{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:38:00Z","timestamp":1791909480955,"version":"4.3.4"},"reference-count":93,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Psychopharmacol"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Psychedelic-assisted psychotherapy (PAP) shows promise for substance use disorders (SUDs), yet the respective contributions of pharmacological, experiential, psychotherapeutic, and contextual factors remain insufficiently understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To synthesize contemporary clinical evidence on PAP for SUDs, with particular attention to therapeutic frameworks, dosing strategies, safety, and mechanisms of action.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review of clinical studies published between 2000 and 2026 was conducted through structured database searches and manual surveillance. Eligibility criteria involved classic psychedelic administration within defined psychotherapeutic frameworks in individuals with a primary SUD diagnosis. Data were narratively analyzed and synthesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventeen studies, encompassing 10 primary clinical trials, met inclusion criteria: ten focused on alcohol use disorder, five on tobacco use disorder, one on methamphetamine use disorder, and one on cocaine use disorder. All trials investigated psilocybin within structured psychotherapeutic protocols, primarily based on cognitive-behavioral and third-wave approaches. PAP was associated with reductions in substance use, higher abstinence rates, and improved psychological well-being, although findings remained heterogeneous and design-dependent. Trials combining repeated high-dose sessions with extended psychotherapeutic engagement consistently reported sustained clinical benefits. Findings further suggest that outcomes may arise from interactions between neurobiological, experiential, psychological, psychotherapeutic, and contextual processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Current evidence supports PAP as a promising but still emerging intervention for SUDs, although available clinical research remains exclusively based on psilocybin-assisted interventions. Findings further support conceptualizing PAP as a complex intervention embedded within an integrated psychotherapeutic process rather than as a pharmacological treatment alone. Larger controlled trials with active comparators, longer follow-up, and systematic investigation of psychotherapeutic and contextual mechanisms remain needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02698811261473436","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:41:40Z","timestamp":1787035300000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Psilocybin-assisted psychotherapy for substance use disorders as a complex intervention: A systematic review of efficacy, mechanisms and psychotherapeutic frameworks"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9434-6226","authenticated-orcid":false,"given":"Lana","family":"Strika-Bruneau","sequence":"first","affiliation":[{"name":"D\u00e9partement de Psychiatrie et d\u2019Addictologie, H\u00f4pital Paul Brousse, Assistance Publique-H\u00f4pitaux de Paris APHP, Villejuif, France"},{"name":"Facult\u00e9 de M\u00e9decine, Unit\u00e9 de Recherche Psychiatrie-Comorbidit\u00e9s-Addictions \u2013 PSYCOMADD, Universit\u00e9 Paris-Saclay, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ch\u00e9rine","family":"Elhssaini","sequence":"additional","affiliation":[{"name":"Laboratoire MC2, Institut de Psychologie, Universit\u00e9 Paris-Cit\u00e9, Boulogne-Billancourt, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baptiste","family":"Fauvel","sequence":"additional","affiliation":[{"name":"Laboratoire MC2, Institut de Psychologie, Universit\u00e9 Paris-Cit\u00e9, Boulogne-Billancourt, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8090-0457","authenticated-orcid":false,"given":"Ewen","family":"Kervadec","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Psychiatrie et d\u2019Addictologie, H\u00f4pital Paul Brousse, Assistance Publique-H\u00f4pitaux de Paris APHP, Villejuif, France"},{"name":"Facult\u00e9 de M\u00e9decine, Unit\u00e9 de Recherche Psychiatrie-Comorbidit\u00e9s-Addictions \u2013 PSYCOMADD, Universit\u00e9 Paris-Saclay, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurore","family":"Bezo","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Psychiatrie et d\u2019Addictologie, H\u00f4pital Paul Brousse, Assistance Publique-H\u00f4pitaux de Paris APHP, Villejuif, France"},{"name":"Facult\u00e9 de M\u00e9decine, Unit\u00e9 de Recherche Psychiatrie-Comorbidit\u00e9s-Addictions \u2013 PSYCOMADD, Universit\u00e9 Paris-Saclay, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0071-0822","authenticated-orcid":false,"given":"Ammar","family":"Amirouche","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Psychiatrie