Psilocybin-assisted therapy (Hopkins, NYU, Imperial)

Domain VII · Transpersonal, psychedelic & altered states · Johnson, William Richards, Griffiths · 2008

What it is

Psilocybin-assisted therapy is a protocol, not a stand-alone psychotherapy. A screened participant has preparation meetings with a therapist pair, then one or more supervised psilocybin sessions in a calm, home-like room with eyeshades and music, then integration meetings. It has been used in two…

Format

• The core structure is the same at all three sites: screening → preparation → psilocybin session(s) → integration → follow-up.
• Format: psychiatric interview and medical work-up. Hopkins lists medical history, physical examination, ECG, blood tests and urinalysis, done by medical staff.

Who practises it, and how they are trained or regulated

• Imperial: two guides, mostly trained or training clinical psychologists, psychotherapists or psychiatrists, all with experience of non-ordinary states. One main guide attended all six face-to-face visits. Monthly group supervision was run by a consultant psychiatrist and psychotherapist.
• Source status. The structure of the ACE model comes from the ACBS abstract of Watts & Luoma 2020 and a secondary summary of the full paper; no public ACE manual is available in these sources, so the ACE exercise steps in 4.5 are. The NYU psychotherapy description comes from Ross et al. 2016 and a 2019 interview with Anthony Bossis; the NYU therapist manual and the paper's Supplementary Methods are not used here. The…
• Legal and regulatory status. As of the Drug Science review dated June 2026:

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• music tied to traumatic memories.
• over-large plans made in the afterglow. Scale them down.
• acceptance used as resignation. Link it to values (4.5.2).
• red-flag history, coercive or unscreened providers, and isolation.
• symptoms that persist or keep returning. Refer for psychiatric assessment.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.