Therapy comes in many different forms, but one growing field of study has researchers committed to alleviating patients’ problems with the help of psychedelic substances. Treatments with substances like psilocybin, (a psychedelic compound in certain species of fungi, or “magic mushrooms”), MDMA (known as “ecstasy”), LSD (known as “acid”), and ayahuasca have been studied for potential benefits that may relieve conditions such as depression, PTSD, and addictions. 

In this emerging branch of therapy called psychedelic-assisted psychotherapy (PAP), a mental health professional accompanies a patient treated with substances to address goals for long-term personal problems. PAP has caught the attention of researchers in recent years, but limits on access to treatment and insufficient reporting have kept it from becoming a commonplace practice. 

A new investigation out of the Champalimaud Centre for the Unknown, a research foundation in Lisbon, has examined the reasons for gaps in PAP reporting, finding that standardized guidelines across all forms of treatment are needed moving forward. Published in The Lancet Psychiatry, the paper reviewed 45 previous studies involving 1,464 participants to evaluate the frequency and success of reporting among PSP sessions. 

Problems with PAP Studies

Research has suggested that psychedelics may promote a process called synaptogenesis, increasing the connections between neurons in the brain. Although more studies are needed to confirm the specific effects of psychedelics on this process, it appears they’re able to provide therapeutic benefits by encouraging restored connections in the cerebral cortex, which has a crucial role in functions related to emotions, learning, and memory.

However, in the recent study, the paper’s authors noted areas where the reviewed studies had failed to describe the process of psychological intervention in proper detail. Several studies, for example, didn’t outline the therapy setting, therapists’ qualifications, and the techniques used during treatment. Another recurring problem in the studies was that the number of therapy sessions was often absent — this information normally establishes how much therapy is needed for successful treatment. 

The relationship between a patient and therapist is pivotal in shaping the outcome of psychotherapy, but researchers also point to other factors that are not always considered in studies. 

“For example, measuring therapist adherence — how closely therapists follow treatment protocols — is essential for ensuring safety and effectiveness,” said first author Carolina Seybert, a clinical psychologist and psychotherapist at the Champalimaud Foundation, in a press release. “However, tracking adherence is costly and time-consuming, so it’s often overlooked. As a result, we can’t be certain the therapy was delivered as intended, which makes it hard to interpret the results.”

Seybert says MDMA studies, compared to psilocybin or ayahuasca studies, were found to have higher quality reporting because they use the same standardized treatment manual. Based on this observation, setting comprehensive guidelines for all treatments would improve researchers’ ability to determine the right course of action for specific mental disorders. 

Read More: Microdosing Psychedelics Could Revolutionize Mental Health Treatment

An Upward Trend for Psychotherapy

Raising the standards in PAP research could yield reliable results and influence the decisions of regulatory agencies to approve psychedelics for further medical use.

“We have a real opportunity to raise research standards across all treatments that combine psychotherapy and medication,” said Albino Oliveira-Maia, director of the Champalimaud Foundation’s Neuropsychiatry Unit and a senior author of the paper, in a press release. “By paying greater attention to the psychotherapy component — both in developing treatment protocols and in publishing trial results — we can improve the replicability, safety, and potential effectiveness of these therapies, and train therapists adequately.”

Despite prior oversight in PAP research, Oliveira-Maia claims the field is on the right track and recent studies have trended towards better reporting. As studies move toward higher quality reporting, psychedelics in therapy may gain traction and eventually become an option for patients struggling with mental health problems.

Read More: Psychedelics Could Be the Future of Psychotherapy

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Jack Knudson is an assistant editor at Discover with a strong interest in environmental science and history. Before joining Discover in 2023, he studied journalism at the Scripps College of Communication at Ohio University and previously interned at Recycling Today magazine.