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Abstract

Background: There is promising evidence that psychedelic-assisted psychotherapy may be a powerful new treatment approach for mortality-related distress. However, less is known about the possible benefits for people experiencing grief. Aim: To explore what is known about using psychedelics to attend to grief following death due to advanced illness. Design: This scoping review followed Arskey and O’Malley’s methodological framework and adheres to the PRISMA-ScR reporting guidelines. Searches were conducted in seven databases in April 2023, and updated in December 2023. No limits or filters were applied. The quality of the papers was not appraised. Results: Of the 4614 records screened, 18 reports were included. Seven are empirical investigations of the impact of psychedelics on grief. This literature is informed by different epistemologies, ontologies, and conceptualizations of grief, adding a layer of complexity and potential for conflict to arise due to differing perspectives. Overall, there is little high-quality evidence about the use of psychedelics to attend to grief. However, across the empirical studies, positive outcomes were generally reported (i.e., reduction in grief symptom severity), with few studies reporting adverse events or negative outcomes. Conclusion: There is not a strong evidence base to guide clinical recommendations for applying psychedelics to the problem of grief at this time. Moving forward, psychedelic authors and researchers can explicitly situate their work (e.g., position, interests) to assist with interpretability of findings, and integrate theory from the field of grief studies, which may require collaborations with grief therapists and theorists to guide future work.

Keywords

grief bereavement psychedelics hallucinogens psychotherapy terminally ill

Key statements

What is already known about the topic?

• There is promising evidence that psychedelic-assisted psychotherapy may be a powerful new treatment approach for mortality-related distress

• Less is known about the possible benefits of psychedelics for people experiencing grief

What this Paper adds

• This scoping review demonstrates that there is not a strong evidence base at this time to guide clinical recommendations for applying psychedelics to the problem of grief following loss from advanced illness at this time.

• Across the few empirical studies identified, there were generally positive outcomes reported in terms of grief symptom reduction, and few reported adverse or negative outcomes

Implications for practice, theory or policy

• Further empirical research with clear theoretical conceptualizations of grief and anticipated mechanisms of action is needed to informal clinical recommendations

Introduction

Public interest in the field of psychedelics is rapidly growing. Annual publications on psychedelics have increased by 1300% over the past two decades (Lewis et al., 2023), with clinical trials exploring the effectiveness of psychedelic-assisted psychotherapy to treat a range of mental health conditions (Horton et al., 2021). Within palliative care, there is evidence that psychedelic-assisted psychotherapy may be a powerful new treatment approach for mortality-related distress (e.g., demoralization, hopelessness, or existential distress) (Agin-Liebes et al., 2020; Beaussant et al., 2021; Ross, 2018; Yaden et al., 2022), for which there are few evidence-based recommendations or targeted interventions (Vehling & Kissane, 2018). Despite these promising findings, most psychedelics remain controlled substances not approved for clinical use. Further research is needed to inform policy and clinical use (Beaussant et al., 2020). While most work in the field of psychedelic-assisted psychotherapy in end-of-life care focuses on those experiencing advanced illness, there have been calls to explore the impact of psychedelic-assisted psychotherapy on family caregiver grief, both while they care for the dying person (Gold et al., 2023) and after the person has died (Beaussant et al., 2021; Rosa et al., 2022).

Grief

Humans have long attended to the deaths of significant others, with every culture and religion providing some guidance on how to come to terms with the death of meaningful individuals (Klass & Goss, 1999). The experience of grief is influenced by culture (Klass, 1999). Rather than searching for one universal conceptualization of grief, as biomedical clinicians working in a multicultural context, we acknowledge there are many griefs, and we seek to understand Western grief scholarship while recognizing other social constructions of grief.

From a Western perspective, grief is commonly described as the natural, personal reaction to loss, especially after the death of a person of significance (Johannsen et al., 2019). Unique to each person, grief responses do not follow predefined stages (Szuhany et al., 2021). Grief often includes distressing and painful emotions (e.g., anger, yearning), thoughts focused on disbelief or confusion, changes to behavioural patterns, and physical sensations (e.g., dizziness, headaches) (CAMH, 2024). Over time, most individuals adjust to the loss and find ways to cope with their grief (Jordan & Litz, 2014; Prigerson et al., 2009; Szuhany et al., 2021). However, up to 10% of bereaved individuals may experience prolonged and profound loss-related distress (Maciejewski et al., 2016).

A systematic review examining psychological interventions for grief in adults found that some individual interventions for people with high baseline symptoms showed promising results in relieving depressive and post traumatic distress symptoms (Johannsen et al., 2019). However, ‘gold standard’ grief interventions show little evidence of improving anxiety symptoms or quality of life (Johannsen et al., 2019). With psychedelic-assisted psychotherapy demonstrating promising results for treating a range of mental health conditions, some clinicians and scholars are examining what psychedelics can do for those experiencing grief.

