A lack of consensus and theoretical clarity in psychedelic-assisted therapy research has led to polarized debates and unusual regulatory recommendations, such as removing psychological and medical safety measures to better study drug effects. This commentary argues that an ecological systems theory approach, adapted from Bronfenbrenner, can make contextual and practical factors explicit and testable in research. The proposed conceptual model aims to improve measurement of acute subjective experience and address limitations in current approaches. The authors suggest this framework could help reconcile conflicting perspectives and enhance safety in ongoing clinical trials.
Psilocybin, a serotonin 2A receptor agonist, shows promise as a psychiatric treatment, but little is known about how session context ("set and setting") affects outcomes. In a study on smoking cessation, ten participants received psilocybin (20–30 mg/70 kg) in two sessions, each with a different musical genre—Western classical or overtone-based—in counterbalanced order. Mystical experience scores tended to be higher during overtone-based sessions. Six of ten participants chose overtone-based music for a third session. Biologically confirmed smoking abstinence was similar between groups, with a slight benefit for those choosing overtone-based music (66.7% versus 50%). The findings question whether Western classical music typically used in psychedelic therapy is uniquely beneficial.