A Delphi consensus study with 89 experts from 17 countries identified 30 extra-pharmacological variables that are important or very important for reporting the setting in psychedelic clinical trials. These variables, forming the ReSPCT guidelines, cover physical environment, dosing session procedure, therapeutic framework and protocol, and subjective experiences. The findings reveal significant ambiguities in current conceptualizations of set and setting. The guidelines provide a new standard for designing and documenting contextual factors in psychedelic research.
As psychedelic treatments become more widely available with less clinical oversight, the psychological support once provided by formal integration sessions may shift to patients' friends and family. This article argues that these social environments likely influence treatment outcomes but have not been studied. It proposes three solutions: educating support networks about psychedelic experiences, creating peer support groups for specific clinical populations, and regularly measuring social-environmental factors in research.