Psychedelic-Assisted Therapy: What Healthcare Workers Should Know

In 2006, researchers at Johns Hopkins administered a psychedelic—psilocybin—to three dozen volunteers. A little over a year later, a survey of those volunteers found that the majority considered their experience to be one of the most spiritually and personally meaningful of their lifetime, associating it with personal well-being, life satisfaction, and positive behavior change (Journal of Psychopharmacology 2008). They rated the significance of their experience on par with that of having a child.

That outcome may not have come as a surprise to the millions of psychedelic users in America, past and present; nor would it have to the ancient and indigenous cultures who use psychedelics in spiritual and religious practice. But it constituted an important step in reviving the small but growing body of scientific and medical literature around the benefits of psychedelic-assisted therapy. 

Medical fact has always moved cautiously, with rigorous and deliberate conditions. But research into the benefits of psychedelics has been particularly slow-going, with research strangled by stigma for over half a century. That’s finally changing. 

Societal closed-mindedness (ironically, a condition psychedelics may help alleviate) is easing. Studies increasingly show that psychedelic-assisted therapy can make a positive impact on depression, anxiety, PTSD, and substance abuse. 

Psychedelics are a potent tool. How many medical treatments have such a storied history, a connection to the mystical and the spiritual? There are still many unknowns related to psychedelics, as well as many strong stigmas and mixed messages. 

Healthcare workers have a crucial role to play in patient education, as well as in ensuring that the same safe, rigorous processes of medical research are translated to the practice of psychedelic-assisted therapy.

The use of psychedelics stretches far back into history: indigenous groups in Mesoamerica used psilocybin for healing and divination; ancient Andean cultures incorporated the mescaline-containing San Pedro cactus into religious ceremonies; ayahuasca was, and still is, used for healing and guidance by indigenous cultures in the Amazon basin. 

But the intersection of psychedelic-assisted therapy and modern Western culture kicked off in 1947, when LSD, a chemical synthesized by Albert Hoffman, was marketed to psychiatrists and researchers. 

From 1953 to 1973, the US government spent $4 million to fund 116 studies of LSD that involved more than 1,700 subjects (not counting classified projects, like MK ULTRA, which had real but frightening consequences). The results of those studies were skewed toward the positive, but their rigor did not meet modern standards. 

Concurrently, the general public was conducting its own broad, unstructured experiment that culminated in 1967’s Summer of Love. That psychedelics had strong and often positive effects was indisputable. The question for researchers was how they could be used safely towards a specific medical end. 

Before that question could be answered definitively, President Nixon signed the 1970 Controlled Substances Act, which prohibited the use of most psychedelics for any purpose. Drugs like psilocybin and LSD were classified as Schedule I, meaning the federal government considered them to have no accepted medical use and a high potential for abuse. Medical research on psychedelics was largely banished underground. 

In 1986, Rick Doblin, PhD, created the nonprofit Multidisciplinary Association for Psychedelic Studies (MAPS). While other psychedelic activism had, until then, focused solely on legalization and cultural change, MAPS prioritized clinical trials, scientific protocols, and physician-led research. Initially centered on MDMA-assisted therapy for the treatment of PTSD (MDMA was added to Schedule I in 1984), MAPS provided a hub for psychedelic research and education that was committed to scientific principles. In 1991, Dr. Doblin followed up on 1962’s famous Good Friday Experiment and found that the psychedelic experience had a lasting, meaningful, and profound impact on its subjects—even 30 years later.

Psychedelic research started its comeback in earnest in the early 21st century, with a 2006 Hopkins study (referenced at the top of this article). It was the first research since the 1970s to administer a classic psychedelic substance to drug-naive participants, and it had strikingly positive results. 

One successful study, performed to the high standards of modern medical science, opened the doors to several others. A 2010 study at Yale found ketamine helped the mind grow new connections, boosting neuroplasticity in observable ways (Science 2010). 

Experiments at Stanford found similar results with LSD, psilocin (the active form of psilocybin), DMT, and MDMA (Cell Reports 2018). And a review of 12 different studies found a significant association between mystical experiences and mental health benefits (Frontiers in Psychiatry 2022). Today, there are hundreds of registered clinical trials related to psychedelics (ClinicalTrials.gov). 

“The science is genuinely exciting, and I say that as someone who has spent years in the weeds of clinical trial data,” says Alia Lilienstein, MD, MPH, a board-certified family medicine physician with ten years of experience in psychedelic drug research and psychedelic-assisted therapy, and a research physician at the UC Berkeley Center for the Science of Psychedelics. 

“We have good evidence that psychedelic drugs, when combined with appropriate psychological support and therapy, have the potential to really help people who are suffering from mental health issues, and they are generally safe and well tolerated when used thoughtfully. It’s exciting to be on the precipice of having new tools to relieve people’s suffering and to understand the mind better.”

But there are still many reasons to be cautious. Dr. Doblin’s 1991 follow-up on the Good Friday Experiment found that the original study had omitted the fact that several participants had experienced acute anxiety during their psychedelic experience; one participant had even needed to be restrained and dozed with thorazine, an antipsychotic (he’d escaped the chapel in which the experiment had been held, and run down the streets of Boston, convinced he’d been ‘chosen’ to announce the arrival of the Messiah). 

In 2023, an off-duty pilot attempted to crash a passenger plane after having a negative experience with a recreational dose of psilocybin. One-off stories like that risk strengthening the stigma around psychedelics (and call to mind pernicious urban legends, like that people on LSD jump from windows thinking they can fly). 

But there is a scientific reason to be cautious: hallucinogens can potentially trigger underlying mental health issues like schizophrenia or bipolar disorder. Adverse effects following psychedelic use may persist for weeks, months, or even years. 

