The short answer
What do people do before a session, is an intention needed, and does preparation change how people fare?
Studies in adults who planned to take a classic psychedelic, or who had had a psychedelic experience of unrecorded substance, measured how clear, ready and calm people rated themselves beforehand, or how prepared they felt looking back. Clearer intentions and calmer, readier states of mind went with more mystical-type and fewer challenging experiences. These are associations in self-selected samples. The scale paper in source 2 asks what people did to prepare through self-rated agreement items on its scale, such as having spoken with a therapist or counsellor. None of the sources read in full assigned people to different preparation. This card does not say whether anyone should prepare, how, or when to postpone.
What did research find?
Figures are as reported, not a recommendation. This marking applies to every figure in this section.
- A prospective online study. It followed adults planning to take a classic psychedelic on their own initiative: 654 signed up, and 379 reported on the experience the day after. Those who, the day before, rated themselves more comfortable, open, ready and less anxious reported fewer challenging experiences. Those who rated their intention as clearer reported more mystical-type experiences. A stated intention to confront difficult emotions went with higher challenging-experience scores (r = 0.22), and the authors did not record whether that intention was carried out. The items were written by the authors and not validated, the sample leaned in favor of psychedelics, and about a third reported a past psychiatric diagnosis. Source 1, level 1
- A preparedness scale. A 20-item Psychedelic Preparedness Scale was built with experts and experienced users. In two online samples (1,236 respondents pooled) people rated their preparedness looking back at their most significant experience. Higher scores went with higher mystical-experience scores (r = 0.55) and well-being scores, and lower challenging-experience scores (r = -0.42). Both were rated after the event, so this is a self-rated sense of preparedness, not a record of what anyone did. The scale's items cover knowledge, intention, readiness and support planning. In 46 people who completed surveys around a 5 to 7 day psilocybin retreat, with many dropping out, higher scores the day before went with a larger fall in depression, anxiety and stress scores two weeks later. Source 2, level 1
- A systematic review. A 2021 systematic review of 14 studies (PubMed searched) linked clear intention, positive mood and surrender beforehand to more positive experiences, and apprehension, preoccupation and confusion to more adverse ones. Its finding on intention comes from the study in source 1. Most studies were small, retrospective or open-label. Source 3, level 1
How is preparation reported?
Reported practice, not a recommendation. These are different groups with different aims, and the figures cannot be combined into a range. None of the three compared one length of preparation with another.
- A trial in people with major depression (24 completers) scheduled eight hours of preparation in total with two facilitators. Source 4, level 1, people with major depression
- In a convenience survey, 92 people who said they prepare clients for naturalistic use gave an average time per session of none (4 people), one hour (11), 1.5 to 4 hours (55, or 59.8%), 5 to 9 hours (19) or 10 hours or more (7). Their answers could not be verified. Source 5, level 1
- A pilot psychiatric consultation service at a university in Oregon described two visits of about 90 minutes, mostly for patients with a psychiatric concern. Source 6, level 1, 29 patients
What is not known?
“Not located” means that the searches Metanoia ran on 7 November 2026 did not return it. They covered PubMed, ClinicalTrials.gov and the preprint servers through Europe PMC. Google Scholar, PsycINFO and Embase were not searched. Two 2026 preprints on intentions were found as abstracts only and carry no claim here. Traditions are not covered. More searching could change the picture.
- Whether preparation itself changes outcomes. A registered randomized feasibility trial of a 21-day self-guided preparation program (meditation or music) in 40 healthy volunteers is recruiting. Its primary outcomes are feasibility and adherence, and its record shows no results (source 7). Three further registered trials of preparation, all in clinical groups, are listed on ClinicalTrials.gov, and only their listings were read.
- Which part matters, and whether this applies to healthy adults outside clinical settings. No study read in full tests which component of preparation matters; one 2026 survey on intention-setting qualities was seen in abstract only and carries no claim here.
- When postponing is advisable. No source read in full says.
What this card does not say
- It is not a protocol or a standard of care.
- It does not say whether to prepare, what intention to hold or when to delay.
- It says nothing about medicines or doses.
- Metanoia does not provide preparation, sessions or screening.
- It does not rate how risky, safe or worthwhile any practice is.
Send a correction
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Where does this come from?
Grade key: 1 = peer-reviewed publication, official document or primary record. 3 = grey source (community, social media, organization pages). A grade names the type of source, and the design and limits are given in the text. “Full text” means Metanoia read the body of the paper in full on the date given, and any part not read is named. A source read only in part carries no claim on this card. Sources described in the text as found and not read carry no claim and are not listed.
Review due by 5 February 2027.
- Haijen E et al. Predicting responses to psychedelics: a prospective study. Front Pharmacol 2018. DOI 10.3389/fphar.2018.00897 PMID 30450045. Grade 1. Prospective online study. Full text read 7 November 2026, passages cited re-checked.
- McAlpine R, Blackburne G, Kamboj S. Development and psychometric validation of a novel scale for measuring psychedelic preparedness. Sci Rep 2024. DOI 10.1038/s41598-024-53829-z PMID 38332334. Grade 1. Scale development, three studies. Full text read 7 November 2026, passages cited re-checked.
- Aday J et al. Predicting reactions to psychedelic drugs: a systematic review of states and traits related to acute drug effects. ACS Pharmacol Transl Sci 2021. DOI 10.1021/acsptsci.1c00014 PMID 33860172. Grade 1. Systematic review. Full text read 7 November 2026, passages cited re-checked.
- Davis A et al. Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA Psychiatry 2021. DOI 10.1001/jamapsychiatry.2020.3285 PMID 33146667. Grade 1. Trial in people with major depression. Full text read 7 November 2026, passage cited re-checked.
- Glynos N et al. Going underground: demographics, services, and best practices endorsed by practitioners providing support for naturalistic psychedelic use. J Psychoactive Drugs 2025. DOI 10.1080/02791072.2024.2405685 PMID 39297183. Grade 1. Self-report survey, convenience sample. Full text read 7 November 2026. Figures for the 92 respondents who said they provide preparation.
- Harrison H et al. Level of preparedness to use psilocybin among individuals seeking psychedelic risk reduction: a retrospective study of a pilot psychiatric consultation service. Front Public Health 2026. DOI 10.3389/fpubh.2026.1921031 PMID 42818591. Grade 1. Chart review, 29 patients. Full text read 7 November 2026, passages cited re-checked.
- ClinicalTrials.gov NCT06815653. Registry record. Grade 1. Registry record, read 7 November 2026.