{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T04:07:04Z","timestamp":1792901224892,"version":"4.5.0"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"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":["Psychedelic Medicine"],"abstract":"<jats:p>This commentary critically examines the interpretation and analytic choices in Goodwin and colleagues\u2019 recent analysis of therapeutic alliance in psilocybin treatment for treatment-resistant depression. While the authors conclude that alliance did not meaningfully contribute to treatment efficacy, we argue that this interpretation is not supported by the reported results, which are, in addition, shaped by methodological decisions that obscure relevant effects. By contextualizing the observed associations, clarifying the logic of mediation analysis, and pointing out methodological weaknesses, we show that the available evidence is more consistent with a meaningful role of therapeutic alliance in shaping both the psychedelic experience and clinical outcomes. Furthermore, we highlight unexplained deviations from the study protocol that warrant scrutiny. These concerns underscore the importance of accurately characterizing psychological and contextual factors in psychedelic treatment research and call for more comprehensive and transparent analyses of psychotherapeutic processes.<\/jats:p>","DOI":"10.1177\/28314425261461057","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:06:22Z","timestamp":1781622382000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Strong Alliance, Weak Conclusions: Comment on Goodwin et al. (2026) \u201cThe Role of Therapeutic Alliance in Psilocybin Treatment for Treatment-Resistant Depression\u201d"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-9633","authenticated-orcid":false,"given":"Max","family":"Wolff","sequence":"first","affiliation":[{"name":"Department of Psychology, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany."},{"name":"German Center for Mental Health (DZPG), Partner Site Berlin\u2014Potsdam, Berlin, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuli","family":"Kangaslampi","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences\/Psychology, Tampere University, Tampere, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Zeifman","sequence":"additional","affiliation":[{"name":"Department of Psychology, The New School for Social Research, New York, New York, USA."},{"name":"Department of Psychiatry, NYU Langone Center for Psychedelic Medicine, NYU Grossman School of Medicine, New York, New York, USA."},{"name":"Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Spangemacher","sequence":"additional","affiliation":[{"name":"Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany."},{"name":"Department of Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany."},{"name":"German Center for Mental Health (DZPG), Partner Site Mannheim\u2014Heidelberg\u2014Ulm, Mannheim, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.20221043"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2026.121662"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.120637"},{"key":"e_1_3_2_5_1","volume-title":"The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD): Study Protocol COMP 001","author":"Compass Pathways","year":"2019","unstructured":"4.Compass Pathways. 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