Psychedelic group therapy

Domain VII · Transpersonal, psychedelic & altered states · Anderson, Lewis, Dames · 2020

What it is

Psychedelic group therapy is a format, not one therapy. It covers protocols that place a psychedelic or dissociative medication session inside a group-psychotherapy container, with group preparation, group (and usually individual) integration, and sometimes co-located dosing of a cohort on the same…

Format

• B. Fully group model with co-located dosing (HOPE / Lewis 2023). Cohorts of 4–6 (12 participants across three cohorts). Three 120-min group preparation sessions, each with about 90 min of group work and 30 min of individual breakout time with the participant's own therapist. Then a group medication…
• B′. Cohort dosing with adjacent rooms (Agrawal et al., Sunstone Therapies, community cancer centre). A phase II open-label trial with 30 participants who had cancer and major depressive disorder. Cohorts of 3–4 were treated on the same day in adjacent rooms that were open to each other, with one…

Who practises it, and how they are trained or regulated

• A. Group psychotherapy with individual medication sessions (UCSF / Anderson 2020). Sequential cohorts of six participants, each with two co-therapists. Over about seven weeks: about 3 h of individual psychotherapy, 12–15 h of group psychotherapy, and an individual full-day medication session in which at least one of the participant's own group co-therapists serves as one of the two guides. Pre-session groups ran 90…
• C. Group ketamine-assisted Community of Practice (Roots To Thrive / Dames 2025). Cohorts of 20–40 split into fixed small groups of 6–9, led by a facilitator pair or trio, with roughly one facilitator for every 3–4 participants. Twelve weekly sessions, each with a large-group segment (30–40 min) and a small-group segment (70–90 min). Several medicine sessions are embedded mid-programme; the protocol sets their…
• D. Regulated non-medical group administration (Oregon Psilocybin Services, OAR 333-333). Group administration sessions are allowed under the adopted rules (OAR 333-333-5230, group administration sessions; OAR 333-333-5020, group preparation). Current rule text (amended effective 1 January 2025): the number of facilitators required depends on the amount each client will consume, and the largest amount in the group…

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

• dependence on the group. Plan a graded ending.
• journaling used to ruminate. Shift the focus to actions.
• pressure to share the experience before the person is ready.
• anticipatory anxiety spreading. Name it as shared and normal.
• material too private for the group. Agree what stays in the dyad.

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.