Due to uncertainty about the evidence informing the burgeoning field of grief and psychedelics, we conducted a scoping review in order to explore the extent of the literature, summarize the evidence, and inform future research (Tricco et al., 2016). Therefore, this scoping review examines what is known about the application of psychedelics for people experiencing grief after a death due to advanced illness (e.g., metastatic cancer). Given the history of the study of both grief and psychedelics outside of medical research, by “what is known” we are referring to scholarship on this topic across a wide range of disciplines (e.g., medicine, psychology, social sciences).

Method: Scoping Review

This scoping review followed Arskey and O’Malley’s methodological framework (Arksey & O'Malley, 2005), with additional suggestions made by Levac et al. (2010). Reporting of this scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to promote transparency and consistency.

Stage 1: Identifying the Research Question

The primary research question this scoping review sought to answer is: what is “known'' about using psychedelics to attend to grief following death due to advanced illness? Secondary questions focused on understanding the proposed mechanisms of action that could explain why psychedelics might be helpful for supporting people through both “normal” grief as well as the challenges that come with prolonged grief. Secondary questions included: which psychedelics in combination with which types of support have been tried or promoted?; with which patients?; with which intended or achieved outcomes?; and with what proposed mechanisms of action?

Stage 2: Identifying the Relevant Studies

Prior to developing a protocol, our team searched the literature broadly to explore the intersection of grief and psychedelics. Next, in collaboration with a research librarian/information specialist (MA) at the University Health Network, we developed a protocol (this was not registered but can be accessed upon request). A search strategy was iteratively developed. The strategy was trialed in Ovid Medline, with two researchers reviewing the first 200 records to determine fit with the purpose of this review. Searches were then conducted in the databases Ovid Medline, Embase and PsycINFO, ProQuest Sociological Abstracts, Web of Science, ClinicalTrials.gov, and International Clinical Trials Registry Platform. The initial results were downloaded in April 2023, with updated searches run in December 2023. Appropriate subject headings and keywords for psychedelics and grief or loss in the context of advanced illness were used for each database. The limited number of results led to a mingled concept structure of psychedelics AND grief OR caregiver OR surviving loved ones. Embase was the exception to this concept structure given initial results were predominantly irrelevant. Consequently, the structure used in Embase was psychedelics AND grief AND caregiver OR surviving loved ones, which led to more relevant results. No limits or filters were applied. For complete strategies, see Supplemental Data.

Stage 3: Study Selection

Records were eligible if they met the following criteria: (1) focused on individuals over age 18; (2) relevant to grief experienced following death from advanced illness; and (3) discussed the use of psychedelics to address grief, including prolonged and/or normative grief. Records were excluded if they: (1) focused exclusively on grief from traumatic loss (e.g., suicide, miscarriage); or (2) focused on interventions aimed at grieving healthcare clinicians.

EndNote 20 was used for reference management, de-duplication (Bramer et al., 2016), and removal of non-English titles and abstracts. Covidence (Covidence Systematic Review Software, 2023) was used for study selection. At the title and abstract screen, two reviewers independently screened all records using the eligibility criteria. To improve consistency, the team met to review inclusion criteria and pilot screen 10 titles and abstracts, discussing the screening process, criteria, and ambiguities. The resulting agreement at the title and abstract screen was 98.3%. Discrepancies were resolved by consensus. At the full-text screen, two reviewers independently screened all articles based on the eligibility criteria. To improve consistency, the team pilot screened two full-texts. Reasons for exclusion included wrong patient population, no use of psychedelics, and insufficient conceptualization of grief. The resulting agreement at the full-text screen was 85.5%. Discrepancies were resolved by consensus. Results of the study selection are presented in the PRISMA flow diagram (Figure 1), which follows standard guidelines and terminology in that a “record” refers to a bibliographic entry (e.g., title and/or abstract) from a database search, while a “report” is the full-text document.

Figure 1.

PRISMA flow diagram. https://www.prisma-statement.org/

Stage 4: Charting the Data

Data extraction from articles was done in Covidence using a table developed by a study author (CC) to summarize the included reports’ characteristics, including the region, year, discipline, methodology, conceptualization of grief, reference to theory, population, type of psychedelic, description of therapies, intended/achieved outcomes, and proposed mechanisms of action. The charting table was completed independently by two reviewers. Discrepancies in charting the data were resolved by consultation with a third reviewer. For the completed data extraction table, see Table 1.

Table 1.

