A team at Geneva University Hospitals developed an interdisciplinary model for psychedelic-assisted psychotherapy (PAP) that combines the altered state of consciousness induced by LSD or psilocybin with traditional dialogue-based psychotherapy. Since 2014, Swiss law has allowed exceptional medical authorizations for these substances. From September 2020 to February 2024, the team received 224 personal authorizations (114 for LSD, 110 for psilocybin) and conducted 396 individual sessions. The protocol includes patient selection, preparatory psychoeducation, controlled substance administration, and integration sessions. The authors argue that psychedelic-induced consciousness alteration can act as a catalyst to revive stalled psychotherapeutic processes and call for continued research and broader clinical integration of PAP.
Early maladaptive schemas (EMS) are common in people seeking psychedelic-assisted psychotherapy and are strongly linked to baseline depression and anxiety. In 192 adults assessed for EMS and 74 patients followed through psilocybin- or LSD-assisted therapy, baseline schema burden—especially around failure and defectiveness—was tied to cognitive-depressive symptoms. However, schema burden did not predict the quality of the acute psychedelic experience or moderate overall symptom improvement. Patients experienced significant reductions in depression and anxiety with each session, but these changes depended on initial symptom severity, not their schema profile. Treatment effects were similar for psilocybin and LSD. The findings indicate that EMS are useful for identifying cognitive-emotional themes, such as core beliefs about failure, to address during psychotherapeutic integration, rather than for patient selection or outcome prediction.