The DOI matches its Crossref record; 62 of the 62 references it cites were found in a registry or an index.
Psychedelics and the essential importance of context
Abstract
Psychedelic drugs are making waves as modern trials support their therapeutic potential and various media continue to pique public interest. In this opinion piece, we draw attention to a long-recognised component of the psychedelic treatment model, namely ‘set’ and ‘setting’ – subsumed here under the umbrella term ‘context’. We highlight: (a) the pharmacological mechanisms of classic psychedelics (5-HT2A receptor agonism and associated plasticity) that we believe render their effects exceptionally sensitive to context, (b) a study design for testing assumptions regarding positive interactions between psychedelics and context, and (c) new findings from our group regarding contextual determinants of the quality of a psychedelic experience and how acute experience predicts subsequent long-term mental health outcomes. We hope that this article can: (a) inform on good practice in psychedelic research, (b) provide a roadmap for optimising treatment models, and (c) help tackle unhelpful stigma still surrounding these compounds, while developing an evidence base for long-held assumptions about the critical importance of context in relation to psychedelic use that can help minimise harms and maximise potential benefits.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“The psychedelic experience comes with an increased sensitivity to internal and external stimuli.”
In the citing paper
“It follows that the general context of psychedelic administration fundamentally shapes drug response and hence safety, as well as potentially therapeutic efficacy [9, 88].”
In the citing paper
“This highlights the frequent clinical observation that patients may need particularly intensive supportive care during, as well as after psychedelic experiences (Carhart-Harris et al., 2018).”
From Naturalistic psychedelic therapy: The role of relaxation and subjective drug effects in antidepressant response (2024) · cites this paper as Carhart-Harris et al., 2018
In the citing paper
“Psychedelic experiences vary depending not only on individual characteristics, such as health status, but also on the type of preparation available, intentions agreed upon before the experience, and the environment in which the experience takes place (Carhart-Harris et al., 2018; Golden et al., 2022).”
From Naturalistic psychedelic therapy: The role of relaxation and subjective drug effects in antidepressant response (2024) · cites this paper as Carhart-Harris et al., 2018
In the citing paper
“It has long been recognised that both set (the mindset of the participant, including their expectations, assumptions and intentions for the psychedelic experience, as well as stable variables such as personality and the presence of psychopathology) and setting (the physical, social and cultural environment in which the experience occurs) have the potential to greatly impact the outcomes of the Psy”
From The psychological processes of classic psychedelics in the treatment of depression: a systematic review protocol (2022) · cites this paper as [43]
In the citing paper
“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 [85]
In the citing paper
“Differences in set and setting, which involve factors such as opportunity for preparation, guidance and integration by a trained guide, have been extensively shown to greatly influence the acute psychedelic experience (136, 137).”
From Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy (2021) · cites this paper as [136]
In the citing paper
“Changes in the ratings of subjective measures that were observed in the present study are not necessarily related to a pharmacological effect of 5-MeO-DMT, but could have resulted from uncontrolled variables such as response expectancy of the participants prior to and after the session or the set and setting of drug administration (Carhart-Harris et al. 2018; Hartogsohn 2016).”
From Prospective examination of synthetic 5-methoxy-N,N-dimethyltryptamine inhalation: effects on salivary IL-6, cortisol levels, affect, and non-judgment (2020) · cites this paper as Carhart-Harris et al. 2018
Citations
Cites
Mediators and Mechanisms of Change in Psychotherapy Research
Kazdin, A. E. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091432 · Cited by 2,504 · cited 1×
“Therapeutic alliance is already known to be a major predictor of response in mental healthcare (Kazdin, 2007) and if the present thesis is correct, its influence is likely to be greater still in the context of psychedelics (see Carhart-Harris and Nutt, 2017).”
BackgroundGriffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116675513 · Cited by 2,201 · cited 4×
“Indirect support for this may be found in the not inconsiderable (before-versus-after treatment) effects sizes observed in control conditions in recent double-blind randomised control trials of psilocybin for end-of-life distress, for example (Griffiths et al., 2016).”