But it’s worth noting that a study of 608 users who experienced bad trips with persistent negative effects still, overwhelmingly, agreed that the insights and healings gained from psychedelics were worth the risks, when taken in a supportive setting (PLOS One 2023). 

“There are still a lot of things about psychedelic-assisted therapy that we don’t know,” Dr. Lillienstein says. “Western medicine has a lot to learn about how to optimize the outcomes for each individual patient.”

In moving from trials to clinics, healthcare workers must be able to ensure that the experiences induced by psychedelics are translated into lasting therapeutic gains in a safe way (Pharmacol Res Perspect. 2026). Research trials have strict guardrails, with comprehensive evaluations (medical histories, physical exams, and psychiatric interviews) used to rule out subjects with a personal or family history of psychotic or bipolar disorders. Integrating psychedelic research into medical practice should incorporate a similar level of diligence. 

“Healthcare practitioners will need to come together to write clinical practice guidelines that expand on what was done in the clinical trials, in dialogue with the traditions that have been working with these medicines for generations,” Dr. Lilienstein says. “These clinical practice guidelines will help the field move forward responsibly as we gather more evidence to inform the practice of psychedelic-assisted therapy.”

That’s a challenge exacerbated by logistical and financial demands, which may pressure clinics to lower their standards in order to increase patient throughput. It’s already happened, in isolated cases: some for-profit ketamine clinics have been reported to advertise benefits beyond what the current scientific evidence suggests, and have administered doses beyond established therapeutic ranges with insufficient medical supervision (JAMA 2021 & JAMA Netw Open. 2023).

Psychedelics are different from other pharmacotherapies in that they draw from set and setting (i.e., the patient’s mindset and their physical environment), which can dramatically impact the experience and its lasting effects. Healthcare workers can help patients attune to both. They can also assist in integration (the process of making sense of the psychedelic experience), which is a central component of psychedelics’ therapeutic benefit (General Hospital Psychiatry 2025). 

Skilled therapeutic support can be the difference between an insightful, positive experience and a negative one. But there’s still work to be done to figure out what that skilled therapeutic support should look like, and what guidelines can be put into place to ensure it’s offered. 

“We don’t really know what effective preparation and integration look like,” Dr. Lilienstein says. “This hasn’t been specifically studied. We know what has been done historically, what different traditions and cultures do, and what has been studied in the clinical trials. But I think this is a big question that still needs to be answered by the field.”

Proper preparation and integration might need to be tailored to specific patients and specific desired outcomes. There’s such a thing as too much preparation and integration: taken too far, it could limit access. What’s the right balance?

“More studies need to be done to better understand what optimum and minimum preparation and integration are needed for the benefits to be likely to exceed the risks,” Dr. Lilienstein says. “While we don’t have these answers yet, we also don’t need to wait to figure them out before implementation. The practice of medicine always has to move forward with some unanswered questions, and we answer them as we learn in the real world. This process is how science and medicine usually work. We may not have all the answers before we implement, but if we believe we know enough to proceed safely, we can continue to learn and refine as we go.”

On April 16, 2026, coinciding with MAPS’s 40th anniversary, the White House signed an executive order to accelerate research into the therapeutic benefits of LSD, MDMA, psilocybin, and other psychedelic drugs, easing some of the restrictions that have up to now limited researchers. It’s a start, but there’s still a lot of work to do.  

“There is significant stigma about psychedelic drugs, and if they get FDA approval, experts in the field will have to do a lot of education amongst healthcare providers and patients alike to ensure people follow the science instead of the stigma,” Dr. Lilienstein says. “This education will first require the field to establish trust and demonstrate its trustworthiness. Unfortunately, there is a lot of distrust in science these days. We need to find ways to come together and understand each other better. It’s exactly the kind of inner work these medicines seem to facilitate: the capacity to soften our defenses, break out of old thought patterns, and actually connect with ourselves and others. We need to see that we are all just people trying to live our lives, with generally the same feelings and needs. These drugs might help us do this hard work of coming together and finding our shared humanity.”

In an ideal future, the field of psychedelic-assisted therapy will continue to evolve as a mature and established science: one with professional societies, clinical practice guidelines, and robust supporting data. Vetted training programs and licensure for healthcare workers assisting with psychedelics can help ensure safe and effective care, as well as credibility and accountability. To get it right will require deep collaboration between many disparate groups, but it can result in psychedelic-assisted therapy being integrated into medical practice in a way that mixes scientific rigor with what Dr. Lilienstein calls “the awe and wonder of consciousness exploration and the humanity of relationship.” 

“If we get it right, I think the good effects ripple outward in ways that are hard to predict,” Dr. Lilienstein says. “People who heal show up differently in their families, their relationships, their communities. Communities that heal and engage in repair with their neighboring communities may be able to tackle social and environmental problems with greater empathy and self-awareness. Infrastructure that supports this healing may be a model for other endeavors in health care, public health, and general welfare. I think we have an opportunity to enact great positive change on the planet, for all beings and the Earth, if we get it right.”

Matt Zbrog

Writer

Matt Zbrog is a writer and researcher from Southern California. Since 2018, he’s written extensively about trends within the healthcare workforce, with a particular focus on the power of interdisciplinary teams. He’s also covered the crises faced by healthcare professionals working at assisted living and long-term care facilities, both in light of the Covid-19 pandemic and the demographic shift brought on by the aging of the Baby Boomers. His work has included detailed interviews and consultations with leaders and subject matter experts from the American Nurses Association (ASCA), the American College of Health Care Administrators (ACHCA), and the American Speech-Language Hearing Association (ASHA).