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William A. Richards

Johns Hopkins University, Johns Hopkins Medicine

27 papers in the library · 5,481 citations · publishing 1970-2026

Papers

Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial

Journal of Psychopharmacology November 30, 2016 Annie Umbricht, Mary P Cosimano, Roland R. Griffiths et al. 2,174 citations

In cancer patients with life-threatening diagnoses and symptoms of depression or anxiety, a high dose of psilocybin (22 or 30 mg/70 kg) produced large decreases in depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety, compared with a very low placebo-like dose (1 or 3 mg/70 kg). At 6-month follow-up, about 80% of participants continued to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life, mood, relationships, and spirituality to the high-dose experience, with over 80% endorsing moderately or greater increased well-being or life satisfaction. The mystical-type experience during the session mediated the effect of dose on therapeutic outcomes.

Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance

Psychopharmacology July 7, 2006 Roland R. Griffiths, William A. Richards, U. Mccann et al. 1,684 citations

A high dose of psilocybin, given under supportive conditions to hallucinogen-naïve adults who regularly participate in religious or spiritual activities, produced acute perceptual changes, subjective experiences, and labile moods including anxiety. It also increased measures of mystical experience. Two months later, volunteers rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed sustained positive changes in attitudes and behavior to it, consistent with ratings by community observers. The ability to prospectively occasion such experiences allows rigorous scientific investigation of their causes and consequences.

Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors

Journal of Psychopharmacology October 11, 2017 Roland R. Griffiths, Matthew W. Johnson, William A. Richards et al. 528 citations

A double-blind trial compared a high dose of psilocybin (20 and 30 mg/70 kg) with a very low dose (1 mg/70 kg) in healthy adults who also undertook a program of meditation and spiritual practices. At six months, the high-dose groups, compared with the low-dose group, showed large, significant positive changes in interpersonal closeness, gratitude, life meaning, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings. The enduring trait-level increases in prosocial attitudes and healthy psychological functioning were linked to the mystical-type experience occasioned by psilocybin and the rate of meditation or spiritual practices.

LSD-Assisted Psychotherapy in Patients with Terminal Cancer

International Pharmacopsychiatry January 1, 1973 S Grof, L. Goodman, William A. Richards et al. 212 citations

A psychotherapeutic program using psychedelic compounds (LSD and DPT) was tested in 60 cancer patients to reduce emotional and physical suffering. Ratings by physicians, nurses, family members, and therapists showed significant improvement in depression, anxiety, fear of death, pain, and psychological isolation after treatment. Narcotic use decreased but not significantly. Global distress indexes indicated dramatic improvement in about 29% of patients, moderate improvement in 41.9%, no change in 22.6%, and worsening in 6.4%.

Current perspectives on psychedelic therapy: use of serotonergic hallucinogens in clinical interventions

International Review of Psychiatry July 4, 2018 Albert Garcia-Romeu, William A. Richards 186 citations

Serotonergic hallucinogens (psychedelics) have been used for millennia, but their integration into Western therapeutic practice is relatively new. Mid-20th-century work developed therapeutic models using both low (psycholytic) and high (psychedelic) doses, often combined with psychoanalytic concepts, and established the importance of set (mindset) and setting (environment) for safe, effective use. Recent clinical and pharmacological research has revisited these substances' therapeutic potential. This article reviews past and present models of psychedelic therapy and discusses key considerations for future research and clinical applications.

The Peak Experience Variable in DPT-Assisted Psychotherapy with Cancer Patients

Journal of Psychedelic Drugs January 1, 1977 William A. Richards, John Rhead, Francesco B. Dileo et al. 95 citations

In a 1977 study of dipropyltryptamine (DPT)-assisted psychotherapy with cancer patients, the occurrence of a peak experience during a drug session was associated with better therapeutic outcomes. Among 128 patients, those who had a peak experience showed greater reductions in anxiety, depression, and pain, and improved quality of life compared to those who did not. The authors suggest that the peak experience may be a key variable in the effectiveness of psychedelic-assisted therapy for this population.

