A study that conducted in-depth interviews with esketamine patients found that receiving proper support and therapeutic presence (not just from therapists, but from all staff) was key in helping them alleviate the anxiety stirred up by the drug effects. They also reported that they felt uncomfortable with providers who didn’t seem to understand their experience of psychedelic treatment, saying it was crucial that they demonstrated respect for the subjective experiences they were having.

A study of 1,278 psychedelic users, which included pre & post assessments of 46 psilocybin retreat participants, found that those who were properly prepared before dosing had greater improvements in well-being after dosing than those who were not well-prepared.

A survey study of 613 psychedelic users found that negative experiences and heightened risk of harm were more likely to occur when factors pertaining to the setting were lacking, such as proper preparation, skillful psychological support, and thoughtful space setup.

An expert review of literature on the risk of triggering psychotic or manic episodes with psychedelic treatment concluded that an optimized setting will likely prevent these outcomes.

A study that surveyed psychedelic users pre and post use found that the right pre-dosing mindset predicted a lower likelihood of challenging experiences. A similar trend was found with the impact of aspects of the setting, such as feeling comfortable in the dosing environment and comfortable with the people present.

An interview study with 19 psilocybin patients found that their feelings about the music that was played for them predicted antidepressant outcomes.

A survey of 886 psychedelic participants found that experiences of “communitas,” or feelings of shared humanity with other people present, predicted greater benefit from the experience.

A survey of 515 psychedelic users found that thoughtful music choices predicted less challenging experiences and that suitable preparatory practices predicted a higher likelihood of receiving benefit.

A survey of 603 psychedelic users found that the appropriateness of the setting predicted a lower degree and a lower variety of extended post-session difficulties for participants.

In a clinical trial in which 30 participants received psilocybin for their depression, a stronger therapeutic alliance predicted greater reductions in depression, both directly and indirectly through facilitating beneficial experiences during dosing sessions.

Another clinical trial that gave 24 participants psilocybin for the treatment of their depression found that therapeutic alliance predicted greater reductions in symptoms.

A systematic review of 178 psychedelic clinical trial participant experiences found that they frequently reported that the treatment context and quality of clinical support they received was very impactful on their treatment experiences.

When 50 psychedelic users who had challenging experiences were surveyed, they emphasized that being well-prepared and being in a thoughtfully designed setting helped them reduce negative outcomes.

A study that conducted in-depth interviews with esketamine patients found that receiving proper support and therapeutic presence (not just from therapists, but from all staff) was key in helping them alleviate the anxiety stirred up by the drug effects. They also reported that they felt uncomfortable with providers who didn’t seem to understand their experience of psychedelic treatment, saying it was crucial that they demonstrated respect for the subjective experiences they were having.

A survey study of 2,751 psychedelic users found that 41% of the variability in how challenging their experiences were was explained by aspects of the context, such as their relationships with others present, space set-up, and their sense of comfort in the setting.