Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature
Golden, T. L., Magsamen, S., Sandu, C. C., Lin, S., Roebuck, G. M., Shi, K. M., Barrett, F. S.
This review (2022) explores the role and value of the setting in the psychedelic experience and the subsequent therapeutic outcomes. It was found that while the importance of setting is emphasized in the literature, there is yet to be any consistent and rigorous testing of setting and its complexities. There is yet to be a shared consensus on the effects setting has and the mechanism by which it affects outcomes as a result.
Abstract
The health and well-being impacts of art and aesthetic experiences have been rigorously studied by a range of disciplines, including cognitive neuroscience, psychiatry, public health, and translational clinical research. These experiences, encompassed in the concepts of set and setting, have long been claimed to be pivotal in determining the acute and enduring effects of psychedelic experiences. Responding to the field’s longstanding emphasis on the role and value of the setting, a rapid scoping review was undertaken to identify the extent to which effects of setting and aesthetics on psychedelic experiences and therapies have been explicitly studied. It offers an analysis of the strengths and limitations of the extant literature and discusses evidentiary gaps as well as evidentiary opportunities for the field. The 43 included studies indicate apparent consensus regarding the importance of setting in psychedelic therapies, as well as consistent interest in theorizing about these effects. However, this consensus has yet to generate consistent, prospective, rigorous tests of setting and its complexities. As a result, the field continues to lack understanding or agreement regarding the effects of various specific elements of setting, the mechanisms by which they affect outcomes, for whom these effects occur, under what circumstances, given what conditions, and other critical factors. Further studies of setting and aesthetics in the context of psychedelic therapies are likely to not only improve these therapies and their delivery but also inform considerations of setting and aesthetics for non-psychedelic interventions.