Data Extraction Table

Authors	Title	Methodology	Objective	Grieving population of interest	Psychedelic used for grief	Intervention to support grief	Grief-related outcomes	Mechanisms of action related to grief
Empirical investigations of the impact of psychedelics on grief
Psychedelics used in conjunction with supportive therapies
Agin-Liebes et al. (2021) (USA)	Participant reports of mindfulness, posttraumatic growth, and social connectedness in psilocybin-assisted group therapy: An interpretive phenomenological analysis	Qualitative research	To explore the therapeutic trajectories of individuals undergoing psilocybin-assisted group therapy and generate hypotheses regarding psychological mechanisms of change	Older gay-identified cisgender men with HIV diagnosed prior to 1996, demoralization (n = 18) and complicated grief (n = 5) in the USA	Psilocybin	4 group preparatory therapy sessions; 1 individual psilocybin session; 1 individual psychotherapy session the following day; and 4-6 subsequent group therapy sessions All sessions included 2 clinician facilitators and took place in the USA	-Reduction in complicated grief ratings [ICG] -Greater access to difficult emotions allowing for processing -Greater access to comforting emotions -Recasting harmful experiences as growth-dominant	-Shift from avoidance to experiential acceptance -Self-transcendence in psilocybin session resulting in increased feelings of belonging and connection -Co-rise of positive and vulnerable feelings -Change in narratives to growth-oriented -Interpersonal support provided in group therapy sessions heightening attachment security
González et al. (2020) (Spain)	Therapeutic potential of ayahuasca in grief: a prospective, observational study	Cohort study	To examine the course of grief over 1 year of follow-up in a bereaved sample that attended a center in Peru to participate in indigenous Shipibo ayahuasca ceremonies, including the roles of experiential avoidance and decentering as mechanisms of change	Adults experiencing grief due to the death of a loved one, who willingly attended ayahuasca ceremonies at an ayahuasca center in Peru (n = 39)	Ayahuasca	9-, 12-, or 30-day retreats, where participants drink ayahuasca in a ceremonial context under the guidance of shipibo curanderos (traditional healers) in Peru On average participants attended 18.1 days at the center, where they participated in 6.6 ayahuasca ceremonies	-Severity of grief [TRIG] significantly decreased and quality of life [WHOQoL-BREF] significantly improved after drinking ayahuasca and was maintained over 1-year of follow-up -Decreased severity of grief was positively correlated with significant decrease in experiential avoidance [AAQ-II] and negatively correlated with significant increase in decentering ability [EQ-D] -Ayahuasca experiences were considered to have a positive effect on grief symptoms for 92.3% of participants, no influence for 5.1% of participants, and a negative effect on 2.6% of participants	-Acute confrontations with difficult memories, thoughts, and feelings to promote increased acceptance and decentering -Re-encountering the deceased that may modulate the internal working model of the deceased and the attachment style maintained with them after death −53.8% perceived ayahuasca as the most relevant factor in the evolution of their grief symptoms, followed by the work of the Shipibo healers (35.9%), being with other guests (5.1%), the experience of being in the jungle (2.6%), and having attended other alternative activities, such as yoga classes (2.6%)
González et al. (2022) (Spain)	Restorative retelling for processing psychedelic experiences: Rationale and case study of complicated grief	Case study	To exemplify the use of the restorative retelling technique and to show how ayahuasca can naturally evoke key psychological content in the process of grief adjustment	Bereaved queer woman, grieving the death of her mother by suicide 25 years prior *Case not directly applicable to primary objective of the present scoping review, but the approach applied is relevant to grief from prolonged illness	Ayahuasca	14 weekly psychotherapeutic sessions and 3 ayahuasca experiences conducted in Spain. 5 facilitators supported ayahuasca sessions with 4 participants in each group. 2 doses were administered in each session (40 mL 35 minutes apart) The psychotherapy used the restorative retelling clinical procedure, involving: a) an ‘assimilation’ process (grounding, reliving experience in the present, explore meaning-oriented narrative), and b) an ‘accommodation’ process (reflective assessment and reorganization of the internal world)	-Significant reduction in complicated grief [ICG] and depressive symptomatology [SCL-90-r] -Construction of positive meaning around the death and grief -	-Encouraging meaning-making -Facilitating reconstruction of a rich and complex reality -Providing connection with the attachment figure -Fostering secure attachment with the deceased
González (2023) (Spain)	Efficacy of ayahuasca in concert with psychotherapy to decrease the severity of grief	A non-randomized controlled trial study protocol	To compare the effectiveness of an ayahuasca-assisted constructivist therapy with constructivist therapy and no treatment to decrease the severity of grief. A secondary purpose is to assess the effectiveness to prevent persistent complex bereavement disorder and prolonged grief disorder, and to assess potential changes in avoidance, meaning-making and self-clarity	Adults experiencing the loss of a first-degree relative not more than 12 months prior to enrollment as indicated by self-report who have scores up to 40 on the TRIG.	Ayahuasca	The ayahuasca-assisted constructivist therapy arm involves 1 preparation session, 9 online constructivist therapy sessions including 3 modules to process trauma, restore attachment security and reconstruct the self, and 2 integration sessions. 2 ayahuasca administrations (0.75 mg/kg DMT) occur after 3rd and 6th therapeutic sessions	-Change in grief severity [TRIG] -Prevalence of persistent complex bereavement (PCBD) and prolonged grief symptoms (PGD) [TGI-SR] -Quality of life [WHO-qol-BREF] -Posttraumatic growth [PSI-SF] -Avoidance [AAQ-II] -Meaning-made [ISLES-SF] -Consistency of self-beliefs [SCS] -Subjective effects of ayahuasca [5D-ASC] -Acceptance promoting effects of psychedelic drug [APEQ]	-Not applicable
