CoChat
Sign Up
Cited by 82Psychedelics and Drug StudiesPsychotherapy Techniques and ApplicationsPain Management and Placebo Effect

The therapeutic alliance between study participants and intervention facilitators is associated with acute effects and clinical outcomes in a psilocybin-assisted therapy trial for major depressive disorder

Open access
Levin, Adam W., Lancelotta, Rafaelle, Sepeda, Nathan D., Gukasyan, Natalie, Nayak, Sandeep, Wagener, Theodore L., Barrett, Frederick S., Griffiths, Roland R. +1 more·2024·PLoS ONE
DOI 10.1371/journal.pone.0300501PMC PMC10939230
Open this paper in CoChat — free accountOpen PDF

Abstract

We examined if the therapeutic alliance between study participants and intervention facilitators in a psilocybin-assisted therapy (PAT) trial changed over time and whether there were relationships between alliance, acute psilocybin experiences, and depression outcomes. In a randomized, waiting list-controlled clinical trial for major depressive disorder in adults (N = 24), participants were randomized to an immediate (N = 13) or delayed (N = 11) condition with two oral doses of psilocybin (20mg/70kg and 30mg/70kg). Ratings of therapeutic alliance significantly increased from the final preparation session to one-week post-intervention (p = .03, d = .43). A stronger total alliance at the final preparation session predicted depression scores at 4 weeks (r = -.65, p = .002), 6 months (r = -.47, p = .036), and 12 months (r = -.54, p = .014) post-intervention. A stronger total alliance in the final preparation session was correlated with higher peak ratings of mystical experiences (r = .49, p = .027) and psychological insight (r = .52, p = .040), and peak ratings of mystical experience and psychological insight were correlated with depression scores at 4 weeks (r = -.45, p = .030 for mystical; r = -.75, p < .001 for insight). Stronger total alliance one week after the final psilocybin session predicted depression scores at 4 weeks (r = -.85, p < .001), 3 months (r = -.52, p = .010), 6 months (r = -.77, p < .001), and 12 months (r = -.61, p = .001) post-intervention. These findings highlight the importance of the therapeutic relationship in PAT. Future research should explore therapist and participant characteristics which maximize the therapeutic alliance and evaluate its relationship to treatment outcomes. Trial registration: Registration: Clinicaltrials.gov NCT03181529. https://classic.clinicaltrials.gov/ct2/show/NCT03181529.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0300501

Cites

73 of 73 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

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?

  • Therapist-patient relationship is one of the strongest predictors of treatment success across psychotherapeutic approaches, including PAT.

    “Studies indicate that the therapist-patient relationship is one of the strongest predictors of treatment success across psychotherapeutic approaches, including PAT (166, 169–171).”

    From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [169]

    The Introduction reports that stronger therapeutic alliance is consistently associated with better outcomes across therapeutic orientations, and the Discussion reports moderate-to-large correlations in this PAT trial. But the paper does not establish that the relationship is one of the strongest predictors across approaches; it describes alliance–outcome correlations in traditional therapies as small to medium. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. [9]Beyer SV. Singing to the plants: a guide to mestizo shamanism in the upper Amazon. 1. paperback print. Albuquerque: University of New Mexico Press; 2010. 530 p.
  2. [29]Kleiger MJP. Beginnings: the art and science of planning psychotherapy. 2. ed. New York, NY: Routledge; 2012. 437 p.
  3. [56]Grof S. Realms of the Human Unconscious: Observations from LSD Research. Main edition. Souvenir Press; 2019. 320 p.

Cited by

Sorted by citations

Related

Authors
Levin, A. W., Lancelotta, R., Sepeda, N. D., Gukasyan, N., Nayak, S., Wagener, T. L., Barrett, F. S., Griffiths, R. R., & Davis, A. K.
Affiliations
  • The Ohio State University (US)
  • Johns Hopkins University (US)
  • The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
Corresponding author
Davis, Alan K.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2024-03-14
Volume
19
Issue
3
Pages
e0300501
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0300501
PMC
PMC10939230
OpenAlex
W4392797453
Cited by
82
References
72
Citations by year
2026: 41 · 2025: 24 · 2024: 17
FWCI
40.97
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Riverstyx Foundation
  • Tim Ferriss, Matt Mullenweg, Craig Nerenberg, Blake Mycoskie, the Steven and Alexandra Cohen Foundation
  • Center for Psychedelic Drug Research and Education
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords
therapeutic relationship, psilocybin-assisted therapy, major depressive disorder, psychedelic therapy, mystical experience, psychological insight, treatment outcomes
MeSH terms
Therapeutic Alliance, Adult, Major Depressive Disorder, Humans, Psilocybin, Treatment Outcome

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