JAMA psychiatry
July 1, 2023
Roman Palitsky, Deanna M Kaplan, Caroline Peacock et al.
86 citations
Spiritual, existential, religious, and theological components are important in psychedelic-assisted therapy, but they have not been systematically integrated into clinical practice. Research shows that spiritually integrated psychotherapies are effective and produce additional benefits on spiritually relevant outcomes, which are particularly relevant to psychedelic therapy. Established standards in spiritually integrated psychotherapy can be applied to psychedelic-assisted therapy. Integrating these topics is needed for culturally competent, evidence-based treatment aligned with high clinical standards, and neglecting them may undermine treatment success and increase risks for patients.
Journal of Psychopharmacology
July 31, 2024
Roman Palitsky, Deanna M. Kaplan, John Perna et al.
32 citations
A multidisciplinary working group identified 54 potential adverse events that warrant systematic assessment in psychedelic-assisted therapies, finding that existing measurement tools substantially fail to cover these constructs. The group developed recommendations for when and how to assess these adverse events across preparation, dosing, integration, and follow-up phases, and demonstrated a preliminary assessment protocol. The framework addresses the need to capture post-acute dosing adverse events, accounting for both the pharmacotherapy and psychotherapy components of psychedelic-assisted therapy, as well as documented impacts on worldviews and spirituality.
PLoS ONE
January 2, 2024
Caroline Peacock, Erin Brauer, Ali John Zarrabi et al.
27 citations
Spiritual health practitioners bring unique expertise to psychedelic-assisted therapy based on their training and professional experience. Interviews with 15 such practitioners revealed seven themes in two domains: unique contributions (competency with spiritual material, awareness of power dynamics, familiarity with non-ordinary states, holding space, counterbalancing biomedical perspectives) and general contributions (using general therapeutic skills and supporting interdisciplinary collaboration). Their skills complement other clinical team members, and psychedelic-assisted therapy teams may benefit from including them. Further work is needed to define roles, qualifications, and training for these clinicians.
Religions
November 24, 2021
David J. Cooper, Jared R. Lindahl, Roman Palitsky et al.
20 citations
Energy-like somatic experiences (ELSEs), such as sensations of heat, tingling, or energy moving through the body, are frequently described in religious texts and have been documented in a few psychological studies, yet they remain understudied in meditation research. Based on narratives from a large qualitative sample of Western Buddhist meditators who reported meditation-related challenges, this paper describes how ELSEs manifest in practitioners' lives. It moves beyond a 'kundalini awakening' framework to catalog the metaphors practitioners used, the trajectories and impacts of ELSEs, factors influencing their nature, how they were interpreted by practitioners, teachers, doctors, and therapists, and the remedies employed. Interpreting and managing ELSEs often drew on frameworks from within or beyond the meditator's Buddhist tradition.
BMC Psychiatry
February 28, 2025
John Perna, Justin Trop, Roman Palitsky et al.
15 citations
A case report describes tensions between legal and underground psychedelic use within therapy training programs, psychiatry, and neo-shamanism. It details how psychiatric interventions like electroconvulsive therapy and energy medicine were used to address prolonged adverse effects from psychedelics. The report urges clinicians to recognize conflicts between psychiatric views of these adverse effects and frameworks in psychedelic communities, which can affect patients' symptoms, decisions, and emotional struggles.
Psychotherapy
January 13, 2025
Roman Palitsky, Jessica L Maples-Keller, Caroline Peacock et al.
13 citations
In an open-label trial of psilocybin-assisted therapy for cancer-related demoralization and chronic pain, patients, facilitators, and caregivers identified key components and improvements for the treatment protocol. Using the Enhanced Critical Incident Technique, interviews revealed critical incidents, wish list items, and contributing factors related to therapy aspects like intention-setting and overall protocol transitions. The findings emphasize tailoring treatment to individual medical history, supporting common therapeutic factors, and ensuring collaborative care. Nine topic areas for protocol improvement emerged from the data.
Journal of Contemplative Studies
July 23, 2025
Roman Palitsky, David J. Cooper, Jared R. Lindahl et al.
10 citations
Western Buddhist meditators often draw on both religious and scientific worldviews to make sense of meditation-related challenges. Interviews with 68 meditators and 33 meditation experts revealed five ways these worldviews relate: conflict, compatibility, nested relationships, discrete domains, and complementarity. These varied relationships carry existential weight and influence how meditators respond to challenges. The findings suggest that the scientific study of contemplative practices should consider the diverse ways religion and science interact, and that nuanced understandings of these relationships can help practitioners and teachers address meditation-related difficulties.
PloS one
January 1, 2025
Nicholas K Canby, Elizabeth A Cosby, Roman Palitsky et al.
10 citations
Childhood trauma and PTSD symptoms are linked to worse depression outcomes and more meditation-related adverse effects in mindfulness-based programs. Across two clinical trials, total childhood trauma and childhood sexual abuse consistently predicted poorer depression outcomes. Childhood sexual abuse also predicted dropout in one study. Multiple forms of trauma and PTSD symptoms predicted meditation-related side effects, while total trauma, emotional abuse, and subclinical PTSD predicted lasting adverse effects. These findings suggest that trauma-sensitive modifications, safety monitoring, screening, and provider education are needed when implementing mindfulness programs for depression.
International review of psychiatry (Abingdon, England)
December 1, 2024
Roman Palitsky, Nicholas K Canby, Nicholas T Van Dam et al.