Psychedelics used without supportive therapies
González et al. (2019) (Netherlands)	Potential use of ayahuasca in grief therapy	Mixed method, cross-sectional retrospective survey	To explore the effects of ayahuasca on grief and to compare its potential therapeutic benefits with peer-support groups in a sample of grieving people	Adults grieving the loss of a first-degree relative (spouse, parent, child, or sibling) within the last 5 years who took ayahuasca during their grief process (n = 30) compared to those who attended a peer-support grief group (n = 30)	Ayahuasca	No description of intervention sessions or location. The authors state the intake of ayahuasca is usually carried out as part of a ritual or ceremony where the use of music and singing are common. The average number of ayahuasca sessions reported to have direct impact on grief was 6.1. Additionally, 7 out of 30 participants attended psychotherapy either before, concurrently with, or following their ayahuasca experiences	−83% of participants believed ayahuasca had very positive influence on grieving process -The ayahuasca group reported a lower level of grief [TRIG present feelings scale], showing benefits in some psychological and interpersonal dimensions -There was no difference in experiential avoidance [AAQ-II] between groups -The ayahuasca group obtained greater benefits compared with the peer-support group regarding preoccupations with thoughts and memories, ability to forgive oneself and others, self-conception, recoding life history, the ability to give sense to their life, and the integration of transcendental dimension of life and death	-Emotional confrontation leading to feelings of peace and acceptance of death -Autobiographical reviews that allow another point of view -Contact with the deceased leading to redefinition of relationship with the deceased, resolution of issues, and maintenance of bond -Integration of subjective meaning of the event into the individual’s life history
Low & Earleywine (2024) (USA)	Psychedelic experiences after bereavement improve symptoms of grief: The influence of emotional breakthroughs and challenging experiences	Cross sectional study	To investigate the impact of psychedelic experiences on symptoms of grief in a sample of recreational users who used psychedelics to address their grief, examining how emotional breakthroughs and challenging experiences relate to changes in the severity of grief symptoms	Participants (n = 363) were over 18 years of age and had used a psychedelic substance after experiencing symptoms of grief following bereavement	The most common psychedelic substances used were psilocybin (30.3%); LSD (23.4%; and MDMA (18.7%) Ketamine (6.9%) Peyote (5.2%); DMT (2.8%) Mescaline (2.8%) Salvia (2.8%) Ayahuasca (2.2%) PCP (1.9%) Ibogaine (0.6%)	Used psychedelic alone or in a group un-guided	-On average, grief symptoms [PG-13-r, 13th item omitted] improved by 20.4% after the psychedelic experience −78.3% of participants reported improvements in grief symptoms, 11% reported no changes and 10.7% saw a worsening of grief symptoms -Improvements in grief symptoms were positively correlated with emotional breakthroughs [EBI] and negatively correlated with challenging experiences [CEQ] -There were no significant differences between participants who used a classic psychedelic and participants who used other psychedelics	-Attending to and processing emotions and thoughts regarding the deceased -Re-establishing social connections -Developing an attitude of optimism about the future
Morton, 2023 (USA)	A phenomenological investigation of psilocybin use among the bereaved	Qualitative research	To expand existing research into how psilocybin may enhance treatment outcomes with specific attention to grief following the death of a loved one by investigating the subjective experiences of participants who ingested psilocybin to process grief	Individuals (n = 7) who experienced death of a loved one and ingested psilocybin with the goal of processing grief	Psilocybin	Not reported	-Participants felt psilocybin helped improve their understanding of themselves and their grief -During the psilocybin experience, participants experienced resolution of internal conflict, feelings of connectedness, and experiential acceptance of emotions -After the psilocybin experience, participants reported increased awareness of thought patterns and self-compassion, increased comfort with mortality and loss, and increased spirituality/belief in life after death	-Experiential emotional acceptance -Self-compassion -Awareness of thought patterns -Increased positive emotions -Enhanced spiritual outlook/altered metaphysical beliefs
Literature reviews
Houle et al., 2021 (Canada)	Ayahuasca and the traveller: A scoping review of risks and possible benefits	Scoping review	To identify and summarize the literature on the safety and effectiveness of ayahuasca among recreational users	This review reported on the study by González et al. (2019)	Ayahuasca	Not reported	Not reported	-Not reported
Maia et al., 2023 (Brazil)	Ayahuasca’s therapeutic potential: What we know - and what not	Narrative review	To provide a comprehensive, up-to-date overview of ayahuasca’s therapeutic effects in diverse clinical conditions in human and preclinical studies	This review reported on González et al. (2019, 2020)	Ayahuasca	Not reported	Not reported	-The mechanisms underlying ayahuasca’s therapeutic effects for grief are sparsely understood
Socio-cultural explorations of the intersection between psychedelics and grief