et d\u2019Addictologie, H\u00f4pital Paul Brousse, Assistance Publique-H\u00f4pitaux de Paris APHP, Villejuif, France"},{"name":"Facult\u00e9 de M\u00e9decine, Unit\u00e9 de Recherche Psychiatrie-Comorbidit\u00e9s-Addictions \u2013 PSYCOMADD, Universit\u00e9 Paris-Saclay, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amine","family":"Benyamina","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Psychiatrie et d\u2019Addictologie, H\u00f4pital Paul Brousse, Assistance Publique-H\u00f4pitaux de Paris APHP, Villejuif, France"},{"name":"Facult\u00e9 de M\u00e9decine, Unit\u00e9 de Recherche Psychiatrie-Comorbidit\u00e9s-Addictions \u2013 PSYCOMADD, Universit\u00e9 Paris-Saclay, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3699-2024","authenticated-orcid":false,"given":"Bruno","family":"Romeo","sequence":"additional","affiliation":[{"name":"D\u00e9partement de Psychiatrie et d\u2019Addictologie, H\u00f4pital Paul Brousse, Assistance Publique-H\u00f4pitaux de Paris APHP, Villejuif, France"},{"name":"Facult\u00e9 de M\u00e9decine, Unit\u00e9 de Recherche Psychiatrie-Comorbidit\u00e9s-Addictions \u2013 PSYCOMADD, Universit\u00e9 Paris-Saclay, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Agin-Liebes G Nielson EM Zingman M et al. (2024) Reports of self-compassion and affect regulation in psilocybin-assisted therapy for alcohol use disorder: An interpretive phenomenological analysis. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors 38(1): 101\u2013113. https:\/\/doi.org\/10.1037\/adb0000935","DOI":"10.1037\/adb0000935"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Bahji A Lunsky I Gutierrez G et al. (2025) Efficacy and safety of four psychedelic-assisted therapies for adults with symptoms of depression anxiety and posttraumatic stress disorder: A systematic review and meta-analysis. Journal of Psychoactive Drugs 57(1): 1\u201316. https:\/\/doi.org\/10.1080\/02791072.2023.2278586","DOI":"10.1080\/02791072.2023.2278586"},{"key":"e_1_3_2_4_1","doi-asserted-by":"crossref","unstructured":"Barksdale BR Doss MK Fonzo GA et al. (2024) The mechanistic divide in psychedelic neuroscience: An unbridgeable gap? Neurotherapeutics 21(2): e00322. https:\/\/doi.org\/10.1016\/j.neurot.2024.e00322","DOI":"10.1016\/j.neurot.2024.e00322"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Barrado-Moreno V Serrano-Ib\u00e1\u00f1ez ER Esteve R et al. (2025) The role of psychological flexibility and inflexibility in substance addiction abuse or misuse: A systematic review and meta-analysis. International Journal of Mental Health and Addiction 24: 1496\u20131519. https:\/\/doi.org\/10.1007\/s11469-025-01468-4","DOI":"10.1007\/s11469-025-01468-4"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Bogenschutz MP Forcehimes AA Pommy J A et al. (2015) Psilocybin-assisted treatment for alcohol dependence: A proof-of-concept study. Journal of Psychopharmacology 29(3): 289\u2013299. https:\/\/doi.org\/10.1177\/0269881114565144","DOI":"10.1177\/0269881114565144"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Bogenschutz MP Ross S Bhatt S et al. (2022) Percentage of heavy drinking days following psilocybin-assisted psychotherapy vs placebo in the treatment of adult patients with alcohol use disorder: A randomized clinical trial. JAMA Psychiatry 79(10): 953\u2013962. https:\/\/doi.org\/10.1001\/jamapsychiatry.2022.2096","DOI":"10.1001\/jamapsychiatry.2022.2096"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Boness CL Votaw VR Schwebel FJ et al. (2023) An evaluation of cognitive behavioral therapy for substance use disorders: A systematic review and application of the society of clinical psychology criteria for empirically supported treatments. Clinical Psychology: Science and Practice 30(2): 129\u2013142. https:\/\/doi.org\/10.1037\/cps0000131","DOI":"10.1037\/cps0000131"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","unstructured":"Byrne SP Haber P Baillie A et al. (2019) Systematic reviews of mindfulness and acceptance and commitment therapy for alcohol use disorder: Should we be using third wave therapies? Alcohol and Alcoholism 54(2): 159\u2013166. https:\/\/doi.org\/10.1093\/alcalc\/agy089","DOI":"10.1093\/alcalc\/agy089"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Calder AE Hasler G (2023) Towards an understanding of psychedelic-induced neuroplasticity. Neuropsychopharmacology 48(1): 104\u2013112. https:\/\/doi.org\/10.1038\/s41386-022-01389-z","DOI":"10.1038\/s41386-022-01389-z"},{"key":"e_1_3_2_11_1","doi-asserted-by":"crossref","unstructured":"Carhart-Harris RL Bolstridge M Rucker J et al. (2016) Psilocybin with psychological support for treatment-resistant depression: An open-label feasibility study. The Lancet. Psychiatry 3(7): 