Mapping psilocybin therapy: A systematic review of therapeutic frameworks, adaptations, and standardization across contemporary clinical trials
Bibliographic record
Abstract
Accumulating evidence suggests that psilocybin can produce rapid and sustained clinical benefits when administered in conjunction with psychological support. Though non-pharmacological procedures are considered integral, the field lacks therapeutic guidelines and little is known about current practices. This systematic review sought to provide a comprehensive and cross-diagnostic synthesis of current psilocybin therapy (PT) protocols across contemporary mental health related trials. Primary objectives were to define and compare PT models with respect to overall therapeutic framework, evidence-based psychotherapeutic adaptations, and therapeutic standardization measures. Database search identified 22 recent trials assessing psilocybin as treatment for major and treatment-resistant depression, medical condition-related distress, substance use, obsessive-compulsive disorders, and eating disorders. Cross-diagnostic review revealed broad consistency in therapeutic structure (i.e. before, during, and after psilocybin treatment), session themes, and external context during drug administration. However, trials varied in therapeutic intensity, diagnostic adaptations, and incorporation of evidence-based psychotherapies. Less than half of reviewed trials reported standardization measures such as manualized procedures, PT-specific training, or adherence and fidelity monitoring. With non-pharmacological treatment mechanisms still unclear, results highlight potential confounds and standardization gaps that undermine the replicability and generalizability of recent psilocybin interventions. Until adjunctive support protocols are adequately operationalized, mechanistic insight and uptake into clinical practice will remain a challenge. • There is little guidance on psychological support within psilocybin interventions • We reviewed 22 adjunctive therapy protocols across five psychiatric indications • Almost all follow a three-phase framework of preparation, intervention, integration • Protocols varied in intensity, evidence-based content, and standardization • Heterogeneities impact outcome generalizability and limit mechanistic testing
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.008 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".