The Compass Psychological Support Model (CPSM) used in psilocybin trials is arguably a form of bona fide psychotherapy, not merely psychological support. Its components—psychoeducation, trust, present-moment focus, and client autonomy—align with humanistic-experiential therapies like client-centered and emotion-focused therapy. These methods, such as building therapeutic alliance and reducing experiential avoidance, have established links to improved outcomes in both general psychotherapy and psilocybin treatments. Framing the CPSM as non-therapeutic undermines methodological transparency and may obscure its contribution to efficacy. Recognizing it as psychotherapy could enable optimization of therapist skills and client factors, enhancing treatment outcomes.
This editorial introduces a Research Topic on the role of set and setting in psychedelic-assisted psychotherapy. It argues that the effects of psychedelic substances are profoundly shaped by the psychological state of the individual (set) and the physical, social, and cultural environment (setting), rather than being purely pharmacological. The editorial emphasizes that understanding and optimizing these contextual factors is crucial for both safe clinical practice and the design of future research. It calls for more systematic investigation into how set and setting influence therapeutic outcomes, and highlights the need to integrate these insights into training and clinical protocols to maximize the potential benefits and minimize risks of psychedelic-assisted therapy.