Psilocybin-assisted psychotherapy (PAP) is emerging as a potential intervention for cancer-related psychological and existential distress. Clinical outcomes have demonstrated promising outcomes, but little is known about how PAP should be delivered in cancer care. We conducted three qualitative studies to examine the perspectives of people living with cancer, healthcare professionals, and international psilocybin researchers. We also conducted a scoping review of qualitative and quantitative studies of PAP in cancer populations.
Participants consistently described PAP as more than a pharmacological intervention. Therapeutic benefit was understood to emerge through the interaction between psilocybin, therapeutic rapport, preparation, integration, and broader elements of set and setting. People living with cancer emphasize trust, safety, meaningful preparation, supportive environments, and continuity of care. Healthcare professionals and researchers highlight multidisciplinary care, specialised training, governance, scalability, and equitable access. The scoping review identified substantial variation in psychotherapeutic frameworks and delivery models, but found recurring qualitative themes of meaning-making, interconnectedness, acceptance of mortality, and reconnection with life. Emerging group-based approaches were identified as potential delivery approach that may be beneficial connection and improving scalability through reducing cost.
Implementation of PAP in cancer care will require attention not only to efficacy but also to therapeutic relationships, workforce development, models of care, and patient experience.