How Psychedelic-Assisted Therapy Works

Published on August 6, 2025 by Zencare Team. Written by Shereen Mohsen, PsyD from Relucent Psychology Group.

Let’s talk about something that used to feel taboo but is now coming up all the time: psychedelic therapy.

In the past year alone, I’ve had clients, colleagues, old friends, and even the occasional PTA parent quietly ask, “Hey, can we talk about psychedelics?” Whether it’s ketamine, MDMA, mushrooms, or ayahuasca, people are curious. And not just for the trippy experience. Folks are looking for real healing. Something different. Something deeper.

Even public figures are opening up about their journeys — like The Secret Lives of Mormon Wives star Jennifer Affleck, who’s shared how ketamine therapy helped her reconnect with herself after trauma, or the musician Lorde, who spoke candidly about how MDMA gave her access to emotions she’d been cut off from for years. These aren't just celebrity soundbites — they reflect a bigger cultural shift. More people are wondering: Could this be the thing that helps?

And I get it. When nothing else seems to move the needle — when therapy plateaus, when meds don’t help, when you’ve read every self-help book but still feel stuck — you start to wonder: Is there something else out there?

That’s exactly why I wanted to write this. Not to sell you on anything. Just to have a real, grounded, open conversation about what psychedelic-assisted therapy actually is, how it works, what I’ve seen in my own clinical work, and what you should know if you're thinking about trying it.

First Things First: What Is Psychedelic-Assisted Therapy?

Psychedelic-assisted therapy is basically what it sounds like: it’s therapy that involves the use of a psychedelic substance, but in a very intentional, structured, and supported way.

This isn’t “take mushrooms in the woods and hope for a breakthrough” (though that’s a valid journey too). In a clinical setting, there’s prep beforehand, a therapist or guide present during the experience, and integration afterward to help you process whatever came up.

I work mostly with Ketamine-Assisted Psychotherapy (KAP), since ketamine is currently legal and available for therapeutic use. And I’ll be honest, when I first started training in this work, I wasn’t sure what to expect. I’m someone who values deep relational therapy, not quick fixes. But the depth I’ve witnessed in ketamine sessions? It’s hard to describe. Clients drop into parts of themselves that are often totally inaccessible through talk therapy alone.

One of my clients, who’d been dealing with complex trauma for years, told me after a session, “I didn’t think my way through that — I felt it. And I survived it.” That was a turning point for her.

What Actually Happens in a Psychedelic Therapy Session?

So, how does psychedelic-assisted therapy work in practice?

Let me walk you through it.

Step one: Prep.

We meet for one or more sessions ahead of time to talk through your goals, fears, history, and what the experience might look like. We’re setting the emotional tone and building trust. Without this step, the whole thing falls flat.

Step two: The medicine session.

If you’re doing KAP, this might happen in the office (if you’re receiving ketamine lozenges or IM injections), or at home if you’re working with a prescriber who does at-home lozenge protocols with remote support. During the session, you’ll be in a quiet, cozy space, eyes covered, music playing, and a therapist nearby. The medicine shifts your state of consciousness, and the inner experience unfolds.

This part looks different for everyone. Some people see vivid images, some feel strong emotions, others have more of a body-based experience. And sometimes, nothing dramatic happens at all, and that’s okay too.

One client of mine went into the session hoping for answers to some big, existential questions. Instead, she spent most of the time feeling held by her grandmother, who passed away 10 years ago. “I didn’t get the answers I wanted,” she said afterward, “but I felt safe for the first time in years.”

That’s a different kind of answer.

Step three: Integration.

This is where the gold is. We talk about what came up, how it connects to your past or present, what your nervous system is still holding onto, what shifted, and what didn’t. We make meaning of the experience together. And we figure out how to carry it with you in daily life.

One of the biggest myths about psychedelic therapy is that the substance does the healing. Nope. It might open the door. But you still have to walk through it. And the therapy, that’s your walking partner.

What’s Happening in the Brain?

Okay, here’s the nerdy part — but I’ll keep it simple.

Psychedelics quiet something in your brain called the default mode network (DMN). That’s the part responsible for self-reflection, your inner narrative, rumination, and sense of identity. In people with depression or trauma, the DMN gets stuck, like a record skipping on “I’m not safe” or “Nothing will ever change.”

When the DMN quiets down, your brain gets a little more spacious. Suddenly, you're not stuck in the same old grooves. People often describe it as “getting out of their own way.” You’re able to step outside of yourself and see things differently.

