Trip sitting or just sitting? Acute psychedelic experiences vary little between session facilitators in healthy trials but substantially in clinical ones.
The authors in this study examined how session facilitators (people supporting participants during psychedelic dosing) influence the acute subjective psychedelic experience across different types of trials.
They found that in healthy volunteer studies (i.e., participants without psychiatric diagnoses), the acute psychedelic experiences were quite similar regardless of who the session facilitator was, with little variation linked to facilitator differences.
In clinical trials, where participants were being treated for mental health conditions, acute experiences varied substantially depending on the session facilitator. That suggests that differences in how facilitators interact, support, or engage with participants may matter more when the participants have clinical needs
The study’s primary outcome was about variability in subjective experiences, not long-term therapeutic outcomes per se. It did not directly prove that facilitators affect treatment outcomes like depression remission.
However, the findings implicitly support a broader idea in the field: extra-pharmacological factors (like the interpersonal environment, therapeutic support, and facilitator role) have a bigger influence in clinical contexts where emotion, trauma, or psychological distress are present.
“Psychedelics’ characteristic acute subjective effects predict therapeutic benefits, such as decreases in depression and anxiety. Thus, optimising treatment involves better understanding of which factors shape subjective effects. Session facilitators, who support participants before, during, and after psychedelic administration sessions, form an important part of the setting of these experiences. Yet, the extent to which session facilitators influence participants’ acute subjective effects is unknown.
To address this gap, we analysed data from 9 psilocybin administration studies involving 298 participants, 670 dosing sessions, and 60 facilitators—the largest dataset of its kind. Using multilevel models, we examined whether facilitators contributed to variance in participants’ acute subjective effects.
Results showed that facilitators accounted for negligible variance (0.8%) in healthy volunteers but greater variance in clinical samples (13.6%), after controlling for study and participant differences.
These findings reveal that facilitators may play a clinically meaningful role in shaping psychedelic treatment outcomes in patient populations, relative to non-patients, comparable to or exceeding therapist effects in traditional psychotherapy (∼8%). These results have direct implications for clinical trial design, training protocols, and the implementation of psychedelic treatments as they continue to scale.”
Goldy, S.P.; Sepeda, N.D.; Hilbert, S.N.; Bari, B.A.; Garcia-Romeu, A.; Gukasyan, N.; Barrett, F.S.; Yaden, D.B.; Nayak, S.M. Trip sitting or just sitting? Acute psychedelic experiences vary little between session facilitators in healthy trials but substantially in clinical ones. Psychiatry Res. 2026, Access Paper
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