Psychedelics, placebo effects, and set and setting: insights from common factors theory of psychotherapy

This commentary paper (pre-print) examines four common factors of psychedelic (healing) experiences and how those factors contribute, next to the molecules themselves, to the therapeutic effects. The factors are: 1) therapeutic relationship/alliance, 2) setting, 3) rationale/set, and 4) ritual.

Authors

  • Gukasyan, N.
  • Nayak, S.

Published

Preprints
meta Study

Abstract

Psychedelic-assisted treatment is at first glance markedly different in structure and approach from mainstream forms of psychotherapy in the West. A major criticism of clinical psychedelic research rests on the difficulty of executing placebo-controlled studies and distinguishing drug effects from those of the psychotherapeutic container in which psychedelics are typically presented. Detractors also tend to find fault in spiritual or mystical themes that often arise in the context of psychedelic use. Common factors theory of psychotherapy is a useful and extensively studied framework that can help make sense of these issues, and has much to contribute to our understanding of contextual effects that are often discussed in psychedelic literature as set and setting. In this paper we examine four major contextual common factors shared by various healing traditions-1) the therapeutic relationship, 2) the healing setting, 3) the rationale, conceptual scheme, or myth, and 4) the ritual. We explain how these factors show up in psychedelic-assisted treatment and how they may contribute to therapeutic effects. Lastly, we discuss implications of these factors for the concept of placebo, and for future research.

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Research Summary of 'Psychedelics, placebo effects, and set and setting: insights from common factors theory of psychotherapy'

Study Details

  • Study Type
    meta
  • Population
    humans
  • Characteristics
    commentary
  • Journal
    Preprints

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