Development and Evaluation of a Therapist Training Program for Psilocybin Therapy for Treatment-Resistant Depression in Clinical Research

Frontiers in Psychiatry February 3, 2021 Sara Tai, Elizabeth M. Nielson, Molly Lennard-Jones et al. 87 citations

A therapist training program for psilocybin therapy, developed for a phase IIb international, multicenter, randomized controlled study of treatment-resistant depression, is described. The manualized approach, based on evidence-based psychotherapeutic methods and approved by the FDA, includes online learning, in-person training, applied clinical training, and ongoing mentoring. After training 65 health care professionals across the US, Canada, and Europe, feedback indicated that didactic and experiential learning helped build conceptual understanding and skills. Clinical training and participant care under experienced therapists were most beneficial and challenging. Rigorous, scalable training requires collaboration among public, academic, and industry partners.

Psilocybin‐assisted group therapy in patients with cancer diagnosed with a major depressive disorder

Cancer December 18, 2023 Manish Agrawal, Yvan Beaussant, Sarah Shnayder et al. 73 citations

A single 25-mg dose of psilocybin, administered alongside one-to-one and group therapeutic support, was safe and feasible for patients with curable and noncurable cancer who also had major depressive disorder. In a phase 2 open-label trial with 30 participants, no serious adverse events or suicidality occurred, and mild side effects like nausea and headache were as expected. Depression severity scores dropped by an average of 19.1 points from baseline to eight weeks after treatment. Eighty percent of participants showed a sustained response, and half achieved full remission of depressive symptoms by week one that lasted for eight weeks. The group-oriented format and compact delivery in a community cancer center may add to therapeutic gains.

Psychedelic Psychotherapy: Insights From 25 Years of Research

Journal of Humanistic Psychology September 29, 2016 William A. Richards 70 citations

After a dormant period of more than two decades, investigations with psychedelic substances such as psilocybin, DMT, LSD, and MMDA have resumed in the United States and Europe. Drawing on 25 years of clinical research experience, the author discusses the cartography of inner space, the therapeutic potential of transcendental states of consciousness, the entelechy of the interpersonally grounded psyche, the importance of integration in drug-free therapy sessions, the roles of expectation, religious education and faith, the role of music, and future research directions.

MDA-ASSISTED PSYCHOTHERAPY WITH NEUROTIC OUTPATIENTS

The Journal of Nervous and Mental Disease October 1, 1976 Richard Yensen, Francesco B. Di Leo, John Rhead et al. 51 citations

Ten neurotic outpatients (five men, five women) received up to 75 hours of psychotherapy over 2 to 6 months, with 3,4-methylenedioxyamphetamine (MDA) administered as an adjunct in two to four sessions. The drug was well tolerated with no serious side effects. Pre- and post-treatment psychometric assessments, including the MMPI, Wittenborn Psychiatric Rating Scales, and Brief Psychiatric Rating Scale, showed significant reductions in depression, anxiety, and obsessive-compulsive traits, along with improvements in well-being and self-actualization. No patient worsened. A 6-month follow-up using the same measures plus a Social History Questionnaire supported these improvements.

Assessment of Psilocybin Therapy for Patients With Cancer and Major Depression Disorder

JAMA Oncology April 13, 2023 Manish Agrawal, Ezekiel Emanuel, Brian D. Richards et al. 48 citations

In a nonrandomized controlled trial, psilocybin was administered to groups of patients with cancer who also had major depressive disorder, using a one-to-one therapist-to-patient ratio. The aim was to develop a scalable, rapidly effective depression treatment. The trial suggests that this approach may offer a feasible model for delivering psilocybin therapy to larger numbers of patients while maintaining therapeutic support.