BackgroundMethodInfluentialRoss, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., Mennenga, S. E., Belser, A., Kalliontzi, K., Babb, J., et al. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116675512 · Cited by 1,698
Griffiths, R. R., Richards, W. A., McCann, U., & Jesse, R. (2006) · Psychopharmacology · doi:10.1007/s00213-006-0457-5 · Cited by 1,684 · cited 2×
“In model 1, it can be seen that: (a) feeling ready to ‘surrender’ to the experience, (b) having a clear intention for it, (c) having the experience in a therapeutic setting, and (d) taking a higher dose, are all predictive of having a certain kind of psychedelic experience which we label ‘peak’ – an intentionally secu…”
BackgroundCaspi, A., Hariri, A. R., Holmes, A., Uher, R., & Moffitt, T. E. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09101452 · Cited by 1,346
Human hallucinogen research: guidelines for safety
Johnson, M., Richards, W., & Griffiths, R. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108093587 · Cited by 1,203
Religions, Values, and Peak-Experiences
Jones, R. G., & Maslow, A. H. (1965) · Journal for the Scientific Study of Religion · doi:10.2307/1384286 · Cited by 949
Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects
Griffiths, R. R., Johnson, M. W., Richards, W. A., Richards, B. D., McCann, U., & Jesse, R. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2358-5 · Cited by 932
MacLean, K. A., Johnson, M. W., & Griffiths, R. R. (2011) · Journal of Psychopharmacology · doi:10.1177/0269881111420188 · Cited by 895
Roseman, L., Nutt, D. J., & Carhart-Harris, R. L. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2017.00974 · Cited by 808
Self-citation
Research works printed but not linked: 10
- Aixala M, 2017, Psychotherapeutic Intervention in Integration of Difficult Psychedelic Experiences: The ICEERS Support Service
- Albarelli HP, 2009, A Terrible Mistake: The Murder of Frank Olson and the CIA’s Secret Cold War Experiments
- Hartogsohn I, 2015, The Psycho-Social Construction of LSD: How Set and Setting Shaped the American Psychedelic Experience 1950–1970
- Hartogsohn I, 2017, Drug Sci Pol Law, 3, 1
- Hofmann A, 1980, LSD: My Problem Child
- Krebs TS, 2012, J Psychopharmacol, 26, 994
- Lee MA, 1992, Acid Dreams: The Complete Social History of LSD, the CIA, the Sixties and Beyond
- Schwartz C (2017) Molly at the Marriott: Inside America’s Premier Psychedelics conference. The New York Times. Available at: https://www.nytimes.com/2017/05/06/style/psychedelic-drug-resurgence-daily-life.html (accessed 6 May 2017).
- Sos P, 2013, Neuro Endocrinol Lett, 34, 287
- Waldman A, 2017, A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage, and My Life
Cited by
Sorted by citations
Items 601–655 of 655
Ehmann, S., Hager, N., Regier, P. S., Jones, G. M., & Allen, J. J. B. (2026) · Addictive Behaviors · doi:10.1016/j.addbeh.2026.108652
Santé mentale et psychédéliques : révolution ou promesse utopique ?
Duguey, A. L., Fauvel, B., & Bioy, A. (2025) · Perspectives Psy · doi:10.1051/ppsy/2025055
Context features influence alcohol reward and motivation
Pandey, S., & Miller, C. A. (2026) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.70274
Bendz, J., Schäfer, L., Sjöström, D., Sikström, S., & Kajonius, P. (2026) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2026.2644856 · Cited by 2
Fachner, J. C., Pasqualitto, F., & Maidhof, C. (2026) · IntechOpen eBooks · doi:10.5772/intechopen.1014268 · Cited by 1
Towards social curative psychedelic treatment
Newson, M., Roseman, L., & Haslam, S. A. (2026) · Discover Mental Health · doi:10.1007/s44192-026-00426-3
Self-citationLeptourgos, P. (2018) · theses.fr (ABES) · doi:10.70675/dafacdb1z9072z4ec2z8cebz0ca09b93b7ce · Cited by 3
Cullen, J. (2026) · Person-Centered & Experiential Psychotherapies · doi:10.1080/14779757.2026.2651879
Orlowski, P., Domagalik, A., & Bola, M. (2026) · Human Brain Mapping · doi:10.1002/hbm.70522
Low, Z. X. B. (2026) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2026.111717 · Cited by 2
"Riding the Wave"—Social Work Roles in Psychedelic Therapy Settings: A Scoping Review
Walker, A., Kolomer, S. R., & Mapson, K. W. (2026) · Clinical Social Work Journal · doi:10.1007/s10615-026-01036-w
