Perceptions and Attitudes on Psilocybin-Assisted Therapy among Underrepresented People with Cancer.

Abstract

Psilocybin-assisted therapy (PAT) shows promise for alleviating psychological and existential distress among people with cancer; however, research is limited by homogeneous samples, raising concerns about generalizability and equity. To explore perceptions and attitudes of PAT among a subset of people with cancer who have been underrepresented in research. A qualitative descriptive study was conducted. Semi-structured interviews occurred September 2024-October 2025. Interviews were transcribed verbatim and analyzed using inductive critical content analysis. Nineteen participants were recruited from a comprehensive cancer center in the Midwestern United States. The sample included Black/African American participants without a completed postsecondary degree (n=7), Black/African American participants with postsecondary degrees (n=6), and White participants without a completed postsecondary degree (n=6). Four categories were identified. (1) Perceptions of psychedelics shaped by comparisons to other substances, stigma, and mixed beliefs about benefits and risks. (2) Perceptions of PAT ranged from viewing it as a legitimate, structured intervention to uncertainty about usefulness, with benefit to others commonly endorsed. (3) Considering PAT participation involved trust in providers and systems, safety/comfort, interpersonal support, intersectional cultural considerations, and timing preferences, with some patterns differing across strata. (4) Ongoing questions and needs included accessible, culturally responsive information, representation, and clearer understanding of PAT. Participants expressed nuanced views of PAT, shaped by structural, cultural, and informational factors. Findings highlight the importance of trust-building, culturally responsive information, and community engagement to support equitable access and translation of PAT in oncology and palliative care.