Implications Of LSD and Experimental Mysticism

Journal of Psychedelic Drugs September 1, 1970 Walter N. Pahnke, William A. Richards 43 citations

The paper explores the implications of LSD-induced mystical experiences, arguing that such states can provide insights into the nature of consciousness and reality, challenging conventional psychological and philosophical frameworks. It suggests that these experiences often share core features with spontaneously occurring mystical states, including unity, transcendence of time and space, and a sense of sacredness, and may have therapeutic potential. The authors caution against simplistic interpretations and emphasize the need for careful integration of these experiences into personal and cultural contexts.

Psychedelic Drug (DPT)-Assisted Psychotherapy with Alcoholics: A Controlled Study

Journal of Psychedelic Drugs October 1, 1977 John Rhead, Robert A. Soskin, Ibrahim Turek et al. 25 citations

In a controlled trial, dipropyltryptamine (DPT)-assisted psychotherapy was compared to conventional group therapy for alcoholics. The DPT group received a single high-dose session plus preparatory and follow-up psychotherapy, while the control group received standard group therapy. At 6-month follow-up, the DPT group showed significantly greater improvement on measures of alcohol abstinence and psychosocial adjustment. The authors suggest that a single DPT session combined with psychotherapy may enhance treatment outcomes for alcoholism, though the small sample size limits generalizability.

DPT as an Adjunct in Brief Psychotherapy with Cancer Patients

OMEGA - Journal of Death and Dying February 1, 1980 William A. Richards, John C. Rhead, Stanislav Grof et al. 20 citations

A pilot project with thirty cancer patients experiencing psychological distress combined about twelve hours of conventional verbal psychotherapy over four weeks with a single intensive drug-assisted therapy session using dipropyltryptamine (DPT), a short-acting psychedelic. Analysis of psychological tests and independent ratings before and after the intervention suggests the total therapeutic approach enhances quality of life. The text discusses the relative merits of DPT compared to LSD and the need for a controlled study.

The Phenomenology and Potential Religious Import of States of Consciousness Facilitated by Psilocybin

Archive for the Psychology of Religion January 1, 2008 William A. Richards 19 citations

Psilocybin, a psychedelic drug, produces a range of conscious states including both mystical and nonmystical experiences. The text surveys and defines these states, discusses how to facilitate mystical experiences based on research experience, and notes their potential religious significance. Such states may help recognize spiritual reality, understand the biochemistry of revelation, and contribute positively to psychological treatment.

HERE AND NOW: DISCOVERING THE SACRED WITH ENTHEOGENS

Zygon: Journal of Religion and Science September 2, 2014 William A. Richards 17 citations

Recent research with entheogens (psychedelic substances) can reliably induce mystical forms of consciousness in healthy volunteers. This article discusses the definition of mystical consciousness used in such studies, distinguishing it from visionary or archetypal states and other altered mental states. It also considers how entheogens can be used skillfully and safely, and explores implications for clarifying confusion within the academic study of mysticism, offering suggestions for future religious research.

Effects of Psilocybin on Religious and Spiritual Attitudes and Behaviors in Clergy from Various Major World Religions

Psychedelic Medicine May 16, 2025 Roland R. Griffiths, William A. Richards, Robert L. Jesse et al. 14 citations

In clergy from various world religions who had never used psychedelics, two supported psilocybin sessions (20 mg/70 kg, then 20 or 30 mg/70 kg) led to sustained positive changes in religious practices, attitudes about their religion, and effectiveness as a religious leader, as well as in non-religious attitudes, moods, and behavior, compared with a waitlist control group. At 16‑month follow‑up, 96% rated at least one experience among the top five most spiritually significant of their lives, 42% rated it the single most profound, and 79% reported positive effects on daily sense of the sacred. No serious adverse events occurred, though 46% rated an experience among the top five most psychologically challenging of their lives.

Lessons to be learned from early psychedelic therapy in Denmark

Nordic Journal of Psychiatry July 20, 2017 David Erritzøe, William A. Richards 14 citations

Psychedelic therapies are being re-evaluated for treating conditions like major depression, cancer-related anxiety and depression, and alcohol use disorder. The research examines their effects and safety, suggesting potential benefits for these psychopathologies.