619\u2013627. https:\/\/doi.org\/10.1016\/S2215-0366(16)30065-7","DOI":"10.1016\/S2215-0366(16)30065-7"},{"key":"e_1_3_2_12_1","doi-asserted-by":"crossref","unstructured":"Carhart-Harris RL Friston KJ (2019) REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics. Pharmacological Reviews 71(3): 316\u2013344. https:\/\/doi.org\/10.1124\/pr.118.017160","DOI":"10.1124\/pr.118.017160"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"Carhart-Harris RL Goodwin GM (2017) The therapeutic potential of psychedelic drugs: Past present and future. Neuropsychopharmacology 42(11): 2105\u20132113. https:\/\/doi.org\/10.1038\/npp.2017.84","DOI":"10.1038\/npp.2017.84"},{"key":"e_1_3_2_14_1","doi-asserted-by":"crossref","unstructured":"Carhart-Harris RL Leech R Hellyer PJ et al. (2014) The entropic brain: A theory of conscious states informed by neuroimaging research with psychedelic drugs. Frontiers in Human Neuroscience 8: 20. https:\/\/doi.org\/10.3389\/fnhum.2014.00020","DOI":"10.3389\/fnhum.2014.00020"},{"key":"e_1_3_2_15_1","doi-asserted-by":"crossref","unstructured":"Carhart-Harris RL Roseman L Haijen E et al. (2018) Psychedelics and the essential importance of context. Journal of Psychopharmacology 32(7): 725\u2013731. https:\/\/doi.org\/10.1177\/0269881118754710","DOI":"10.1177\/0269881118754710"},{"key":"e_1_3_2_16_1","doi-asserted-by":"crossref","unstructured":"Close JB Hajien EC Watts R et al. (2020) Psychedelics and psychological flexibility: Results of a prospective web-survey using the Acceptance and Action Questionnaire II. Journal of Contextual Behavioral Science 16: 37\u201344. https:\/\/doi.org\/10.1016\/j.jcbs.2020.01.005","DOI":"10.1016\/j.jcbs.2020.01.005"},{"key":"e_1_3_2_17_1","doi-asserted-by":"crossref","unstructured":"Davis AK Barrett FS Griffiths RR (2020) Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. Journal of Contextual Behavioral Science 15: 39\u201345. https:\/\/doi.org\/10.1016\/j.jcbs.2019.11.004","DOI":"10.1016\/j.jcbs.2019.11.004"},{"key":"e_1_3_2_18_1","doi-asserted-by":"crossref","unstructured":"Eleftheriou ME Thomas E (2021) Examining the potential synergistic effects between mindfulness training and psychedelic-assisted therapy. Frontiers in Psychiatry 12: 707057. https:\/\/doi.org\/10.3389\/fpsyt.2021.707057","DOI":"10.3389\/fpsyt.2021.707057"},{"key":"e_1_3_2_19_1","doi-asserted-by":"crossref","unstructured":"Estric C Duron T Kabani S et al. (2025) Set and setting of psychedelics for therapeutic use in psychiatry: A systematic review. Journal of Psychopharmacology 39(9): 910\u2013929. https:\/\/doi.org\/10.1177\/02698811251338214","DOI":"10.1177\/02698811251338214"},{"key":"e_1_3_2_20_1","doi-asserted-by":"crossref","unstructured":"Faustino B (2021) Transdiagnostic perspective on psychological inflexibility and emotional dysregulation. Behavioural and Cognitive Psychotherapy 49(2): 233\u2013246. https:\/\/doi.org\/10.1017\/S1352465820000600","DOI":"10.1017\/S1352465820000600"},{"key":"e_1_3_2_21_1","doi-asserted-by":"crossref","unstructured":"Faustino B Vasco AB Farinha-Fernandes A et al. (2023) Psychological inflexibility as a transdiagnostic construct: Relationships between cognitive fusion psychological well-being and symptomatology. Current Psychology 42(8): 6056\u20136061. https:\/\/doi.org\/10.1007\/s12144-021-01943-w","DOI":"10.1007\/s12144-021-01943-w"},{"key":"e_1_3_2_22_1","doi-asserted-by":"crossref","unstructured":"Fl\u00fcckiger C B\u00f6hme M Schweizer A-M et al. (2025) In psychedelic-assisted therapy the alliance in the psychotherapy component is as important as the drug. Psychotherapy and Psychosomatics 94(4): 304\u2013305. https:\/\/doi.org\/10.1159\/000546270","DOI":"10.1159\/000546270"},{"key":"e_1_3_2_23_1","doi-asserted-by":"crossref","unstructured":"Garcia-Romeu A Griffiths RR Johnson MW (2014) Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. Current Drug Abuse Reviews 7(3): 157\u2013164. https:\/\/doi.org\/10.2174\/1874473708666150107121331","DOI":"10.2174\/1874473708666150107121331"},{"key":"e_1_3_2_24_1","doi-asserted-by":"crossref","unstructured":"Gold ND Pagni BA Petridis PD et al. (2025) Psilocybin-assisted therapy may enhance conservation values in patients with alcohol use disorder. Psychedelic Medicine 3(1): 31\u201340. https:\/\/doi.org\/10.1089\/psymed.2024.0030","DOI":"10.1089\/psymed.2024.0030"},{"key":"e_1_3_2_25_1","doi-asserted-by":"crossref","unstructured":"Golden TL Magsamen S Sandu CC et al. (2022) Effects of setting on psychedelic experiences therapies and outcomes: A rapid scoping review of the literature. Current Topics in Behavioral Neurosciences 56: 35\u201370. https:\/\/doi.org\/10.1007\/7854_2021_298","DOI":"10.1007\/7854_2021_298"},{"key":"e_1_3_2_26_1","doi-asserted-by":"crossref","unstructured":"Grau PP Sripada RK Ganoczy D et al. (2023) Outcomes of acceptance and commitment therapy