Common factors in altered states: Understanding psychedelic therapy through the lens of Grawe's general change mechanisms.
Psychological review November 1, 2025 Max Wolff, Hans Rutrecht, Lea J Mertens et al.
Psychedelic therapy is often viewed as a distinct form of psychotherapy, but this article argues that its effectiveness can be understood through the same general change mechanisms that operate in all effective psychotherapies. Drawing on Klaus Grawe's empirically grounded model of common factors, the authors propose that psychedelic therapy works via five mechanisms: resource activation, therapeutic relationship, problem actuation, clarification, and mastery. The article integrates evidence from psychedelic research to support this transtheoretical framework and discusses its implications for clinical practice, training, and future studies.