Learnings from a hybrid communities of practice group therapy model to support psilocybin-assisted therapy for patients with a terminal diagnosis.

BACKGROUND

Psilocybin-assisted therapy is continuing to show significant positive effects for palliative cancer patients, both in reducing symptoms and improving one's sense of hope and meaning. Most research has focused on individual therapy models, limiting access and overlooking potential community-based benefits.

METHODS

This qualitative study describes the results of patients experiencing distress related to a terminal health condition who enrolled in six to eight once-weekly group resilience-based community of practice (CoP) sessions combined with one psilocybin-assisted therapy (PaT) session. This virtual hybrid group therapy model is research informed, with a curriculum that provides knowledge-based content, combined with the relational elements necessary to successfully deliver group-administered psilocybin-assisted therapy. Patients were interviewed using semi-structured question list and transcripts were coded and themes captured in an iterative manner. The CoP sequence included preparation meetings before the in-person medicine session and integration meetings afterward, allowing the group relationship and safety practices to be established before dosing.

RESULTS

Thirty-one PaT sessions were provided for 25 participants within four iterative cohorts over the span of 1 year (November 2021-November 2022). Completion rates were high (84%), with participants reporting enhanced trust in self, improved outlook on life, and strengthened connection to community. Peer support, relational safety, and regulation practices were central to outcomes.

CONCLUSION

This study demonstrates the feasibility, safety, and psychosocial benefits of group-administered PaT supported by virtual CoPs, providing a scalable, cost-effective model for public health interventions in end-of-life care. Its novelty lies in combining group therapy, hybrid delivery, and resilience-based curriculum to expand access and enhance community support for a vulnerable population. Participants' mixed feedback also suggests that hybrid group PaT may offer distinctive benefits of peer witnessing and community continuity while requiring careful attention to individual preference, room logistics, and sensory control during group dosing.