We conducted a scoping review on psilocybin-assisted therapy for addiction, depression, anxiety and post-traumatic stress disorder. Psilocybin is a naturally-occurring tryptophan derivative found in species of mushroom with psycho-active properties. From 2022 records identified by database searching, 40 publications were included in the qualitative synthesis from which we identified 9 clinical trials with a total of 169 participants. Trials used a peak-psychedelic model of therapy, emphasizing inward journey through the use of eyeshades, set musical scores and with medium to high doses of psilocybin. No serious adverse effects were reported; mild adverse effects included transient anxiety, nausea and post-treatment headaches. Overall, the 9 trials all demonstrated safety, tolerability and preliminary efficacy in the treatments of obsessive-compulsive disorder, substance use disorder, treatment-resistant unipolar depression, anxiety or depression in patients with life-threatening cancer and demoralization among long-term AIDS survivors.The literature was found to be early and exploratory, with several limitations: only 5 were randomized controlled trials, small and homogenous patient sample size, difficulties in blinding, and the confounding influence of psychological supports provided. Further research is indicated to establish effectiveness for these and other indications, with a more diverse range of patients, and with differing program and dosing modalities.

Background and Aims Psilocybin is a psychedelic drug that may hold promise for a wide range of human health conditions, yet the identification of therapeutic processes and mechanisms of action remains exploratory. We conducted a scoping review on pre-clinical behavioural investigations of psilocybin in non-human animals to help determine the behavioural effects of psilocybin in non-human animals, to identify studies completed, behavioural tests employed, and what dosing modalities had been studied. Methods A librarian-conducted literature search was performed using predefined key terms and search criteria and additional searching was conducted by reviewers, using electronic databases, grey literature sources, and reference lists of relevant articles or reviews. The final search updated occurred in October, 2021. Studies were reviewed, screened and selected against an a priori protocol using Covidence software by multiple reviewers with results plotted across the Research Domains Criteria construct. Results From 4124 records identified by database searching, 260 publications were subjected to full-text review with 77 studies included in this scoping review, published between 1962-2021. The preponderance of studies (n=64) investigated behavioural outcomes in rodents. Only 43 studies (55.8%) reported on housing conditions, and seventeen studies (22.1%) failed to report sample size. All studies reported behavioural outcomes following drug administration, with fifty-one studies (66.2%) using psilocybin, thirty studies (42.9%) psilocin, four studies (5.2%) administering whole mushroom extracts (WME), and a further eight studies investigating both psilocybin and psilocin and one study reporting the effects of both psilocin and WME. One hundred and thirty distinct behavioural investigations using fifty different behavioral paradigms were identified. Few adverse events were reported, and even exceedingly high doses were apparently well tolerated. Conclusion With seventy-seven publications spanning close to sixty years, there is huge variation in study design and quality. Overall psilocybin presents a unique and strong safety profile with no evidence of biological toxicity, is characterized by unique time and dose-dependent effects, and its pattern of drug action is significantly context and training-sensitive. Data suggest putative effects of psilocybin include acute arousal, dose-dependent sedation, reductions in fear conditioning at low doses, reduced aggression, improved valence, acute disruption of working memory, the rescuing of deficits from chronic stress, and improved learning when combined with repeated environmental exposure after resolution of drug effect.

The CAnadian Network for Psychedelic-Assisted Cancer Therapy (CAN-PACT) was launched in 2025 to address urgent gaps in supportive care for Canadians with cancer experiencing demoralization syndrome (loss of meaning, dysphoria, disheartenment, helplessness, a sense of failure) and related psychosocial distress. CAN-PACT has six major objectives: (1) to develop a national interdisciplinary research and practice network; (2) to set research priorities through structured stakeholder engagement; (3) to develop and provide PAT training and education for clinicians, researchers, and patients; (4) to pilot test the feasibility of intervention and assessment procedures; (5) to conduct a multi-center, randomized controlled trial of PAT for people with advanced cancer; and (6) to inform and influence healthcare policy on PAT in Canada. We discuss the background and need for PAT in cancer, describe challenges currently limiting its use, and outline CAN-PACT’s strategy for building capacity, generating Canadian evidence, and preparing the oncology healthcare environment for potential implementation. This manuscript presents a summary overview of CAN-PACT as a multi-objective research program; detailed protocols for each discrete study component will be published separately as the research program progresses. Through environmental scans, national engagement, targeted training, rigorous research, and ongoing collaboration with policymakers, CAN-PACT aims to enable equitable access to safe, evidence-based PAT for people with advanced cancer in Canada’s publicly funded cancer centers.