for depression and predictors of treatment response in Veterans Health Administration patients. Journal of Affective Disorders 323: 826\u2013833. https:\/\/doi.org\/10.1016\/j.jad.2022.12.025","DOI":"10.1016\/j.jad.2022.12.025"},{"key":"e_1_3_2_27_1","doi-asserted-by":"crossref","unstructured":"Gr\u00fcnder G Brand M Mertens LJ et al. (2024) Treatment with psychedelics is psychotherapy: Beyond reductionism. The Lancet. Psychiatry 11(3): 231\u2013236. https:\/\/doi.org\/10.1016\/S2215-0366(23)00363-2","DOI":"10.1016\/S2215-0366(23)00363-2"},{"key":"e_1_3_2_28_1","doi-asserted-by":"crossref","unstructured":"Haddaway NR Page MJ Pritchard CC et al. (2022) PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews 18(2): e1230. https:\/\/doi.org\/10.1002\/cl2.1230","DOI":"10.1002\/cl2.1230"},{"key":"e_1_3_2_29_1","doi-asserted-by":"crossref","unstructured":"Hartogsohn I (2016) Set and setting psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology. Journal of Psychopharmacology 30(12): 1259\u20131267. https:\/\/doi.org\/10.1177\/0269881116677852","DOI":"10.1177\/0269881116677852"},{"key":"e_1_3_2_30_1","doi-asserted-by":"crossref","unstructured":"Heinzerling KG Sergi K Linton M et al. (2023) Nature-themed video intervention may improve cardiovascular safety of psilocybin-assisted therapy for alcohol use disorder. Frontiers in Psychiatry 14: 1215972. https:\/\/doi.org\/10.3389\/fpsyt.2023.1215972","DOI":"10.3389\/fpsyt.2023.1215972"},{"key":"e_1_3_2_31_1","doi-asserted-by":"crossref","unstructured":"Hendricks PS Lappan SN Shelton RC et al. (2026) Psilocybin in the treatment of cocaine use disorder: A randomized clinical trial. JAMA Network Open 9(5): e2611029. https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.11029","DOI":"10.1001\/jamanetworkopen.2026.11029"},{"key":"e_1_3_2_32_1","doi-asserted-by":"crossref","unstructured":"Hesselgrave N Troppoli TA Wulff AB et al. (2021) Harnessing psilocybin: Antidepressant-like behavioral and synaptic actions of psilocybin are independent of 5-HT2R activation in mice. Proceedings of the National Academy of Sciences USA 118(17): e2022489118. https:\/\/doi.org\/10.1073\/pnas.2022489118","DOI":"10.1073\/pnas.2022489118"},{"key":"e_1_3_2_33_1","doi-asserted-by":"crossref","unstructured":"Horton DM Morrison B Schmidt J (2021) Systematized review of psychotherapeutic components of psilocybin-assisted psychotherapy. American Journal of Psychotherapy 74(4): 140\u2013149. https:\/\/doi.org\/10.1176\/appi.psychotherapy.20200055","DOI":"10.1176\/appi.psychotherapy.20200055"},{"key":"e_1_3_2_34_1","doi-asserted-by":"crossref","unstructured":"Horvath AO Luborsky L (1993) The role of the therapeutic alliance in psychotherapy. Journal of Consulting and Clinical Psychology 61(4): 561\u2013573. https:\/\/doi.org\/10.1037\/\/0022-006x.61.4.561","DOI":"10.1037\/0022-006X.61.4.561"},{"key":"e_1_3_2_35_1","doi-asserted-by":"crossref","unstructured":"Jeanblanc J Bordy R Fouquet G et al. (2024) Psilocybin reduces alcohol self-administration via selective left nucleus accumbens activation in rats. Brain 147(11): 3780\u20133788. https:\/\/doi.org\/10.1093\/brain\/awae136","DOI":"10.1093\/brain\/awae136"},{"key":"e_1_3_2_36_1","doi-asserted-by":"crossref","unstructured":"Jensen ME Stenb\u00e6k DS Messell CD et al. (2025) Single-dose psilocybin therapy for alcohol use disorder: Pharmacokinetics feasibility safety and efficacy in an open-label study. Journal of Psychopharmacology 39(5): 463\u2013473. https:\/\/doi.org\/10.1177\/02698811251319457","DOI":"10.1177\/02698811251319457"},{"key":"e_1_3_2_37_1","doi-asserted-by":"crossref","unstructured":"Johnson MW Garcia-Romeu A Cosimano MP et al. (2014) Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology 28(11): 983\u2013992. https:\/\/doi.org\/10.1177\/0269881114548296","DOI":"10.1177\/0269881114548296"},{"key":"e_1_3_2_38_1","doi-asserted-by":"crossref","unstructured":"Johnson MW Garcia-Romeu A Griffiths RR (2017) Long-term follow-up of psilocybin-facilitated smoking cessation. The American Journal of Drug and Alcohol Abuse 43(1): 55\u201360. https:\/\/doi.org\/10.3109\/00952990.2016.1170135","DOI":"10.3109\/00952990.2016.1170135"},{"key":"e_1_3_2_39_1","doi-asserted-by":"crossref","unstructured":"Johnson MW Naud\u00e9 GP Hendricks PS et al. (2026) Psilocybin or nicotine patch for smoking cessation: A pilot randomized clinical trial. JAMA Network Open 9(3): e260972. https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.0972","DOI":"10.1001\/jamanetworkopen.2026.0972"},{"key":"e_1_3_2_40_1","doi-asserted-by":"crossref","unstructured":"Kalin NH (2020) Substance use disorders and addiction: Mechanisms trends and treatment implications. American Journal of Psychiatry 177(11): 1015\u20131018. https:\/\/doi.org\/10.1176\/appi.ajp.2020.20091382","DOI":"10.1176\/appi.ajp.2020.20091382"},{"key":"e_1_3_2_41_1","doi-asserted-by":"crossref","unstructured":"Kangaslampi