People who use classic psychedelics outside of clinical settings commonly do so alone when aiming to improve their mental health, and solo use is linked to greater subjective symptom improvement than group use. However, overall perceived mental health benefit does not differ significantly between solo and group settings. Negative mental health outcomes are rare regardless of setting. Most naturalistic use occurs informally, with no notable difference between solo and group users. These findings suggest that group settings for psychedelic-assisted psychotherapy warrant further investigation, as they appear no more harmful than solo use and yield comparable overall benefits.
Tehseen Noorani's ethnographic study of the Johns Hopkins psychedelic research program between 2015 and 2019 argues that the emphasis on 'set and setting' in psychedelic-assisted therapy articulates not only therapeutic imperatives but also social, political, and economic ones. Noorani problematizes the notion of 'containment' and interrogates how psychedelics alter conceptions of self and the social environments they arise from. The commentary notes that while Noorani's analysis reveals complex sociocultural interpretations, simpler pragmatic explanations exist for research design choices, such as using living room settings and CCTV cameras for safety, data collection, and medicolegal protection. These design features are empirical claims testable through research.