Dyck, 2019 (Canada)	Psychedelics and dying care: a historical look at the relationship between psychedelics and palliative care	Historical review	To examine the historical relationship between psychedelics and palliative care drawing on Aldous Huxley and his first wife Maria Nys’s experience ingesting psychedelics while he cared for her at the end of life	A caregiver who cared for a dying spouse	Mescaline and LSD	Local church of Native american church ceremonies; direct experience with LSD.	-Use of psychedelics on Nys’s deathbed helped Huxley experience peace during bereavement, overcoming the barriers created by regrets, remorse, and anxiety	-Supportive of a holistic conceptualization of healing that embraces body, mind, and spirit -Making dying and bereavement a more spiritual, less strictly physiological process
Isfahani-Hammond, 2020 (USA)	Haunting pigs, swimming jaguars: Mourning, animals and ayahuasca	Cultural critique and subjective account	To provide a collage of reflections on death, grief, animals and communion with “thingified” kin in the context of literature, cinema, politics and the author’s experiences of caregiving for her parents, and furthering exploration of dying in ayahuasca ceremonies	Daughter (author) grieving the death of her parents	Ayahuasca	14 ayahuasca ceremonies guided by shamans in Brazil	-Gained new perspectives about wisdom learned at her parents’ deathbeds -A feeling of being supported by a maternal embrace	-Confrontation with the deceased’s dying -Re-connection with the deceased in a never-ending moment of tenderness -An opening of a pathway between the worlds to access ancient wisdom -Communication via souls that supports contact among beings
Shepard (1998) (USA)	Psychoactive plants and ethnopsychiatric medicines of the Matsigenka	Ethnography	Provide insight into the culture, botany and pharmacology of psychoactive plans in Indigenous medical systems	Matsigenka people of Hayapaari, Peru	Psychoactive plant-based eye drops containing DMT	Shamanic ritual in Peru	-Control of negative emotions (e.g., due to grief) -Dispelling of bad dreams, ghostly apparitions, sadness, anger and other socially disruptive emotional or psychological states	-Not reported
Shepard, 2002 (USA, Brazil)	Three days for weeping: Dreams, emotions, and death in the Peruvian amazon	Ethnography	Describe the Matsigenka people of Peru's funeral customs and beliefs and reflect on the phenomenology of grief across cultures	Bereaved Matsigenka people of Hayapaari, Peru	Psychoactive plants	Culturally-specific mourning rituals in Peru	-Restores happiness and health -Allows the living and the dead to distance themselves from one another -Allows the bereaved to return to daily activities	-Eyedrop medicines chemically induce tears, which cleanse the eyes of harmful apparitions, purify the soul through the eye, and act as a release of repressed tears of sorrow
Expert opinion & commentaries
Adrian & Spence (2022) (USA)	The worst thing	Opinion	To provide opinion on a psychedelic retreat for bereaved parents, held in Jamaica	Bereaved parents	Psilocybin	Weeklong ‘psychedelic retreat’ including group ceremonies in Jamaica guided by physicians and therapists; details not specified. Participants are invited to share stories, refine goals, and revisit the pain in their life	-Support for bereaved parents	-Experiential acceptance of suffering -Meaning-making in the face of suffering -Cultivating connection and community with others who have undergone loss
Beaussant et al., 2021 (USA)	Mapping an agenda for psychedelic-assisted therapy research in patients with serious illness	Qualitative research on expert opinion	To identify themes that shape priorities and an agenda for research on psychedelic-assisted therapy for those affected by serious illness	Bereaved caregivers	Not reported	Not reported	-Improved mental health and quality of life	-Consciousness-expanding properties of psychedelics with psychotherapy could facilitate the processing and relief of psychological and existential issues -Caregiver outcomes might be affected by psychedelic-assisted therapies indirectly, because of the effect on patient’s symptoms and communication (i.e., if psychedelic therapy is offered to the patient with serious illness); or directly, if conjoint therapy; and directly if psychedelic-assisted therapies were offered to the bereaved
Johnston et al., 2023 (USA)	The safety and efficacy of psychedelic-assisted therapies for older adults: Knowns and unknowns	Opinion	To review the basic pharmacology of psychedelics, the primary findings of the most important trials relevant to older adults, the prevalence of conditions in older adults that might benefit from psychedelic therapies, and what is known about the safety of these substances in older adults, and thoughts on next steps for studying these medicines in older adults	Older adults	Not reported	Not reported	-Not reported	-Because prolonged grief disorder shares many clinical features with depression (i.e., dysphoria, guilt, anhedonia), it is plausible that patients with grief might benefit from psychedelic therapies
Rosa et al., 2022 (USA)	Top ten tips palliative care clinicians should know about psychedelic-assisted therapy in the context of serious illness	Opinion	To offer ten evidence-informed tips for palliative care clinicians synthesized through consultation with interdisciplinary and international leading experts in the field	Families of origin or chosen families of people with serious illness or who died from serious illness including to parents of young children	Not reported	Not reported	-Achieving positive outcomes associated with psychedelic assisted psychotherapy – not specified	-Nonordinary states of consciousness can catalyze profound insights and shifts in symptoms within a short period of time -Cultivation of trust in inner healing intelligence -Acceptance, meaning-making and spiritual transcendence
Whinkin et al., 2023 (USA)	Psilocybin in palliative care: An update	Opinion	To summarize clinically and socially relevant developments in the therapeutic use of psilocybin with respect to the common challenges faced by palliative care patients and their care teams	This review reported on Adrian & Spence (2022)	Psilocybin	Not reported	-Not reported	-Not reported