S Wolff M Doss MK et al. (2025) Questioning the recovery of dissociated traumatic memories under psilocybin: Comment on \u201cTherapeutic emergence of dissociated traumatic memories during psilocybin treatment for anorexia nervosa\u201d. Journal of Eating Disorders 13(1): 278. https:\/\/doi.org\/10.1186\/s40337-025-01484-8","DOI":"10.1186\/s40337-025-01484-8"},{"key":"e_1_3_2_42_1","doi-asserted-by":"crossref","unstructured":"Kervadec E Fauvel B Strika-Bruneau L et al. (2023) Reduction of alcohol use and increase in psychological flexibility after a naturalistic psychedelic experience: A retrospective survey. Alcohol and Alcoholism 59(2): agad078. https:\/\/doi.org\/10.1093\/alcalc\/agad078","DOI":"10.1093\/alcalc\/agad078"},{"key":"e_1_3_2_43_1","doi-asserted-by":"crossref","unstructured":"Knock E Siefried K Bedi G et al. (2025) Psilocybin-assisted psychotherapy for methamphetamine use disorder: A pilot open-label safety and feasibility study. Addiction (WOS:001574795200001). Epub ahead of print 20 September 2025. https:\/\/doi.org\/10.1111\/add.70187","DOI":"10.1111\/add.70187"},{"key":"e_1_3_2_44_1","doi-asserted-by":"crossref","unstructured":"Koslowski M Johnson MW Gr\u00fcnder G et al. (2022) Novel treatment approaches for substance use disorders: Therapeutic use of psychedelics and the role of psychotherapy. Current Addiction Reports 9(1): 48\u201358. https:\/\/doi.org\/10.1007\/s40429-021-00401-8","DOI":"10.1007\/s40429-021-00401-8"},{"key":"e_1_3_2_45_1","doi-asserted-by":"crossref","unstructured":"Krabbe A Sikka P Jylkk\u00e4 J (2024) Acceptance as a possible link between past psychedelic experiences and psychological flexibility. Scientific Reports 14(1): 24253. https:\/\/doi.org\/10.1038\/s41598-024-75595-8","DOI":"10.1038\/s41598-024-75595-8"},{"key":"e_1_3_2_46_1","doi-asserted-by":"crossref","unstructured":"Krotter A Aonso-Diego G Gonz\u00e1lez-Men\u00e9ndez A et al. (2024) Effectiveness of acceptance and commitment therapy for addictive behaviors: A systematic review and meta-analysis. Journal of Contextual Behavioral Science 32: 100773. https:\/\/doi.org\/10.1016\/j.jcbs.2024.100773","DOI":"10.1016\/j.jcbs.2024.100773"},{"key":"e_1_3_2_47_1","doi-asserted-by":"crossref","unstructured":"Levin M MacLane C Daflos S et al. (2014) Examining psychological inflexibility as a transdiagnostic process across psychological disorders. Journal of Contextual Behavioral Science 3(3): 155\u2013163. https:\/\/doi.org\/10.1016\/j.jcbs.2014.06.003","DOI":"10.1016\/j.jcbs.2014.06.003"},{"key":"e_1_3_2_48_1","doi-asserted-by":"crossref","unstructured":"Luoma JB Sabucedo P Eriksson J et al. (2019) Toward a contextual psychedelic-assisted therapy: Perspectives from acceptance and commitment therapy and contextual behavioral science. Journal of Contextual Behavioral Science 14: 136\u2013145. https:\/\/doi.org\/10.1016\/j.jcbs.2019.10.003","DOI":"10.1016\/j.jcbs.2019.10.003"},{"key":"e_1_3_2_49_1","doi-asserted-by":"crossref","unstructured":"Luquiens A Belahda D Graux C et al. (2025) Psilocybin in alcohol use disorder and comorbid depressive symptoms: Results from a feasibility randomized clinical trial. Addiction. Epub ahead of print 24 July 2025. https:\/\/doi.org\/10.1111\/add.70152","DOI":"10.1111\/add.70152"},{"key":"e_1_3_2_50_1","doi-asserted-by":"crossref","unstructured":"Macri JA Rogge RD (2024) Examining domains of psychological flexibility and inflexibility as treatment mechanisms in acceptance and commitment therapy: A comprehensive systematic and meta-analytic review. Clinical Psychology Review 110: 102432. https:\/\/doi.org\/10.1016\/j.cpr.2024.102432","DOI":"10.1016\/j.cpr.2024.102432"},{"key":"e_1_3_2_51_1","doi-asserted-by":"crossref","unstructured":"Madsen MK Fisher PM Burmester D et al. (2019) Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels. Neuropsychopharmacology 44(7): 1328\u20131334. https:\/\/doi.org\/10.1038\/s41386-019-0324-9","DOI":"10.1038\/s41386-019-0324-9"},{"key":"e_1_3_2_52_1","doi-asserted-by":"crossref","unstructured":"Martin DJ Garske JP Davis MK (2000) Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology 68(3): 438\u2013450. https:\/\/doi.org\/10.1037\/0022-006X.68.3.438","DOI":"10.1037\/0022-006X.68.3.438"},{"key":"e_1_3_2_53_1","doi-asserted-by":"crossref","unstructured":"Menon J Kandasamy A (2018) Relapse prevention. Indian Journal of Psychiatry 60: S473\u2013S478. https:\/\/doi.org\/10.4103\/psychiatry.IndianJPsychiatry_36_18","DOI":"10.4103\/psychiatry.IndianJPsychiatry_36_18"},{"key":"e_1_3_2_54_1","doi-asserted-by":"crossref","unstructured":"Meshkat S Malik G Zeifman RJ et al. (2025) Efficacy and safety of psilocybin for the treatment of substance use disorders: A systematic review. Neuroscience and Biobehavioral Reviews 173: 