Expectancies for Cannabis-Induced Emotional Breakthrough, Mystical Experiences and Changes in Dysfunctional Attitudes: Perceptions of the Potential for Cannabis-Assisted Psychotherapy for Depression

People who use cannabis expect that a cannabis-assisted psychotherapy session, modeled on psychedelic-assisted psychotherapy, would reduce depression. Over 500 participants in each of two studies imagined such a session and reported expected antidepressant effects. Expected reductions in depression were linked to anticipated psychedelic-like subjective experiences, such as mystical-type feelings, and also to expected changes in dysfunctional attitudes—a separate pathway that resembles how cognitive therapy works. These findings support calls for clinical trials of cannabis-assisted psychotherapy and indicate that users anticipate it would work through mechanisms similar to both psychedelics and cognitive therapy.

Study at a glance

Abstract

Psychedelic-assisted psychotherapy has established antidepressant effects. Cannabis users appear to expect high doses administered in a session much like psychedelic-assisted psychotherapy to create comparable subjective effects. The current studies explored expectations of antidepressant effects of such cannabis-assisted sessions to replicate and extend previous work. Users not only expected a cannabis-assisted psychotherapy session to decrease depression, but also to alter some of the same mediators of psychedelic or psychological treatments. Over 500 participants in Study I envisioned a cannabis-assisted therapy session akin to those used in psychedelic therapies and reported the effects that they expected on depression as well as relevant subjective reactions. A second sample of over 500 participants responded to identical measures and an index of dysfunctional attitudes that appears to mediate antidepressant effects of psychotherapy. Expectancies of cannabis-induced antidepressant effects covaried with expected psychedelic effects. Participants also envisioned that cannabis-assisted therapy would alter dysfunctional attitudes, which served as a separate, unique path to expected antidepressant effects unrelated to the subjective effects of psychedelics. These results add support to arguments for relevant clinical trials of cannabis-assisted psychotherapy and suggest that cannabis users would expect it to work in ways similar to psychedelics as well as cognitive therapy.