Carhart-Harris, R. L., Zeifman, R. J., Pasquini, L., Nandi, B., Rohani-Shukla, C., Suseelan, S., Mediano, P. A. M., Rosas, F. C. W., Timmermann, C., Kettner, H., et al. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1875339
Self-citationBarfoot, S., Luke, D., Robinson, O. C., & Evans, J. (2026) · Research Square · doi:10.21203/rs.3.rs-9668424/v1
Torre, J. T. L., Gallo, J., Buonarroti, M., Williams, M., Sabé, M., & Sackett, N. B. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100021
Psychothérapie assistée par psychédéliques : enjeux et contenu des séances de préparation
Briefer, J.-F., Seragnoli, F., Thorens, G., Penzenstadler, L. E., Furtado, L., Buchard, A., Bachmann, S., Iuga, R., Cazorla, L., Sabé, M., et al. (2026) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2026.03.020
Morris, R. C., Gundogan, A., Lawrence, V. C., Himmerich, H., Treasure, J. L., & Keeler, J. L. (2026) · BMC Medicine · doi:10.1186/s12916-026-04929-2
Zeller, M. (2026) · Philosophical Psychology · doi:10.1080/09515089.2026.2678957
Psychedelic-Assisted Interventions in Palliative Care: A Narrative Overview and Critical Evaluation
Soares, D. A., & Campolina, A. G. (2026) · Healthcare · doi:10.3390/healthcare14111550
Reynante, B. M., & Buchanan, J. (2026) · Journal of Psychedelic Studies · doi:10.1556/2054.2026.00523
Mosina, I., & Luke, D. P. (2026) · Research Square · doi:10.21203/rs.3.rs-9966224/v1
Ten practical suggestions for setting up a psychedelic study
Caulfield, A., Butler, M., & Mehta, M. A. (2026) · Journal of Psychopharmacology · doi:10.1177/02698811261458350
Simonsson, O., Hendricks, P. S., Osika, W., & Goldberg, S. B. (2026) · Psychedelic Medicine · doi:10.1177/28314425261444135
Fletcher, K., Ezard, N., Siefried, K. J., van der Helder, S., Freestone, J., Brett, J., May, R., Acheson, L. S., & Clifford, B. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1873497
The purpose of the psychosocial protocol in the psychedelic-assisted therapy: A scoping review
Ferreira, F. G. D. P., Fernandes, J. A. B., Filev, R., da Silveira, D. X., & Fidalgo, T. M. (2026) · Journal of Psychopharmacology · doi:10.1177/02698811261453850
T-shaped expertise: rethinking interdisciplinarity in psychedelic research
Breeksema, J. J., Bremberg, U., van Dalfsen, J. H., Lindskog, M., Páleníček, T., Stenbæk, D. S., Granqvist, P., Dalla, C., Antoniou, K., Müller, F., et al. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100026
Whitfield, H. J., Schepers, J., Mason, N. L., Luca, M., & Kuypers, K. P. C. (2026) · Journal of Psychedelic Studies · doi:10.1556/2054.2026.00530
Psychedelics, rebirth experiences, and the limits of current research
Artru, E. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100028
The Evolution of Psychedelics and Psychedelic-Assisted Therapy
Brar, G., Lally, K., Kelly, J. R., & O'Connell, H. P. (2026) · Springer eBooks · doi:10.1007/978-3-032-27009-2_16
Longitudinal neural and psychological changes following psilocybin under compassion imagery priming
Pallavicini, C., Llobenes, L., Cavanna, F., de la Fuente, L. A., Muller, S. L., Costa, M., Gumiy, N., Bruno, N. M., D’Amelio, T. A., Basran, J. K., et al. (2026) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2026.1874178
Cellular mechanisms of serotonergic psychedelics - apical hypercontextualisation
Kaup, K., Jiménez, J. H., & Aru, J. (2026) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2026.106876
Poggini, S., Veleanu, M., Albanese, N. C., Bronnec, M., Schuberth, L. E., Colli, C. D., Viglione, A., Maggi, L., Normann, C., Vestring, S., et al. (2026) · Neuroscience · doi:10.1016/j.neuroscience.2026.07.047
Self-citationPsychedelic attunements: rethinking set and setting and context
Gearin, A. K., & Noorani, T. N. (2026) · BioSocieties · doi:10.1057/s41292-026-00397-2
Seynaeve, M., Dunbar, F., Ermakova, A. O., Mitcheson, L., Rucker, J., Cleare, A. J., & Marsden, J. (2026) · Addiction · doi:10.1111/add.70555
Die Rolle der Psychotherapie im Rahmen der Therapie mit Psychedelika
Wolff, M., Jungaberle, H., Evens, R., & Mertens, L. J. (2026) · Elsevier eBooks · doi:10.1016/b978-3-437-21293-2.00006-x
Branchi, I. (2026) · Psychological Medicine · doi:10.1017/s003329172610467x
