Hopkins Releases Scoping Review on “Setting” for Psychedelic Experience

As research grows, interest also continues to rise in psychedelic therapies as treatments for addiction and mental health conditions, including PTSD and depression. But how does the “set and setting” of a psychedelic experience affect the experience of patients receiving these treatments?

A scoping review published in 2022 from the International Arts + Mind Lab (IAM Lab) and Johns Hopkins University Center for Psychedelic and Consciousness Research examines 43 studies for their use of setting — including variables like music, enriched environment, ritual, participation, and facilitation.

Published in Disruptive Psychopharmacology, this review serves as an important foundation for a new multi-university collaboration between Johns Hopkins University, the University of California at San Francisco, and McGill University. This first of its kind, inter-institutional initiative explores unique approaches to studying setting with an ultimate goal of informing best practices, a needed step in making psychedelic therapies more evidence-based and effective for a range of populations.

“Setting is assumed to be of fundamental importance to psychedelic experiences,” said Frederick Barrett, Ph.D., senior author of the study and a cognitive neuroscientist at the Johns Hopkins Center for Psychedelic and Consciousness Research. “But our review shows that nothing truly systematic and comprehensive has not yet been shown in the psychedelic literature.”

Previous studies have observed and begun to describe various settings used in psychedelic therapies and experiences, including music, religious ceremony or ritual, the surrounding physical environment, and the group or social context. But, according to the review, few studies have rigorously tested how setting interacts with psychedelic interventions. As a result, we do not yet have a deep understanding of how setting and aesthetics affect outcomes.

Despite the lack of rigorous studies, a standard approach to setting has emerged from decades of clinical practice. Psychedelic therapies typically take place in a warm room with pleasing artwork. Patients recline on a sofa while wearing eyeshades and listening to music from curated playlists. This environment appears to have supported the promising outcomes observed in psychedelics studies, but additional research could lead to customization and greater effectiveness.

It could also increase our understanding of how settings affect us more generally. Tasha Golden, Ph.D., lead author of the study and director of research at IAM Lab, suggested that studies of setting in the realm of psychedelics could have important ripple effects, providing “a model for examining how setting and aesthetics affect a wide variety of health interventions.”

To build on these findings, researchers at Hopkins and other institutions have received philanthropic funding to conduct research and develop this multi-university collaboration. The team at Johns Hopkins will test how psychedelic experiences are affected by music using a variety of conditions including personally significant songs for the listener.

Studies across the three universities will be conducted independently, but the research groups have formed a unique collaborative network to share findings and opportunities, and enhance the insight and value generated by each study. Over the next several years, this network will fill in key knowledge gaps to improve our understanding and application of the relationship between setting and psychedelic experiences. Susan Magsamen, executive director of IAM Lab says, “This new approach to interdisciplinary collaborative science is the key to standardized protocols and outcome measures for the field and deeper insights. The benefits to both therapists and clients will have significant impact.”