How Important Is a Guide Who Has Taken Psilocybin in Psilocybin-Assisted Therapy for Depression?

People with depressive symptoms consider it somewhat important that guides in psilocybin-assisted therapy have personally used psilocybin. In a survey of over 800 MTurk respondents with depressive symptoms, ratings for the importance of a guide who had used psilocybin exceeded the "somewhat important" level (50 on a 0–100 scale) and were higher than ratings for other guide qualities and for a cognitive behavioral therapist who shared demographics, had depression experience, or received personal therapy. People of color and those with prior therapy gave even higher importance ratings. Participants listed similar desired qualities—proper training and empathy—for both psilocybin guides and CBT therapists. The findings suggest that guides who have used psilocybin and inform clients might enhance therapy's antidepressant effects for some clients.

Study at a glance

Abstract

Promising outcomes of Psilocybin-Assisted Therapy (PAT) for depression have generated concerted efforts to replicate, extend, and refine protocols to maximize efficacy. Psychotherapy research reveals that clients benefit most when important components of treatment align with their personal preferences. One open question related to PAT concerns the importance of the psilocybin experience of the guides (trained professionals present during acute effects). We sought to assess the importance of a guide who had used psilocybin to potential clients with depressive symptoms. Over 800 MTurk respondents with depressive symptoms rated the import of a guide who had used psilocybin relative to alternative characteristics in guides and cognitive behavioral (CBT) therapists. Importance ratings for guides who had used psilocybin significantly exceeded the "somewhat important" level (50 on a 0-100 scale), other guide-related qualities, and comparable ratings for a cognitive behavioral therapist who shared demographics, had experience with depression and received cognitive therapy personally. People of color (those who are not Caucasian) and those who had previous therapy gave significantly higher importance ratings for guides who had used psilocybin. Participants who chose to list other qualities important for guides listed very similar ones for CBT therapists, often emphasizing proper training and an empathic demeanor. Guides who have used psilocybin, who inform clients of the fact, might have advantages for facilitating PAT's antidepressant effects, as least in a subset of clients.