106163. https:\/\/doi.org\/10.1016\/j.neubiorev.2025.106163","DOI":"10.1016\/j.neubiorev.2025.106163"},{"key":"e_1_3_2_55_1","doi-asserted-by":"crossref","unstructured":"Moher D Liberati A Tetzlaff J et al. (2010) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. International Journal of Surgery 8(5): 336\u2013341. https:\/\/doi.org\/10.1016\/j.ijsu.2010.02.007","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"e_1_3_2_56_1","doi-asserted-by":"crossref","unstructured":"Moliner R Girych M Brunello CA et al. (2023) Psychedelics promote plasticity by directly binding to BDNF receptor TrkB. Nature Neuroscience 26(6): 1032\u20131041. https:\/\/doi.org\/10.1038\/s41593-023-01316-5","DOI":"10.1038\/s41593-023-01316-5"},{"key":"e_1_3_2_57_1","doi-asserted-by":"crossref","unstructured":"Muthukumaraswamy SD Baggott MJ Schenberg EE et al. (2025) Psychedelic-assisted therapy as a complex intervention: Implications for clinical trial design. Therapeutic Advances in Psychopharmacology 15: 20451253251381074. https:\/\/doi.org\/10.1177\/20451253251381074","DOI":"10.1177\/20451253251381074"},{"key":"e_1_3_2_58_1","doi-asserted-by":"crossref","unstructured":"Noorani T Garcia-Romeu A Swift TC et al. (2018) Psychedelic therapy for smoking cessation: Qualitative analysis of participant accounts. Journal of Psychopharmacology 32(7): 756\u2013769. https:\/\/doi.org\/10.1177\/0269881118780612","DOI":"10.1177\/0269881118780612"},{"key":"e_1_3_2_59_1","doi-asserted-by":"crossref","unstructured":"Osaji J Ojimba C Ahmed S (2020) The use of acceptance and commitment therapy in substance use disorders: A review of literature. Journal of Clinical Medicine Research 12(10): 629\u2013633. https:\/\/doi.org\/10.14740\/jocmr4311","DOI":"10.14740\/jocmr4311"},{"key":"e_1_3_2_60_1","doi-asserted-by":"crossref","unstructured":"Pagni BA Petridis PD Podrebarac SK et al. (2024) Psilocybin-induced changes in neural reactivity to alcohol and emotional cues in patients with alcohol use disorder: An fMRI pilot study. Scientific Reports 14(1): 3159. https:\/\/doi.org\/10.1038\/s41598-024-52967-8","DOI":"10.1038\/s41598-024-52967-8"},{"key":"e_1_3_2_61_1","doi-asserted-by":"crossref","unstructured":"Pagni BA Zeifman RJ Mennenga SE et al. (2025) Multidimensional personality changes following psilocybin-assisted therapy in patients with alcohol use disorder: Results from a double-blind placebo-controlled clinical trial. The American Journal of Psychiatry 182(1): 114\u2013125. https:\/\/doi.org\/10.1176\/appi.ajp.20230887","DOI":"10.1176\/appi.ajp.20230887"},{"key":"e_1_3_2_62_1","doi-asserted-by":"crossref","unstructured":"Phelps J (2017) Developing guidelines and competencies for the training of psychedelic therapists. Journal of Humanistic Psychology 57: 002216781771130. https:\/\/doi.org\/10.1177\/0022167817711304","DOI":"10.1177\/0022167817711304"},{"key":"e_1_3_2_63_1","doi-asserted-by":"crossref","unstructured":"Piper T Small F Brown S et al. (2025) Psychedelic-assisted treatment for substance use disorder: A narrative systematic review. Addiction. Epub ahead of print 30 January 2025. https:\/\/doi.org\/10.1111\/add.16762","DOI":"10.1111\/add.16762"},{"key":"e_1_3_2_64_1","doi-asserted-by":"crossref","unstructured":"Raison CL Jain R Penn AD et al. (2022) Effects of naturalistic psychedelic use on depression anxiety and well-being: Associations with patterns of use reported harms and transformative mental states. Frontiers in Psychiatry 13: 831092. https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.831092","DOI":"10.3389\/fpsyt.2022.831092"},{"key":"e_1_3_2_65_1","doi-asserted-by":"crossref","unstructured":"Rieser NM Bitar R Halm S et al. (2025) Psilocybin-assisted therapy for relapse prevention in alcohol use disorder: A phase 2 randomized clinical trial. eClinicalMedicine 82: 103149. https:\/\/doi.org\/10.1016\/j.eclinm.2025.103149","DOI":"10.1016\/j.eclinm.2025.103149"},{"key":"e_1_3_2_66_1","doi-asserted-by":"crossref","unstructured":"Romeo B Fauvel B Dejean S et al. (2023) Impact of a naturalistic psychedelic experience on smoking: A retrospective survey. Journal of Psychoactive Drugs 55(5): 640\u2013649. https:\/\/doi.org\/10.1080\/02791072.2023.2227171","DOI":"10.1080\/02791072.2023.2227171"},{"key":"e_1_3_2_67_1","doi-asserted-by":"crossref","unstructured":"Romeo B Hermand M P\u00e9tillion A et al. (2021) Clinical and biological predictors of psychedelic response in the treatment of psychiatric and addictive disorders: A systematic review. Journal of Psychiatric Research 137: 273\u2013282. https:\/\/doi.org\/10.1016\/j.jpsychires.2021.03.002","DOI":"10.1016\/j.jpsychires.2021.03.002"},{"key":"e_1_3_2_68_1","doi-asserted-by":"crossref","unstructured":"Romeo B Kervadec E Fauvel B et al. (2024) Safety and risk assessment of psychedelic psychotherapy: A meta-analysis and systematic review. Psychiatry