6 citations
Research on adverse effects (AEs) of psychedelics has been limited, leading to underspecified profiles and potential undercounting. This article argues that meditation-related AE research, which shares phenomenological and contextual features with psychedelic AEs, offers valuable insights. An integrative review of both fields is presented, recommending that meditation AEs serve as a comparator condition. The authors propose adopting detailed, comprehensive, user-informed, impact-based, standardized, unbiased, and representative measures of AEs, along with examining factors that influence their impacts and trajectories, to advance psychedelic AE research.
March 5, 2024
Roman Palitsky, Deanna M. Kaplan, John Perna et al.
4 citations
preprint
A multidisciplinary working group identified 53 potential adverse events (AEs) specific to psychedelic-assisted therapies (PATs) that current assessment tools miss. Existing measures cover only a fraction of these constructs. The group recommends new assessment methods—including patient, clinician, and informant reports—and specifies when to measure AEs across preparation, dosing, integration, and follow-up phases. The framework addresses gaps in capturing post-acute dosing effects, including changes in worldview and spirituality, which distinguish PAT from other treatments.
Psychotherapy (Chicago, Ill.)
June 1, 2026
Roman Palitsky, Laura E Captari, Jessica L Maples-Keller et al.
3 citations
The relational spirituality model (RSM) provides a framework for developing spiritual and religious competence in psychedelic-assisted psychotherapies. Psychedelic-assisted therapies can provoke personally meaningful spiritual or existential experiences linked to improved outcomes. The RSM's inclusive spiritual, existential, religious, and theological approach offers a pluralistic way to engage diverse traditions in therapy. The article describes the RSM and introduces pragmatic training methods—deliberate practice, experiential components, SERT groups, and assessment training—that can be integrated into existing mental health or psychedelic therapy training programs. It also discusses how the RSM can inform interdisciplinary collaborations across disciplines and healing communities.
Psychedelics
April 29, 2025
Ishan Pasricha, Caroline Peacock, Roman Palitsky et al.
3 citations
Spiritual health practitioners (healthcare chaplains) increasingly facilitate psychedelic-assisted therapy. A qualitative study of 15 such practitioners (60% female, average age 46.57) found two main themes: initial motivations and ongoing sources of meaning. Personal psychedelic experiences were a key initial motivator. Ongoing fulfillment came from witnessing healing in others and positive personal impacts of facilitating care. Personal experiences provide valuable firsthand knowledge of psychedelic phenomenology but may introduce bias. Training guidelines from the Association for Clinical Pastoral Education, emphasizing self-literacy and reflection, may help address these risks. The authors introduce a reflective learning exercise based on these findings.
Psychedelic medicine (New Rochelle, N.Y.)
March 1, 2026
Syed F Rab, Salman S Ahmad, Roman Palitsky et al.
1 citation
Muslims living in the United States show moderate openness to psychedelic therapies, and a weak negative correlation exists between their rejection of mental health services and their acceptance of psychedelics. Higher education is associated with more favorable attitudes toward both mental health services and psychedelic therapies. The findings highlight the need to understand educational and cultural factors shaping these views to advance equitable mental health care for this underrepresented group.
Contemporary Buddhism
April 22, 2025
Nicholas K. Canby, Jared R. Lindahl, David J. Cooper et al.
1 citation
Meditation teachers can have both beneficial and detrimental impacts on practitioners facing meditation-related challenges. A mixed-methods study of 68 meditation practitioners and 33 experts from various Buddhist lineages found that beneficial relationships involved access to well-qualified teachers, appropriate guidance, and teachers with psychology or mental health training. Unhelpful factors included teacher unavailability, limited student tracking or disclosure, invalidating or victim-blaming responses, lack of perceived expertise, and mismatched interpersonal or cultural dynamics. The psychologization of Buddhist meditation in the West shapes student-teacher relationships and expectations, especially during challenges.
The American journal of orthopsychiatry
March 24, 2025
Matthew J Lyons, Deanna M Kaplan, Sarah H Cross et al.
1 citation
Mindfulness-based interventions (MBIs) show promise for improving health outcomes, but their effectiveness varies significantly across populations. In low-resource settings, focusing solely on individual change overlooks critical structural issues affecting health. With a call to action for community ownership and engagement, it’s essential to address inequities in power and incorporate cross-sector collaboration. By centering community-defined needs and integrating complementary interventions, MBIs can better serve vulnerable populations, potentially leading to significant positive social change and improved health outcomes for those most in need.
Psychedelics.
December 17, 2024
Zachary Bosshardt, Jessica L. Maples‐keller, Deanna M. Kaplan et al.
Attendees at a conference on psychedelics and spiritual care generally agreed that microdosing may have benefits and expressed modest concern about potential harm from therapeutic psychedelic use. Among 178 survey respondents, 40.2% agreed or strongly agreed that psychedelics could be harmful therapeutically, while 30.7% were unsure. A subset of 32 psychedelic care facilitators reported using psychedelics to treat a wide range of diagnoses with diverse psychotherapy approaches and endorsed a need for cultural adaptations in psychedelic treatments.
Transcultural psychiatry
August 1, 2023
Jared R Lindahl, Roman Palitsky, David J Cooper et al.
Worldviews can both increase the risk of meditation-related challenges and serve as a remedy for them, depending on the individual. Buddhist practitioners and teachers in the contemporary West navigate both religious and scientific explanatory frameworks, a context shaped by "Buddhist modernism" which presents Buddhism as compatible with science. Interview data from the Varieties of Contemplative Experience project show that for some, having, applying, or changing a worldview helped mitigate challenging experiences or distress, while for others, worldviews acted as a risk factor influencing the onset and course of difficulties.