Trial PaperDepressive DisordersAdolescentsMajor Depressive Disorder (MDD)Palliative & End-of-Life DistressHealthy VolunteersInterpersonal Functioning & Social ConnectednessAnxiety DisordersPsilocybin

Acceptability of psilocybin-assisted group therapy in patients with cancer and major depressive disorder: Qualitative analysis

In interviews with 28 cancer patients with major depressive disorder, a combined model of psilocybin‑assisted simultaneous individual and group therapy was generally judged acceptable and was felt to enhance perceived safety, preparedness, connection and opportunities for self‑transcendence and compassion. Participants emphasised the therapeutic framework, the complementary value of individual sessions, and careful attention to group size and interaction structure as key factors influencing acceptability and scalability in cancer care.

Authors

  • Manish Agrawal
  • Yvan Beaussant

Published

Cancer
individual Study

Abstract

Background

The present study explored the acceptability of psilocybin‐assisted group therapy from the perspective of patients with cancer and depression who participated in a clinical trial assessing the safety and efficacy of this novel intervention.

Methods

Guided by the conceptual framework of acceptability, the authors conducted semi‐structured interviews with participants of the psilocybin trial. Data were analyzed using template and thematic analyses.

Results

Participants’ (n = 28) perspectives on the acceptability of the group and simultaneous sessions was generally positive, both in terms of safety and efficacy: first, the groups contributed to increase participants’ sense of safety and preparedness as they were engaging in the therapy; and second, the groups fostered a sense of connection and of belonging, which served to enrich and deepen the meaning of participants’ experience, ultimately opening a dimension of self‐transcendence and compassion. Other subthemes related to factors influencing the acceptability of the group approach included: 1) the importance of the therapeutic framework, 2) the complementary value of individual sessions, 3) disruptive factors related to the group and/or simultaneous setting, and 4) opportunities and challenges related to group size and how to structure interactions.

Conclusions

This study enhances understanding of what promotes acceptability of the psilocybin‐assisted therapy group model for the treatment of MDD in cancer patients.Plain Language Summary We conducted exit interviews with participants of a phase 2 trial of psilocybin‐assisted therapy (PAT) conducted in a community cancer center, to assess the acceptability of a novel psilocybin delivery model combining simultaneous individual therapy and group sessions. Our findings support the acceptability of this intervention and suggest that in addition to being feasible, it might also enhance participants’ perceived safety and efficacy compared to uniquely individual or group delivery models of PAT. Our analysis highlights critical factors conditioning acceptability and suggests new ways PAT may be scaled and integrated into cancer care.

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Research Summary of 'Acceptability of psilocybin-assisted group therapy in patients with cancer and major depressive disorder: Qualitative analysis'

Introduction

Depression is common among people with cancer and substantially worsens outcomes: up to one in five cancer patients meet criteria for major depressive disorder (MDD), and available treatments reach only a minority and produce full remission for only a small proportion. Previous randomised trials have demonstrated safety and promising efficacy of psilocybin-assisted therapy (PAT) for MDD in non-cancer populations, prompting regulatory interest, but the conventional individual-delivery model for PAT is resource intensive, requiring multiple sessions and two trained therapists per patient. These logistical demands constrain scalability and access for people with cancer who have psycho‑existential distress. To address scalability, group-based PAT approaches have been piloted in other populations (for example, long-term HIV survivors and healthy volunteers undergoing simultaneous dosing), but they had not been studied in people with cancer and comorbid MDD. Beaussant and colleagues therefore set out to explore the acceptability of a novel delivery model that combined simultaneous individual dosing with group preparation and integration sessions, drawing on participants from a Phase II open‑label trial in patients with cancer and MDD. The primary aim was to understand patients' cognitive and emotional responses to the group/simultaneous format and to identify factors that promote or impede acceptability of this model.

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Study Details

References (15)

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