And during this state, the brain becomes more neuroplastic, which just means it's more open to rewiring. That’s why the therapy piece is so important. If we just blast open awareness and don’t support it, the insights disappear. But with integration, those new insights can stick around and become part of who you are.

Does It Work?

“Does psychedelic-assisted therapy work?” This is the question I get the most. And my answer is… yes, when done thoughtfully.

There’s solid research behind this. MDMA-assisted therapy for PTSD has shown that more than two-thirds of people no longer met the criteria for PTSD just a couple months after treatment. Ketamine has shown fast-acting effects for treatment-resistant depression, sometimes within hours.

But honestly, as a therapist, what stands out most to me isn’t the data — it’s the stories.

Like the client who came in feeling so numb he couldn’t remember the last time he felt joy. After his third KAP session, he showed up to therapy and said, “I watched the sun rise this morning and cried because it was beautiful. That’s not me. But it felt like it was supposed to be.”

Or the woman who carried deep shame from childhood abuse. In one session, she told me she saw her younger self sitting in a field of sunflowers, finally smiling. “I don’t know if it was real,” she said. “But it felt true.”

That kind of language, “not real, but true”, comes up a lot. Psychedelic experiences often feel symbolic or surreal, but emotionally they strike right at the heart of things we’ve spent years avoiding.

Is This a Magic Cure?

Nope. Let’s not pretend it is.

Psychedelic therapy can be powerful — but it’s not easy. It’s not always pleasant. Sometimes it brings up grief, fear, or shame that’s been buried deep. That’s why having a skilled, compassionate therapist is so important. Someone who can stay with you in the messy parts.

I've had clients leave a session feeling cracked open, vulnerable, raw. And then, in integration, we slowly piece together what that experience meant. Sometimes the healing shows up weeks later, like a ripple effect.

It’s also worth saying: this isn’t for everyone. People with a history of psychosis, certain types of bipolar disorder, or active substance use issues may not be good candidates. That’s why proper screening matters.

What’s the Legal Status of Psychedelic Therapy (As of 2025)?

The legal status of psychedelic therapy in the U.S. is constantly evolving. It’s confusing, honestly. Here’s the rundown:

Legal & Available
- Ketamine is FDA-approved for depression and can be prescribed by licensed medical providers. It’s the only psychedelic therapy that’s legally accessible right now in most of the U.S.

In Clinical Trials
- MDMA (for PTSD) and psilocybin (for depression and end-of-life anxiety) are both in late-stage clinical trials. MDMA was recently denied approval by the FDA, but research and advocacy are ongoing.

Decriminalized in Some Places
- Cities like Oakland, Denver, and Santa Cruz have decriminalized certain psychedelics, but that doesn’t make them legal for therapy.

Still Illegal Elsewhere
- Outside of clinical trials or specific state programs, most psychedelics (MDMA, psilocybin, LSD, etc.) are still federally illegal.

If someone’s offering “psychedelic healing” in a state where it’s not legal, do your homework. There are skilled underground facilitators out there… and also people who have no idea what they’re doing. You deserve to feel safe, informed, and empowered before going into any altered state.

How Do I Find Someone I Can Trust?

If you're wondering how to find therapists that use psychedelics, start with legal ketamine providers.

Look for:

Licensed medical and mental health professionals
A clear intake and screening process
Therapy or integration support (not just “take this and go”)
Transparency around risks, benefits, and pricing

You can check out directories like:

If someone’s pushing miracle claims, skipping prep, or asking you to just “trust the medicine” — those are red flags.

Final Thoughts

If you’ve made it this far, I imagine you’re curious. Maybe you’ve tried everything and feel stuck. Maybe you’re just drawn to the idea of reconnecting with yourself in a new way.

Here’s what I’ll say: Psychedelic-assisted therapy isn’t a shortcut. But it can be a catalyst. A door. A disruption. A reminder of what’s possible when we meet ourselves with courage and support.

At Relucent Psychology Group, we offer Ketamine-Assisted Psychotherapy in a way that’s trauma-informed, relationship-based, and genuinely collaborative. We don’t do guru stuff. No ego trips. Just humans walking with humans through hard things.

If you’re curious, you can read more about our approach here. Or reach out. We’re always happy to talk, no pressure.

Healing doesn’t have to follow a straight line. Sometimes it takes an unexpected path. If this feels like your path, we’ll walk it with you.