This commentary argues that the debate over whether psychedelic-assisted interventions qualify as psychotherapy should be grounded in empirical evidence rather than normative assumptions. The author examines the criteria typically used to define psychotherapy—such as therapeutic relationship, theoretical framework, and intentional therapeutic process—and evaluates how these apply to psychedelic sessions. The piece suggests that the classification has practical implications for research, regulation, and clinical practice. By focusing on what actually occurs during psychedelic sessions, the commentary aims to move the discussion from abstract definitions to observable features, ultimately proposing that the answer depends on the specific practices and contexts involved.
This commentary argues that psychological support and psychotherapy in psychedelic medicine should be distinguished by the intent and behavioral frameworks guiding the interaction. It emphasizes that conflating the two may lead to conceptual confusion and hinder the development of appropriate clinical practices and research designs. The authors propose that clarifying these distinctions can improve the precision of therapeutic models and outcome measures in the field.
Ethical reflexivity and relational presence are central to psychedelic-assisted psychotherapy. The work argues that therapists must continuously examine their own biases and maintain an authentic, present-centered relationship with clients to navigate the unique ethical challenges that arise during altered states of consciousness. This approach emphasizes the importance of therapist self-awareness and interpersonal attunement in fostering safe and effective therapeutic outcomes.