Set and setting: a randomized study of different musical genres in supporting psychedelic therapy
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Abstract
Abstract Mounting evidence supports the serotonin 2A receptor agonist psilocybin as a psychiatric pharmacotherapy. Little research has experimentally examined how session “set and setting” impacts subjective and therapeutic effects. We analyzed the effects of the musical genre played during sessions of a psilocybin study for tobacco smoking cessation. Participants (N = 10) received psilocybin (20–30 mg/70 kg) in two sessions, each with a different musical genre (Western classical versus overtone-based), with the order counterbalanced. Participants chose one genre for a third session (30 mg/70 kg). Mystical experiences scores tended to be higher in overtone-based sessions than in Western classical sessions. Six of ten participants chose the overtone-based music for a third session. Biologically confirmed smoking abstinence was similar based on musical choice, with a slight benefit for participants choosing the overtone-based playlist (66.7% versus 50%). These data call into question whether Western classical music typically used in psychedelic therapy holds a unique benefit. Broadly, we call for experimentally examining session components toward optimizing psychedelic therapeutic protocols.
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Contextual factors, such as the environment in which the experience takes place (setting), the mindset of the individual (set), and the support available after the experience (integration and setting), have a huge impact on the effects of psychedelics.
“Contextual factors, such as the environment in which the experience takes place (setting), the mindset of the individual (set), and the support available after the experience (integration and setting), have a huge impact on the effects of psychedelics (85–88).”
From Potential therapeutic effects of an ayahuasca-inspired N,N-DMT and harmine formulation: a controlled trial in healthy subjects (2024) · cites this paper as [88]
The paper’s introductory discussion (page unavailable) calls mindset and environment central to psychedelic effects. It also reports an association between greater support and improved wellbeing, but says post-session support varied alongside dose and preparation. It therefore does not establish that support after the experience has a huge, independent impact. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSet and setting are well-known to influence the subjective effects of psychedelics.
“set and setting are well-known to influence the subjective effects of psychedelics”
From Psychedelics and Other Psychoplastogens for Treating Mental Illness. (2021) · cites this paper as [297]
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Guest Editors' Introduction to "Psychedelica and Electronica"
Reddell, T., & John, G. S. (2023) · Dancecult · doi:10.12801/1947-5403.2023.15.01.01
If psychedelics heal, how do they do it?
Beans, C. M. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2321906121
Breeksema, J. J. (2024) · doi:10.33612/diss.912040905
Introduction to the EMBARK Approach
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0003
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0006
Bringing It Home and Carrying It Forward
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0009
Considerations Prior to Meeting With a Participant
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0005
INTRODUCTION: A New Approach for the Whole Person
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0001
Choosing Suggested Integration Goals
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0004
Working Within the EMBARK Domains Cheat Sheet
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0003
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0007
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0002
An Overview of Psychedelic-Assisted Therapy
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0002
Personal Care for the Therapist
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.005.0001
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0008
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.002.0004
EMBARK Mechanisms of Change in the Treatment of Depression
Brennan, B., & Belser, A. (2024) · Oxford University Press eBooks · doi:10.1093/9780197762622.003.0004
Hartogsohn, I., Yavelberg, Y., & Ezra, O. B. (2025) · Journal of Psychedelic Studies · doi:10.1556/2054.2024.00359 · Cited by 1 · see citing works
Integrating music to navigate dissociative effects of ketamine in depression and suicidality
Raj, R., Wani, Z. A., & Priya (2025) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2025.104676
Henningfield, J. E., Barrett, F. S., Evans, S., Garcia-Romeu, A., Garrett, B. E., Hienz, R., Lukas, S., Nayak, S. M., Strain, E. C., Weerts, E., et al. (2026) · Journal of Psychopharmacology · doi:10.1177/02698811251398801 · Cited by 1 · see citing works
Holding space between notes: Music, silence, and cultural attunement in psychedelic-assisted therapy
Balsamo, D. N., Garodia, P., Fayazmanesh, N., & Nguy, A. K. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100015
Cullen, J. (2026) · Person-Centered & Experiential Psychotherapies · doi:10.1080/14779757.2026.2651879
Reynante, B. M., & Buchanan, J. (2026) · Journal of Psychedelic Studies · doi:10.1556/2054.2026.00523
O’Callaghan, C. C., Kallianis, V., & Ross, M. (2026) · Journal of Music Therapy · doi:10.1093/jmt/thag015
Pobihuszka, D. (2026) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.6c00489
Lewis, B. R., Garland, E. L., Schwartz, Z., Xin, Y., Byrne, K., & Brent, K. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100041
Clinical Evidence on Psilocybin and Its Representation in Media Reporting
Madden, K., Flood, B., Kashir, I., Ahmad, R., Ali, H., Petranker, R., MacKillop, J., & Adili, A. F. (2026) · JAMA Network Open · doi:10.1001/jamanetworkopen.2026.38843
Moskovitz, M. (2026) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.6c00402
Set and Setting Beyond Reductionism: A Response to Patch and Smith
Hartogsohn, I., Pronovost-Morgan, C., & Ramaekers, J. G. (2026) · Neuroethics · doi:10.1007/s12152-026-09678-w
- Authors
- Strickland, J. C., Garcia-Romeu, A., & Johnson, M. W.
- Affiliations
- Johns Hopkins University (US)
- Johns Hopkins University School of Medicine , , 5510 Nathan Shock Drive , , ,
- Corresponding author
- Johnson, Matthew W.
- Venue
- ACS Pharmacology & Translational Science
- Publisher
- American Chemical Society (ACS)
- Published
- 2020-12-29
- Volume
- 4
- Issue
- 2
- Pages
- 472-478
- ISSN
- 2575-9108 (ISSN-L)
- PMC
- PMC8033606
- OpenAlex
- W3117921577
- Cited by
- 97
- References
- 31
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 28 · 2023: 11 · 2022: 18 · 2021: 8
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Licence
- Locations
- ACS Pharmacology & Translational Science (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Funders
- Johns Hopkins University
- Heffter Research Institute
- Steven and Alexandra Cohen Foundation
- Beckley Foundation
- National Institute on Drug Abuse (T32-DA07209)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Social Sciences › Psychology › Social Psychology › Music Therapy and Health
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- psilocybin, set and setting, music genres, classical music, psychedelic therapy, smoking cessation, mystical experience, smoking abstinence, music selection
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