The Afterglow Inventory (AGI): Validation of a new instrument for measuring subacute effects of classic serotonergic psychedelics

Journal of Psychopharmacology March 31, 2025 Tomislav Majić, Timo Torsten Schmidt, Anna Gröticke et al. 4 citations

A new questionnaire called the Afterglow Inventory (AGI) reliably measures pleasant psychological effects that can occur days after a psychedelic experience, such as with psilocybin or LSD. The AGI captures five distinct dimensions: vitality, transpersonal aspects, inspiration/creativity, interpersonal relationships, and relationship to nature. In an international online survey of 1,323 people who had recently used a psychedelic and 157 controls, the AGI successfully distinguished between the two groups. Stronger and more positive acute psychedelic experiences were associated with higher afterglow scores. This tool may help researchers understand how short-term afterglow effects connect to longer-term therapeutic outcomes.

The Afterglow Inventory (AGI) – validation of a new instrument for measuring subacute effects of classic serotonergic psychedelics

October 22, 2024 Tomislav Majić, Timo Torsten Schmidt, Anna Gröticke et al. 1 citation preprint

A new questionnaire called the Afterglow Inventory (AGI) was developed and validated to measure the pleasant, temporary psychological effects that sometimes follow the acute phase of a psychedelic experience. An international online survey of 1,323 people who had taken a psychedelic and 157 who had taken a non-psychedelic substance in the past four weeks identified five key factors: vitality, transpersonal aspects, inspiration/creativity, interpersonal relationships, and relationship to nature. The 24-item AGI successfully distinguished psychedelic users from controls, and its overall score was positively correlated with the intensity and positive valence of the acute effects. The AGI may help researchers better understand how acute, subacute, and long-term effects of psychedelics relate to each other.

Approaches to Unitive Consciousness

Columbia University Press eBooks December 8, 2015 William A. Richards, G. William Barnard 1 citation

The abstract discusses the concepts of Internal Unity and External Unity, referencing the works of Walter Stace, Walter Pahnke, Kierkegaard, and Aldous Huxley. It suggests that these thinkers explore different forms of unity experience, possibly related to consciousness and mystical or paranormal states. The text implies a distinction between internal, subjective unity and external, objective unity, drawing on philosophical and psychological perspectives. However, as the abstract is brief and lacks a clear finding or argument, it primarily indicates a theoretical or philosophical analysis of these concepts within health psychology.

Integrating the Mystical Experience Questionnaire Into a Broader Psychometric Framework: English Validation of the Psychedelic Experience Scale and Comparison of Psilocybin and LSD Sessions Across Two Controlled Settings

Repository for Publications and Research Data (ETH Zurich) April 30, 2026 Kurt Stocker, Matthias Hartmann, Frederick S. Barrett et al.

The Psychedelic Experience Scale (PES48) has an eight-factor structure that includes the well-validated Mystical Experience Questionnaire (MEQ30) plus four additional factors: paradoxicality, connectedness, visual experience, and distressing experience. This study tested whether the full eight-factor structure is valid in English, using data from 280 PES measurements from 145 healthy participants in four placebo-controlled psilocybin studies. Six of the eight subscales showed high internal consistency, one good, and one acceptable. Confirmatory factor analysis indicated acceptable to good model fits for the MEQ30 and MEQ40, with English data showing better fits than the German validation sample. The findings suggest the PES48 is a valid psychometric tool in English, enabling broader measurement of mystical and non-mystical aspects of psychedelic experience.

Music in Psychedelic Research: The Continuing Legacy of Helen Bonny

Journal of the Association for Music and Imagery January 1, 2021 William A. Richards

Music serves as a dynamic presence during psychedelic psychotherapy sessions, enhancing the therapeutic experience. Drawing from the book Sacred Knowledge, this lecture traces the early history of combining music with psychedelic drugs for psychotherapeutic purposes, a lineage shared with Guided Imagery and Music (GIM). It describes playlists designed for 7-hour psychedelic sessions and the specific qualities of music selected for them, illustrating how music can guide and deepen the psychedelic journey.