Self-citationGentry, J. (2026) · Journal of the American Academy of Religion · doi:10.1093/jaarel/lfag046
Spata, A., Sturges, J. W., & Earleywine, M. (2026) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2026.2710057
Jewell, J. S., James, C., & Black, J. C. (2026) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2026.2710054
Garvey, M. D. (2026) · SSRN Electronic Journal · doi:10.2139/ssrn.7428998
Lived experience as systems-relevant evidence in psychedelic public health
Dara, P. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1951513
Employment-Related Risk Is Reasonable to Disclose—Even to the Unemployed
Bach, M. C. (2026) · The American Journal of Bioethics · doi:10.1080/15265161.2026.2717113
Hogg, D. E., Romanos, J., Albiez, J., Hofer, C., Wicki, S., Argunşah, A. Ö., Sigrist, H., Thomann, J., Luethi, D., Vollenweider, F. X., et al. (2026) · Frontiers in Pharmacology · doi:10.3389/fphar.2026.1918182
Grimshaw, S., & Revell, S. (2026) · Counselling Psychology Quarterly · doi:10.1080/09515070.2026.2732966
Sznitman, S. R., & Tiwari, S. (2026) · Addiction · doi:10.1111/add.70616
Moving beyond 5-HT2A: language models map neurotransmitter receptors to experiential semantics
Suresh, P., Kins, J., Levkovskyy, L., Thieme, A., Wren, P. B., Ray, T., Barrett, F. S., Carhart-Harris, R. L., & Bzdok, D. (2026) · Psychopharmacology · doi:10.1007/s00213-026-07170-0
Self-citationGroup psychedelic-assisted therapy for mental health conditions: a mixed-methods systematic review
Tsang, V. W. L., Bhatia, F., Ferrey, A. E., & Hartmann‐Boyce, J. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1788352
Laborde, S., Falchi-Carvalho, M., Maia, L. O., Tullman, S., Barros, H., Lima-Araujo, G., Bolcont, R., Wießner, I., Galvão-Coelho, N., Palhano-Fontes, F., et al. (2026) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2026.102773
Breaking psychedelic boundaries in public health: emerging ideas with ancient roots
Bartlett, K., Gezon, L. L., Ward, W. D., & Sears, F. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1923284
Feeling safe: an empirical-ethical analysis of vulnerability in (es)ketamine treatment
Kind, A., Görke, J., Smirr, H., Ni, C., Yan, K., & Repantis, D. (2026) · BMC Medical Ethics · doi:10.1186/s12910-026-01637-7
Seynaeve, M., Schneider, L., Roullier, I., Lazenby, K., Lilley, C., Lobo, S., Ermakova, A. O., Wells, H., Cleare, A. J., & Rucker, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1682810
Context Shapes Alpha-Band Electrophysiological Signatures under PsilocybinPreprint
Dhanawansa, V., Stoliker, D., Novelli, L., Biabani, M., Razi, A., & Kuhlmann, L. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.10.06.757155
Mathai, D. S., Pilecki, B. C., Zaki, H., Morris, T., Morris, M., & Garcia‐Romeu, A. (2026) · Psychedelics · doi:10.1016/j.psyche.2026.100046
Psychedelic tourism as a structured precision field: A predictive-processing framework
Zhang, W., & Zhang, F. (2026) · Journal of Psychedelic Studies · doi:10.1556/2054.2026.00538
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
Metadata
- Authors
- Carhart-Harris, R. L., Roseman, L., Haijen, E., Erritzoe, D., Watts, R., Branchi, I., & Kaelen, M.
- Affiliations
- Imperial College London (GB)
- Psychedelic Research Group, Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
- Istituto Superiore di Sanità (IT)
- Corresponding author
- Carhart-Harris, Robin L
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2018-02-15
- Volume
- 32
- Issue
- 7
- Pages
- 725-731
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- OpenAlex
- W2788854095
- Cited by
- 657
- References
- 62
- Citations by year
- 2026: 83 · 2025: 102 · 2024: 112 · 2023: 105 · 2022: 97 · 2021: 72 · 2020: 49 · 2019: 24 · 2018: 13
- FWCI
- 46.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2013-21-501)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- psychedelics, set and setting, context effects, 5-HT2A receptor agonism, neuroplasticity, long-term mental health outcomes, harm reduction
- MeSH terms
- Animals, Clinical Trials as Topic, Hallucinogens, Humans, Research Design, Serotonin 5-HT2 Receptor Agonists
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
