Set & Setting

Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology

This literature review (2016) explores the theoretical distinctions and overlaps between placebo response theory and the concept of ‘set and setting’ in psychedelic contexts. It suggests that integrating these frameworks offers a broader understanding of how non-biological factors, such as expectancy and environment, shape therapeutic outcomes.

Authors

  • Ido Hartogsohn

Published

Journal of Psychopharmacology
meta Study

Abstract

Placebo response theory and set and setting theory are two fields which examine how non-biological factors shape the response to therapy. Both consider factors such as expectancy, preparation and beliefs to be crucial for understanding the extra-pharmacological processes which shape the response to drugs. Yet there are also fundamental differences between the two theories. Set and setting concerns itself with response to psychoactive drugs only; placebo theory relates to all therapeutic interventions. Placebo theory is aimed at medical professionals; set and setting theory is aimed at professionals and drug users alike. Placebo theory is primarily descriptive, describing how placebo acts; set and setting theory is primarily prescriptive, educating therapists and users on how to control and optimize the effects of drugs. This paper examines how placebo theory and set and setting theory can complement and benefit each other, broadening our understanding of how non-biological factors shape response to drugs and other treatment interventions.

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Research Summary of 'Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology'

Introduction

Placebo response and set and setting are two literatures that address how non-pharmacological factors shape therapeutic outcomes. Placebo research, rooted in modern clinical trial methodology, examines how expectations, clinician behaviour and symbolic aspects of treatment contribute to improvement across many medical interventions. Set and setting arose within mid-twentieth century psychedelic research and contends that psychological disposition (set) and the physical/social environment (setting) powerfully modulate the subjective and clinical effects of psychoactive drugs. Hartogsohn frames the paper as an integrative, conceptual review that compares and contrasts placebo theory and set and setting theory, identifies their commonalities and differences, and explores how bringing them into dialogue could broaden understanding of extra-pharmacological influences on drug effects. The study aims to show how the two perspectives can complement one another theoretically and practically and to propose areas for empirical research into their interrelation, especially in the context of contemporary psychedelic research and clinical practice.

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Study Details

  • Study Type
    meta
  • Journal
    Journal of Psychopharmacology
  • Topic
    Set & Setting
  • Author
    Ido Hartogsohn
  • APA Citation

    Hartogsohn, I. (2016). Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology. Journal of Psychopharmacology, 30(12), 1259-1267. https://doi.org/10.1177/0269881116677852

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