Set and Setting: A Narrative Review on the Importance of Context in Psychedelic-AssistedTherapy

Abstract

This article presents a narrative review of the extra-pharmacological variables that influence psychedelic-assisted therapy (PAT). Based on recent literature, it highlights the importance of the person (Set) and the environment (Setting) in modulating the subjective and therapeutic effects of substances such as psilocybin or MDMA. The main objective was to synthesize the key findings on how these variables influence treatment outcomes and the experience of well-being. Conceptual and empirical articles published in the last two decades were reviewed, considering inclusion criteria related to clinical approaches and contextual descriptions of psychedelic-assisted therapy. The findings are structured in three levels: therapeutic preparation, the setting during the session, and post-session integration. It is concluded that extra-pharmacological variables are essential to enhance the therapeutic potential of PAT, and a comprehensive model for clinical and research application is proposed.