Group Retreat Psilocybin Therapy for People with Metastatic Cancer with Anxiety and Depression: A Rite of Passage Facilitation Model for a Phase 1/2 Study

Background: Psilocybin therapy is an emerging treatment for cancer-related anxiety, depression, and existential distress. Most clinical trials to date have studied individual models of psilocybin therapy, but group models may offer increased access and benefits of community. Purpose: This technical report describes a group facilitation model developed for an food and drug administration (FDA)-approved Phase 1 to 2 clinical trial that recruited people with metastatic cancer who had moderate or severe symptoms of anxiety or depression in which psilocybin was administered at a 3-day, in-person retreat. Results: The facilitation model we developed for this intervention is based on anthropological studies of ritual, specifically rites of passage, to develop a secular ritual with therapeutic aims. Using rites of passage terminology, “separation” corresponds to preparation, “liminal” corresponds to the psilocybin dosing session, and “reincorporation” corresponds to integration. In our usage, the term “ritual” refers to intentionally structured, symbolic acts that embody and reinforce shared meaning, guiding participants through experiences that may otherwise feel unbounded or overwhelming. In the group psilocybin retreat model, ritual functions both psychologically—by supporting emotional regulation, orientation, and meaning-making—and communally—by embedding the individual’s process within a shared field of intention and care. Conclusion: To our knowledge this is the first FDA-approved clinical trial of a secular ritual-based group facilitation model for psychedelic therapy that is associated with empirically demonstrated safety and efficacy outcomes.