Research 335: 115880. https:\/\/doi.org\/10.1016\/j.psychres.2024.115880","DOI":"10.1016\/j.psychres.2024.115880"},{"key":"e_1_3_2_69_1","doi-asserted-by":"crossref","unstructured":"Romeo B Kervadec E Fauvel B et al. (2025a) The intensity of the psychedelic experience is reliably associated with clinical improvements: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews 172: 106086. https:\/\/doi.org\/10.1016\/j.neubiorev.2025.106086","DOI":"10.1016\/j.neubiorev.2025.106086"},{"key":"e_1_3_2_70_1","doi-asserted-by":"crossref","unstructured":"Romeo B Kervadec E Fauvel B et al. (2025b) Significant psychedelic experiences evaluated for mystical characteristics associated with cannabis use reduction and psychological flexibility improvement: A naturalistic cross-sectional retrospective survey. Journal of Psychoactive Drugs 57: 374-385. https:\/\/doi.org\/10.1080\/02791072.2024.2375720","DOI":"10.1080\/02791072.2024.2375720"},{"key":"e_1_3_2_71_1","doi-asserted-by":"crossref","unstructured":"Romeo B Kervadec E Fauvel B et al. (2025c) Exploring factors affecting psychological flexibility after psychedelic experiences. Journal of Psychoactive Drugs. Epub ahead of print 25 April 2025. https:\/\/doi.org\/10.1080\/02791072.2025.2495937","DOI":"10.1080\/02791072.2025.2495937"},{"key":"e_1_3_2_72_1","doi-asserted-by":"crossref","unstructured":"Sharma R Batchelor R Sin J (2023) Psychedelic treatments for substance use disorder and substance misuse: A mixed methods systematic review. Journal of Psychoactive Drugs 55(5): 612\u2013630. https:\/\/doi.org\/10.1080\/02791072.2023.2190319","DOI":"10.1080\/02791072.2023.2190319"},{"key":"e_1_3_2_73_1","doi-asserted-by":"crossref","unstructured":"Skivington K Matthews L Simpson SA et al. (2021) A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ 374: n2061. https:\/\/doi.org\/10.1136\/bmj.n2061","DOI":"10.1136\/bmj.n2061"},{"key":"e_1_3_2_74_1","doi-asserted-by":"crossref","unstructured":"Sloshower J Guss J Krause R et al. (2019) Psilocybin-assisted therapy of major depressive disorder using acceptance and commitment therapy as a therapeutic frame. Journal of Contextual Behavioral Science 15: 12\u201319. https:\/\/doi.org\/10.1016\/j.jcbs.2019.11.002","DOI":"10.1016\/j.jcbs.2019.11.002"},{"key":"e_1_3_2_75_1","doi-asserted-by":"crossref","unstructured":"Sloshower J Zeifman RJ Guss J et al. (2024) Psychological flexibility as a mechanism of change in psilocybin-assisted therapy for major depression: Results from an exploratory placebo-controlled trial. Scientific Reports 14(1): 8833. https:\/\/doi.org\/10.1038\/s41598-024-58318-x","DOI":"10.1038\/s41598-024-58318-x"},{"key":"e_1_3_2_76_1","doi-asserted-by":"crossref","unstructured":"Spoelstra SK Schoevers RA Venema SD et al. (2024) Psychedelics as a potential treatment for tobacco use disorder: A systematic review. Discover Mental Health 4(1): 37. https:\/\/doi.org\/10.1007\/s44192-024-00095-0","DOI":"10.1007\/s44192-024-00095-0"},{"key":"e_1_3_2_77_1","doi-asserted-by":"crossref","unstructured":"Strika-Bruneau L Fauvel B Dupuis D et al. (2023) Articulation de la th\u00e9rapie d\u2019acceptation et d\u2019engagement \u00e0 la psychoth\u00e9rapie assist\u00e9e par psych\u00e9d\u00e9liques en addictologie [Articulating acceptance and commitment therapy to psychedelic-assisted psychotherapy in addictology]. L\u2019\u00c9volution Psychiatrique 88(2): 284\u2013298. https:\/\/doi.org\/10.1016\/j.evopsy.2023.01.003","DOI":"10.1016\/j.evopsy.2023.01.003"},{"key":"e_1_3_2_78_1","doi-asserted-by":"crossref","unstructured":"Stubbe DE (2018) The therapeutic alliance: The fundamental element of psychotherapy. Focus: Journal of Life Long Learning in Psychiatry 16(4): 402\u2013403. https:\/\/doi.org\/10.1176\/appi.focus.20180022","DOI":"10.1176\/appi.focus.20180022"},{"key":"e_1_3_2_79_1","doi-asserted-by":"crossref","unstructured":"Thal SB Baker P Marinis J et al. (2024) Therapeutic frameworks in integration sessions in substance-assisted psychotherapy: A systematised review. Clinical Psychology & Psychotherapy 31(1): e2945. https:\/\/doi.org\/10.1002\/cpp.2945","DOI":"10.1002\/cpp.2945"},{"key":"e_1_3_2_80_1","doi-asserted-by":"crossref","unstructured":"Tyndall I Waldeck D Pancani L et al. (2019) The Acceptance and Action Questionnaire-II (AAQ-II) as a measure of experiential avoidance: Concerns over discriminant validity. Journal of Contextual Behavioral Science 12: 278\u2013284. https:\/\/doi.org\/10.1016\/j.jcbs.2018.09.005","DOI":"10.1016\/j.jcbs.2018.09.005"},{"key":"e_1_3_2_81_1","doi-asserted-by":"crossref","unstructured":"Volkow ND Koob GF McLellan AT (2016) Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine 374(4): 363\u2013371. https:\/\/doi.org\/10.1056\/NEJMra1511480","DOI":"10.1056\/NEJMra1511480"},{"key":"e_1_3_2_82_1","doi-asserted-by":"crossref","unstructured":"Watts R