Stage 5: Collating, Summarizing, and Reporting the Results

Team members (CC, DR, SH) each reviewed the data, summarizing and descriptively analyzing the data extraction table with a focus on answering the research questions. Due to the heterogeneity of frameworks, patients, settings, approaches, and outcomes across reports, it proved unhelpful to organize our findings in this decontextualized way. The team then descriptively analyzed each report based on our research questions, noting critiques, similarities, and differences between reports. These descriptive accounts, including the final data extraction table, were finalized through consensus, and the results were interpreted through group discussion and reflection with attention to our overall objectives and clinical experience.

Results

Eighteen eligible records were identified (see Figure 1 for the PRISMA flow diagram). Of these eighteen records, seven have a central focus on investigating the impact of psychedelics to attend to grief (Agin-Liebes et al., 2021; González, 2023; González et al., 2019, 2020, 2022; Low & Earleywine, 2024; Morton, 2023), with four describing the use of psychedelics with accompanying supports (e.g., therapy, a retreat), and three describing psychedelic experience without explicit structured support. The remaining 11 reports contained brief paragraphs on the connection between psychedelic therapies and grief. Our results begin with a summary of methodological approaches, followed by a description of the conceptualizations of grief and theoretical frameworks applied. We then report on what is known about using psychedelics to attend to grief resulting from death due to advanced illness.

Methodological Approaches

We identified seven empirical studies explicitly investigating the impact of psychedelics on grief. These reports include two qualitative research studies (Agin-Liebes et al., 2021; Morton, 2023) and five quantitative studies including a cohort study (González et al., 2020), a cross-sectional study (Low & Earleywine, 2024), one mixed-methods cross-sectional retrospective study (González et al., 2019) and one mixed-methods case study (González et al., 2022), and a non-randomized controlled trial study protocol (González, 2023).

The other 11 reports include one scoping review (Houle et al., 2021) and one narrative review (Maia et al., 2023), four socio-cultural explorations of the intersection of psychedelics and grief, a historical analysis (Dyck, 2019), a subjective account and cultural critique in a book chapter (Isfahani-Hammond, 2020), two ethnographies of Indigenous practices (Shepard, 1998; Shepard Jr., 2002), and five expert opinion and commentary articles (Adrian & Spence, 2022; Beaussant et al., 2021; Johnston et al., 2023; Rosa et al., 2022; Whinkin et al., 2023).

Conceptualizations of Grief and Theoretical Frameworks

A challenge in answering our primary research question was the diversity of perspectives across publications in terms of conceptualizing grief. Several papers made no explicit reference to theory informing the author(s)’s approach. Where specific perspectives were cited, these included: biological (neuropharmacology (Maia et al., 2023), botany (Shepard, 1998; Shepard Jr., 2002)); psychological (attachment theory, humanistic psychology, dual process theory, post-traumatic growth (González et al., 2019)); philosophical (constructivism (González, 2023; González et al., 2022)); spiritual (mysticism, the sacred, transcendence); and cultural/anthropological perspectives (shamanism, the Matsigenka worldview, (Shepard, 1998; Shepard Jr., 2002) “feminist-vegetarian interpretations”(Isfahani-Hammond, 2020)).

