framework translates these functions into consent-based, culturally humble, and autonomy-protective clinical practice, shifting from prescribed techniques to co-created processes across preparation, dosing, and integration. This approach supports flexible, relational care that honors cultural context, participant agency, and situated meaning-making.
Journal of psychoactive drugs
April 23, 2026
Brayan Jonas Mano-Sousa, Maria Clara Gama Fontes, Ana Clara Anacleto Gonçalves et al.
In people with treatment-resistant depression, ayahuasca—a traditional Amazonian psychedelic—rapidly reduces suicidal thoughts and depressive symptoms. A systematic review of five studies found consistent evidence of these effects, attributed to the synergistic action of β-carbolines and DMT. Neurobiologically, ayahuasca promotes neuroplasticity by upregulating Brain-Derived Neurotrophic Factor and decreasing Default Mode Network activity, enabling profound introspection and emotional processing. Despite promising results, large-scale, rigorous longitudinal studies are needed to establish safe clinical guidelines.
Acta Psychedelica
April 16, 2026
B. Insua-Summerhays, Edward Jacobs
Adolescent depression requires a distinct approach to psychedelic-assisted therapy due to age-related differences in psychology, biology, and social dependence. Unlike adults, adolescents have less autonomy and are more influenced by their family and social environment, which creates a unique risk-benefit profile when using pro-plasticity psychedelics. The authors advocate for a systems-psychological treatment model that includes expanded screening, psychosocial formulation, family psychoeducation, and tailored integration and post-trial support. This interdisciplinary framework addresses the socio-ecological context in which adolescent psychopathology emerges, aiming to make psychedelic-assisted therapy safe, effective, and ethically sound for this population.
Journal of Psychopharmacology
April 12, 2026
L. M. Wallace, Andrea Bujor, Gustavo Sudre et al.
A systematic review and meta-analysis of studies from 1960 to 2024 found that the psychedelic agent DMT produced a large overall effect on reducing substance abuse (g = 0.94). Effects were larger for drug use (g = 1.35) than for alcohol use (g = 0.65). Studies that included psychotherapy showed significantly greater effects (g = 1.38) than those without (g = 0.60). However, the included studies had high risk of bias and high heterogeneity, so the findings should be considered preliminary rather than proof of established efficacy.
Frontiers in Psychiatry
April 1, 2026
Jonathan Stellmacher, Christopher Schmidt, Helena Aicher et al.
Therapists in Switzerland who provide psychedelic-assisted therapy (PAT) adapt psychotherapeutic techniques to the psychedelic context but retain similarities to non-psychedelic practices. The psychedelic and psychotherapeutic elements work synergistically, amplifying general therapeutic factors such as trust, a sense of profundity, and the emergence of therapeutic experiences. Therapists agreed that psychedelics act as unspecific catalysts for psychotherapeutic processes, while also acknowledging unique interactions between the drug and therapy. For specific indications, incorporating psychedelics into long-term psychotherapy may strengthen therapeutic processes.