Treatment with psychedelics is psychotherapy: beyond reductionism
This opinion piece (2023) challenges the traditional conceptualization of psychedelic-assisted psychotherapy (PAP/PAT), emphasizing that the therapeutic effects of psychedelics should not be solely attributed to the substance itself but also to the importance of psychotherapy. The authors argue against reducing the role of psychotherapy to mere psychological support for safety, advocating for a more integrated approach to understanding and studying the therapeutic potential of psychedelics in treating psychiatric disorders.
Authors
- Lea Mertens
- Henrik Jungaberle
- Gerhard Gründer
Published
Abstract
Treatment of psychiatric disorders with psychedelic substances represents one of the most promising current treatment approaches in psychiatry. Since its inception in the 1950s, therapy with psychedelics has been conceptualised as psychedelic-assisted psychotherapy-ie, a form of psychotherapy that uses the profound biological effects of this class of substances as a catalyst for changing thinking, emotions, and behaviour. In this view, the psychotherapy component of the treatment is considered as being of the utmost importance for both the safety and efficacy of the therapy. This conceptualisation has been challenged by the idea that the latest clinical studies suggest that the potential therapeutic effects of psychedelics must be attributed solely to the substance itself, with no role for psychotherapy. Here, accompaniment by therapists is understood as mere psychological support, to maintain the safety of the substance administration. In this Personal View, we contrast these two views and argue that the characterisation of treatment with psychedelics as a biological intervention (with psychological support as a purely safety-related component) represents an outdated and reductionistic dualism that has dominated psychiatric treatment and research for far too long. This discussion has important implications for the study and the regulation of these compounds.
Research Summary of 'Treatment with psychedelics is psychotherapy: beyond reductionism'
Introduction
Since the 1950s the relative contributions of psychotropic drugs and psychotherapy to psychiatric outcomes have been fiercely debated. In the context of psychedelic treatments, this debate has re-emerged because these interventions traditionally combine potent pharmacology with structured psychotherapeutic support. Some recent proposals and regulatory views treat psychedelic effects as separable from their psychosocial context, attributing therapeutic benefit primarily to the substance and framing therapist contact as safety-focused rather than therapeutically active. Gründer and colleagues set out to contest that reductionist framing. In this Personal View they argue that the effects of psychedelics are inherently context dependent, that psychotherapy is central to safety and efficacy, and that regulatory and research approaches should recognise treatment with psychedelics as a form of psychotherapy rather than as a purely biological intervention. The piece aims to bring clinical, translational, historical, and regulatory perspectives to bear on this argument and to urge changes in how such treatments are studied, regulated, and implemented.
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Study Details
- Study Typeindividual
- Journal
- Authors
- APA Citation
Gründer, G., Brand, M., Mertens, L. J., Jungaberle, H., Kärtner, L., Scharf, D. J., Spangemacher, M., & Wolff, M. (2024). Treatment with psychedelics is psychotherapy: beyond reductionism. The Lancet Psychiatry, 11(3), 231-236. https://doi.org/10.1016/S2215-0366(23)00363-2
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Papers cited by this study that are also in Blossom
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Mertens, L. J., Wall, M. B., Roseman, L. et al. · Journal of Psychopharmacology (2020)
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Stellmacher, J., Schmidt, C., Aicher, H. D. et al. · Frontiers in Psychiatry (2026)
Smith, K. A., Harcourt, E., Cipriani, A. · BJPsych Open (2026)
Goodwin, G. M., Aaronson, S. T., Alvarez, O. et al. · Journal of Affective Disorders (2026)
Mertens, L. J., Koslowski, M., Betzler, F. et al. · JAMA Psychiatry (2026)
Cherniak, A. D., Granqvist, P., Mikulincer, M. et al. · Journal of Psychoactive Drugs (2026)
Goldy, S. P., Sepeda, N. D., Hilbert, S. N. et al. · Psychiatry Research (2026)
Kvam, T. M., Goksøyr, I. W., Rog, J. et al. · Journal of Psychiatric Research (2026)
Gründer, G., Mertens, L. J., Spangemacher, M. et al. · European Neuropsychopharmacology (2026)
Modlin, N. L., Williamson, V., Goodwin, G. M. et al. · EClinicalMedicine (2025)
Kvam, T. M., Goksøyr, I. W., Rog, J. et al. · British Journal of Psychiatry (2025)
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Ham, R., Gardner, J., Carter, A. et al. · Brain and Behavior (2025)
Erritzoe, D., Barba, T., Greenway, K. T. et al. · EClinicalMedicine (2024)
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