Demoralization syndrome (DS) - a distinct clinical entity characterized by helplessness, hopelessness, and a persistent loss of meaning - affects approximately one in five Canadians with advanced cancer and is associated with increased desire for hastened death, negative clinical outcomes, and higher economic burden, yet recognition and treatment of DS remains suboptimal in modern oncology. While current pharmacological treatments fail to address demoralization's existential dimensions, and despite the potential effectiveness of a number of psychosocial interventions, not everyone responds to behavioral therapies and they remain chronically underfunded in mainstream oncology. Mindfulness-Based Psilocybin-Assisted Therapy (MB-PAT) offers enhanced therapeutic potential by synergistically integrating evidence-based mindfulness training with psilocybin's neuroplastic effects; however, the traditional dyadic delivery model limits scalability within healthcare s settings. This viewpoint opines that MB-PAT delivered in a group format represents a potentially optimal solution to this evidence-implementation gap. Our contention is that MB-PAT may harness synergistic biopsychosocial mechanisms that directly counter the isolation of demoralization through an integrative approach. We finish by highlighting the Canadian Network for Psychedelic-Assisted Cancer Therapy (CAN-PACT) as a pioneering initiative poised to generate critical evidence, infrastructure and capacity through its planned multi-phase initiatives and projects. By leveraging existing group-therapy infrastructure and therapist familiarity with mindfulness-based interventions as the basis for multi-site national clinical trials, and developing a scalable, equity-focused delivery model, MB-PAT offers a pragmatic pathway to integrate potentially transformative existential care into publicly funded Canadian oncology practice.

Objectives: To explore stakeholder perspectives on care coordination barriers and facilitators in regionalized neuro-oncology delivery, using brain tumors as a model for examining complex care pathways serving mixed rural-urban populations. Design: Reflexive thematic analysis of semi-structured interviews from stakeholders across the neuro-oncology care pathway was used to identify themes of care system strengths, systemic barriers to effective service delivery and priorities for system improvement. Setting: Regionalized Canadian health system serving one of Ontario’s largest catchment areas, characterized by predominantly rural populations and substantial geographic distances to tertiary care. Participants: Thirty-six stakeholders purposively sampled to represent diverse roles across the care pathway, including family caregivers (n=6), healthcare providers from multiple specialties and care settings (n=28) and Indigenous community advisors (n=2). Results: Two main themes with subthemes emerged revealing a tension between localized excellence and systemic fragmentation. Theme 1 (Care System Strengths) included three subthemes: responsive palliative care integration, exceptional provider commitment, and effective intra-institutional communication. Theme 2 (Systemic Barriers to Care Continuity) included four subthemes: absent cross-institutional coordination infrastructure, insufficient pathway standardization, inadequate educational infrastructure for patients and providers and limited regional clinical trial access. Coordination mechanisms functioning effectively within the tertiary center consistently failed at interfaces with referring hospitals and community services, with participants describing patients becoming "lost in transitions." Conclusions: Findings reveal how regionalized cancer systems can achieve localized coordination while failing at system integration. The contrast between internal institutional coherence and external fragmentation suggests that effective care delivery requires deliberately extending coordination mechanisms across organizational boundaries through standardized pathways, shared information systems and defined cross-site accountability structures. Brain tumors, requiring rapid multidisciplinary coordination, expose these interface failures with clarity, offering transferable insights for improving integrated cancer care in regionalized health systems serving geographically dispersed populations. ARTICLE SUMMARY: Strengths and limitations of this study: Purposive sampling captured diverse stakeholder perspectives across the entire care continuum, from tertiary providers to community services and family caregivers Reflexive thematic analysis with independent coding by three researchers enhanced interpretive rigor and depth Brain tumors function as a model condition for examining care coordination due to their rapid progression and sensitivity to variability in care Single health system design limits direct generalizability but enables in-depth examination of coordination mechanisms in a regionalized context Geographic and organizational characteristics common to Canadian regionalized systems support transferability of findings Indigenous patient perspectives were represented through community advisors; direct patient voices from Indigenous communities would strengthen future work

Psychedelic-assisted interventions are complex, context-sensitive interventions in which pharmacological, psychological, relational, environmental, cultural, and temporal processes interact. Trials of psilocybin and related compounds have reported promising but heterogeneous findings across psychiatric, substance-use, and existential indications, while also revealing challenges related to functional unmasking, expectancy, under-specified psychological support, incomplete reporting of extra-pharmacological variables, facilitator training, and altered-state suggestibility. Contemporary neuroscience suggests that classic psychedelics acutely perturb large-scale brain dynamics, alter functional connectivity, expand dynamical repertoire, and may transiently relax high-level predictive constraints. These effects may create windows of enhanced plasticity, learning, psychological flexibility, and context sensitivity, but neither destabilization nor plasticity is inherently therapeutic.This article introduces ANCHOR, a complex-systems and mechanism-informed framework for psychedelic preparation, support, and integration. ANCHOR comprises six interdependent domains: Approach, Non-imposition, Context, Holism, Openness, and Relationality. It conceptualizes psychedelic support as therapeutic accompaniment: the deliberate shaping of safe, ethical, and participant-centred boundary conditions around a transiently destabilized brain-mind-body-relationship-environment system. Building on transition-state modelling, ANCHOR contributes a framework for complex-systems care, temporal transition-state support, active non-imposition, bounded openness, grounded self-trust, and threshold-state accompaniment.ANCHOR is not proposed as a stand-alone psychotherapy, certification standard, clinical indication, or empirically validated treatment. Its immediate contribution is educational, operational, and methodological, providing a process-based language for facilitator stance, observable competencies, fidelity assessment, and research reporting. Future research should evaluate feasibility, reliability, training effects, participant experience, safety, cultural adaptation, and associations with therapeutic alliance, integration quality, adverse events, and clinical or educational outcomes.Keywords: psychedelics; psilocybin; complex systems; threshold states; transition state; set and setting; therapeutic alliance; integration; psychedelic-assisted therapy; facilitator competencies; ethics; ANCHOR