The included reports also varied in their psychological conceptualizations of grief. With respect to Western psychological theories, González et al. (2019; 2022) cited the dual process model (Stroebe & Schut, 1999), the constructs of posttraumatic growth (Tedeschi & Calhoun, 2004) and continuing bonds (Field, 2006; Russac et al., 2002), the constructivist approach to grief and grief therapy (Neimeyer, 2006; Neimeyer & Sands, 2011), and meaning reconstruction theory (Neimeyer, 2012; 2015a). A non-Western conceptualization of grief was invoked by Shepard (Shepard Jr., 2002), namely the notion that it is the dead who grieve the living. Many authors acknowledged certain features of normative grief, including the tasks of acceptance and moving on (Dyck, 2019; González et al., 2019). Little was included regarding how normative grief should be supported, with the exception of González’s (González, 2023) study that aims to treat adults experiencing grief in order to prevent Persistent Complex Bereavement Disorder and Prolonged Grief Disorder. Many studies distinguished between normative and pathological grief. However, with respect to the latter, various frameworks and language were used. The terms “pathological”, “prolonged”, “persistent complex” and “complicated” were all used to denote an emotional process distinct from normative grief. Across the included publications, it was commonly implied or stated explicitly that pathological grief warrants treatment.

What is “Known” About Using Psychedelics to Attend to Grief following Death due to Advanced Illness?

Ayahuasca

Ayahuasca was used in all four of the Gonazalez et al. studies (González, 2023; González et al., 2019, 2020, 2022). However, only in the mixed-methods case study (González et al., 2022) and the non-randomized controlled trial (González, 2023) is ayahuasca used as part of a psychotherapeutic intervention designed specifically to prevent Prolonged Grief Disorder. In the mixed-methods case study (González et al., 2022), the therapeutic approach and mechanisms of action explored are relevant to this body of literature; restorative retelling (Neimeyer & Rynearson, 2022) was employed following the participant’s ayahuasca sessions, with the aim of helping the participant “assimilate” the experience and subsequently reorganize their internal world or schemas (a process referred to as “accommodation”). Following the intervention, the participant no longer met criteria for complicated grief. The authors hypothesize that ayahuasca facilitates the emergence of psychological content that helps participants adapt to grief. The participant was noted to “connect with the presence of her mother” during the ayahuasca session(s), highlighting the potential relevance of continuing bonds theory (Klass et al., 1996) to psychedelic therapy for grief. Furthermore, the experience of “contact” with her mother was felt to facilitate a shift in the participant’s “internal working model” of her mother, and this shift was felt to be “the most relevant aspect in [the] participant’s adaptation of grief” (González et al., 2022). The authors suggest such psychological shifts may be understood through the lens of attachment theory, noting, “fostering a secure attachment with the deceased is the objective of various contemporary techniques employed in grief therapy” (Jordan & Neimeyer, 2012; Kosminsky & Jordan, 2016; Neimeyer, 2015b, 2022).

In the non-randomized controlled trial study protocol (González, 2023), the intervention described involves constructivist psychotherapy sessions, one preparation session, and two integration sessions following two ayahuasca administrations (0.75 mg/kg DMT) that take place after the 3rd and 6th therapeutic sessions. The two control groups include (1) constructivist psychotherapy only, and (2) no treatment. Mechanisms of action will be determined by measuring the following at baseline, post-intervention, and at 3 months follow-up: change in grief severity, prevalence of Persistent Complex Bereavement Disorder and Prolonged Grief Disorder, quality of life, posttraumatic growth, avoidance, meaning-made, consistency of self beliefs, subjective effects of ayahuasca, and acceptance or avoidance-promoting effects of ayahuasca.

In the retrospective study, González et al. (2019) explored the potential effects of ayahuasca on grief by comparing experiences of 30 participants who had taken ayahuasca with 30 participants who attended peer-support grief groups (González et al., 2019). Seventy percent of participants in the ayahuasca group had experienced loss due to illness, versus only 43.3% in the peer support group. People who used ayahuasca reported lower levels of grief post-test than people in the control group (p < .001). All of the ayahuasca participants believed their experience had a very positive (25/30) or positive (5/30) influence on their grieving process. Subjectively, ayahuasca participants reported feelings of peace and acceptance of death via emotional confrontation and release; recollection of forgotten memories with the deceased or the experience of an “autobiographical review” from another point of view; and contact with the deceased during the ayahuasca experience. The emotional confrontation during the ayahuasca experience, while often painful, was hypothesized to promote feelings of peace and acceptance via the integration of the loss into the patient’s life history. Recollection of forgotten memories, the authors suggest, may “facilitate the redefinition of their relationship with the deceased and of their own life history.” Notably, the authors claim contact with the deceased and maintenance of the bond may offer “the greatest therapeutic impact.”