Day C Krzanowski J et al. (2017) Patients\u2019 accounts of increased \u201cconnectedness\u201d and \u201cacceptance\u201d after psilocybin for treatment-resistant depression. Journal of Humanistic Psychology 57(5): 520\u2013564. https:\/\/doi.org\/10.1177\/0022167817709585","DOI":"10.1177\/0022167817709585"},{"key":"e_1_3_2_83_1","doi-asserted-by":"crossref","unstructured":"Watts R Luoma J. B (2020) The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science 15: 92\u2013102. https:\/\/doi.org\/10.1016\/j.jcbs.2019.12.004","DOI":"10.1016\/j.jcbs.2019.12.004"},{"key":"e_1_3_2_84_1","doi-asserted-by":"crossref","unstructured":"Weleff J Pulido-Saavedra A Aghaei AM et al. (2025) The therapeutic effects of psychedelics for opioid use disorder: A systematic review of clinical studies. Psychiatry Research 348: 116446. https:\/\/doi.org\/10.1016\/j.psychres.2025.116446","DOI":"10.1016\/j.psychres.2025.116446"},{"key":"e_1_3_2_85_1","doi-asserted-by":"crossref","unstructured":"Witkiewitz K Marlatt GA (2004) Relapse prevention for alcohol and drug problems: That was Zen this is Tao. The American Psychologist 59(4): 224\u2013235. https:\/\/doi.org\/10.1037\/0003-066X.59.4.224","DOI":"10.1037\/0003-066X.59.4.224"},{"key":"e_1_3_2_86_1","doi-asserted-by":"crossref","unstructured":"Wolff M Evens R Mertens LJ et al. (2020) Learning to let go: A cognitive-behavioral model of how psychedelic therapy promotes acceptance. Frontiers in Psychiatry 11: 5. https:\/\/doi.org\/10.3389\/fpsyt.2020.00005","DOI":"10.3389\/fpsyt.2020.00005"},{"key":"e_1_3_2_87_1","doi-asserted-by":"crossref","unstructured":"Wolff M Gukasyan N Roseman L et al. (2025a) Reframing psychedelic regulation: Tools not treatments. Drug Science Policy and Law 11: 20503245251348272. https:\/\/doi.org\/10.1177\/20503245251348272","DOI":"10.1177\/20503245251348272"},{"key":"e_1_3_2_88_1","doi-asserted-by":"crossref","unstructured":"Wolff M Rutrecht H Mertens LJ et al. (2025b) Common factors in altered states: Understanding psychedelic therapy through the lens of Grawe\u2019s general change mechanisms. Psychological Review 132(6): 1467\u20131492. https:\/\/doi.org\/10.1037\/rev0000589","DOI":"10.1037\/rev0000589"},{"key":"e_1_3_2_89_1","unstructured":"World Health Organization (2024) Global status report on alcohol and health and treatment of substance use disorders. Available at: https:\/\/iris.who.int\/handle\/10665\/377960 (accessed 9 December 2025)."},{"key":"e_1_3_2_90_1","doi-asserted-by":"crossref","unstructured":"Yaden D Earp D Graziosi M et al. (2022) Psychedelics and psychotherapy: Cognitive-behavioral approaches as default. Frontiers in Psychology 13: 873279. https:\/\/doi.org\/10.3389\/fpsyg.2022.873279","DOI":"10.3389\/fpsyg.2022.873279"},{"key":"e_1_3_2_91_1","doi-asserted-by":"crossref","unstructured":"Yaden D Griffiths RR (2020) The subjective effects of psychedelics are necessary for their enduring therapeutic effects. ACS Pharmacology & Translational Science 4(2): 568\u2013572. https:\/\/doi.org\/10.1021\/acsptsci.0c00194","DOI":"10.1021\/acsptsci.0c00194"},{"key":"e_1_3_2_92_1","doi-asserted-by":"crossref","unstructured":"Yao Y Guo D Lu T-S et al. (2024) Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis. Psychiatry Research 335: 115886. https:\/\/doi.org\/10.1016\/j.psychres.2024.115886","DOI":"10.1016\/j.psychres.2024.115886"},{"key":"e_1_3_2_93_1","doi-asserted-by":"crossref","unstructured":"Zeifman RJ Spriggs MJ Kettner H et al. (2025) From relaxed beliefs under psychedelics (REBUS) to revised beliefs after psychedelics (REBAS). Scientific Reports 15(1): 3651. https:\/\/doi.org\/10.1038\/s41598-023-28111-3","DOI":"10.1038\/s41598-023-28111-3"},{"key":"e_1_3_2_94_1","doi-asserted-by":"crossref","unstructured":"Zeifman RJ Wagner AC Monson CM et al. (2023) How does psilocybin therapy work? An exploration of experiential avoidance as a putative mechanism of change. Journal of Affective Disorders 334: 100\u2013112. https:\/\/doi.org\/10.1016\/j.jad.2023.04.105","DOI":"10.1016\/j.jad.2023.04.105"}],"container-title":["Journal of Psychopharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02698811261473436","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02698811261473436","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02698811261473436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T08:09:39Z","timestamp":1787299779000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02698811261473436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,17]]},"references-count":93,"alternative-id":["10.1177\/02698811261473436"],"URL":"https:\/\/doi.org\/10.1177\/02698811261473436","relation":{},"ISSN":["0269-8811","1461-7285"],"issn-type":[{"value":"0269-8811","type":"print"},{"value":"1461-7285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,17]]},"article-number":"02698811261473436"}}