Participant experiences of therapeutic touch in psilocybin-assisted therapy

Psychedelic-assisted therapy (PAT) is expanding rapidly as a clinical approach, including recent regulatory changes that have increased authorised clinical access to psilocybin and MDMA in some jurisdictions. The paper situates therapeutic touch as a common but under-researched element of contemporary PAT protocols. The authors note that psychedelics create transient, intense changes in conscious awareness that can impair verbal communication and that non-verbal supports such as touch are therefore often used during dosing sessions, yet empirical evidence about the safety, utility and acceptability of touch in PAT is lacking. This study reports participant perspectives on therapeutic touch collected within a Phase II randomised clinical trial of psilocybin-assisted therapy for Generalised Anxiety Disorder (PsiGAD-1). The researchers aimed to answer three questions: what are participants' perspectives on including therapeutic touch in psychedelic therapy; do attitudes to touch change across treatment; and what do participants perceive as the utility of touch in PAT. The paper emphasises the ethical considerations surrounding touch and frames the investigation as informing guideline development, therapist training, and safety protocols for PAT contexts where touch is used.

The study used mixed qualitative and descriptive methods embedded within a Phase II randomised clinical trial (PsiGAD-1) of psilocybin-assisted therapy for Generalised Anxiety Disorder. Trial treatment comprised two dosing sessions (psilocybin or diphenhydramine as an active placebo) and nine psychotherapy sessions delivered by a mixed-gender co-therapy team. The trial's touch protocol permitted minimal, supportive touch (for example handholding) during dosing sessions to manage distress; somatic therapies were not permitted and sexual or sensual touch was explicitly prohibited. Consent for touch was obtained and practised prior to dosing, with participants able to adjust preferences between sessions. All trial participants consented to touch with personalised specifications. Descriptive data included demographics collected in REDCap and a single-item Visual Analogue Scale (0–100) administered six weeks after the second dosing session asking participants to rate how important therapeutic touch was in psychedelic-assisted psychotherapy. For participants in the placebo arm who later received active PAT, the same item was administered three weeks after their extension-arm dose; these ratings were summarised descriptively. Qualitative data came from semi-structured Zoom interviews of approximately 60 minutes conducted at three timepoints by the first author and another male researcher trained in qualitative methods. Transcripts were coded in NVivo. The qualitative sample comprised 39 longitudinal interviews across 18 participants (13 active arm; 5 placebo arm) drawn from a larger pool of 62 interviewees; the subset was selected for data richness and relevance and sampling continued until the team judged thematic saturation had been reached. Thematic analysis used an inductive, iterative coding process; a subset of three interviews was triple-coded by multiple team members to reach consensus, after which the first author completed the remaining coding. The team regularly reviewed codes for coherence and validated themes, with particular attention paid to representing atypical or negative experiences.

The qualitative analysis produced three related primary themes: (1) expectations and attitudes towards therapeutic touch, (2) varied experience and interpretation of touch, and (3) relational dynamics in touch delivery. Descriptive survey data and demographic tables are referenced but not reproduced in the extracted text. On the single-item importance rating, participants reported a high mean importance (m = 75.38) with a positively skewed distribution; nine participants assigned the maximum score of 100. The observed range ran from 23 to 100, indicating substantial inter-individual variability in perceived importance. Theme 1: Expectations and attitudes. At baseline many participants held positive or neutral expectations about touch, commonly anticipating it would help manage distress and be grounding. Those who described themselves as comfortable with touch in everyday life (self-described “huggers”) tended to anticipate more favourable responses, while participants with uncomfortable or difficult childhood experiences of physical contact described greater baseline hesitancy. A short illustrative baseline quote captured this expectation: "For me, [touch] is a way of feeling safe and feeling connected..." (Participant 1). Theme 2: Shifts and varied experiences. After dosing sessions, many participants reported that touch was more important than they had expected, with some saying they would not want to undergo a psychedelic session without touch available. Several participants who were initially uncomfortable found touch helpful in practice, often describing it as fostering connection that made intense emotions more manageable or enriched positive affect. However, experiences were not uniformly positive: at least one participant reported that touch immediately amplified emotional intensity and later declined touch for that session. Participants described a functional distinction between the immersive inner experience (

This is presented as the first analysis of clinical trial participant data on therapeutic touch in PAT. The study highlights substantial heterogeneity in participants' responses: while many valued touch and some reported that it supported going deeper into or staying within the psychedelic experience, others found it unnecessary or at times counterproductive. The authors interpret the descriptive and qualitative findings as supporting a tailored, client-directed approach to touch rather than a universal protocol. They emphasise that touch appeared most useful when embedded in a robust consent process and within a trusting therapeutic relationship, noting that in this sample trust appeared to be a prerequisite for accepting touch rather than an outcome of touch itself. The authors note that the high mean importance rating (m = 75.38) and the skew towards high ratings indicate general favourability among participants in this trial, but the wide range (23–100) and qualitative examples of negative or paradoxical effects demonstrate the need for individualisation. Reported motivations for using touch included managing acute emotional intensity, navigating an unfamiliar altered state, and practising interpersonal processes such as asking for help. No participants in this sample described significant adverse outcomes attributable to touch, although the authors caution that touch can distract from therapeutic content, be inappropriately timed across stages of the acute drug effect, or paradoxically amplify distress in some cases. Practical implications discussed by the authors include strengthening consent procedures (for example, encouraging participants to pre-specify acceptable minimal forms of touch), offering non-contact alternatives (weighted blankets, synchronised breathing), and using post-dosing debriefs to reflect on touch as a potential boundary crossing. They also stress that different clinical indications, substances and therapeutic models will likely interact with touch in distinct ways; in particular, protocols that endorse somatic or bodywork approaches differ markedly from the minimal, client-directed approach studied here and may carry greater risk without specialised training and clearer ethics/safety protocols. Finally, the authors call for future research into therapists' experiences and training needs to inform the safe, effective incorporation of touch into PAT.

The authors conclude that therapeutic touch can be a valuable, client-directed tool in psilocybin-assisted therapy for fostering connection and addressing emotional needs during acute psychedelic states, when implemented within a minimalist protocol and thorough consent procedures. Many participants in this sample were favourable to supportive touch under those conditions, but the authors stress continued empirical and ethical work is needed to clarify its role across different patient groups, substances and therapeutic approaches, and to develop training and governance for safe use.