Drug-Centered or Drug-Assisted? Epistemic Perspectives and Methodological Tensions in Psychedelic Psychotherapy
Karen Yan*, Christina Ni, Yun-Ying Kuo, Mu-Hong Chen
The first and corresponding author: Karen Yan, karenyan@nycu.edu.tw
Paper Introduction
This paper examines how psychedelic-assisted psychotherapy is understood and studied. We focus on two perspectives:
We explore two main ways of looking at psychedelic therapy:
- Drug-centered: the therapeutic effect is attributed mainly to the pharmacological action of the substance.
- Drug-assisted: the drug is seen as supporting a psychotherapeutic process, where healing comes from the interaction between the drug-induced experience and the therapeutic relationship.
Both views are usually tested through evidence-based medicine, especially randomized controlled trials (RCTs). While RCTs are powerful tools for establishing safety and efficacy, they are designed to isolate variables—an approach that fits the drug-centered model but creates challenges for the drug-assisted model, where the interaction itself is central but harder to measure.
Our work highlights these methodological tensions and suggests that complementing RCTs with approaches that consider values, relationships, and meaning can provide a fuller understanding of psychedelic-assisted psychotherapy. In this way, the paper seeks to connect scientific evidence with the interpersonal and experiential dimensions of care.
You can download the paper here.