The prospective, observational cohort study reported on the course of grief related to the loss of a loved one among 50 participants (39 of whom completed the study) who attended a retreat centre in Peru to participate in Indigenous Shipibo ayahuasca ceremonies (González et al., 2020). Most participants experienced loss from a naturally foreseeable death. Subjects participated in one of a range of retreats which were not designed specifically to support those experiencing grief. A significant decrease in grief severity was observed at all time points following participation in the ayahuasca ceremonies (p < .001), and effect sizes were large at all time points. Ratings of quality of life in physical health, psychological health, and social relationships all improved significantly and endured at 12 months following the retreat. The proposed mechanisms of change – acceptance (i.e., the positive formulation of experiential avoidance) and decentering (i.e., the capacity to observe one’s thoughts and feelings in a detached manner) – both significantly improved after the retreat (p < .001), with improvements noted at all timepoints. The authors propose that acceptance and decentering mediate the improvement of grief symptoms.

Ayahuasca was discussed in two literature reviews citing the work of González et al. (2019, 2020), (Houle et al., 2021; Maia et al., 2023) as well as in a subjective account of an adult child grieving the death of their parents (Isfahani-Hammond, 2020). The author noted that ayahuasca facilitated contact with the deceased, which helped create a renewed sense of connection and “tenderness”.

Psilocybin

Psilocybin is explored in the interpretive phenomenological analysis conducted by Agin-Liebes et al. following a group therapy intervention for the treatment of demoralization among long-term AIDS survivor men (Agin-Liebes et al., 2021). Five of the 18 participants in the trial experienced “complicated grief” related to numerous losses during the AIDS epidemic. The therapeutic approach of the group therapy sessions was not discussed in detail. Among those who reported grief at baseline (n = 5), there were significant reductions in complicated grief following the intervention. Subjectively, participants reported greater access to and ability to process emotions during the psilocybin experience, including grief. More generally, participants described an enhanced capacity for meta-awareness; increased emotion processing and regulation capacity, along with enhanced emotional/experiential acceptance; and increased transcendence and dissolution of self-boundaries, leading to increased feelings of connectedness. The authors described how the therapy facilitated the appreciation of past traumatic experiences as vehicles for growth through changing “from automatic to mindful modes of processing” and from trauma-dominant to growth-dominant narratives.

In a phenomenological qualitative study, Morton investigated the subjective experiences of seven individuals who used psilocybin to process grief after losing a “loved one” (Morton, 2023). Three of the participants had experienced loss due to illness, two to suicide, one to murder/suicide, and one to a car accident. The time between loss and psychedelic experience ranged from less than a year to 13 years. The psilocybin experience was identified as important, with respondents describing resolution of internal conflict, feelings of connectedness, and experiential acceptance of emotions during the experience. In terms of outcomes attributed to psilocybin, participants described increased awareness of thought patterns and self-compassion, increased comfort with mortality and loss, and increased spirituality/belief in life after death. The study also reported an improvement in depressive symptoms and reduced feelings of numbness after loss among participants. Morton drew parallels between these outcomes and the goals of complicated grief therapy, suggesting that psilocybin could serve as a useful complement (Morton, 2023). A spiritual dimension was also described, with participants reporting an enhanced spiritual outlook after the psilocybin experience that helped them address feelings of death anxiety and existential distress associated with bereavement.

Psilocybin use for grief was described in a recent update on new palliative care interventions (Whinkin et al., 2023) as well as a reflective opinion piece (Adrian & Spence, 2022), both of which discuss a ceremonial retreat model in Jamaica where psilocybin is provided to bereaved parents under supervision from physicians and therapists from the US, Canada, and Jamaica (where psilocybin is legal). Some of the parent participants are described as having lost a child suddenly, i.e. to overdose, suicide, accident, or murder. The intervention involves a group ceremony in which participants are invited to “[open] up, [share] stories, [refine] goals, [and revisit] ‘the worst pain of their lives'” with staff support. The retreats aim to support grieving parents in spiritual, psychological, and existential struggles around the death of their children. Adrian & Spence hypothesize that the mechanisms by which grieving parents might benefit from such an approach include experiential acceptance of suffering, meaning-making from suffering, and forging connections and community with others who have experienced similar losses (Adrian & Spence, 2022).

Other

The cross-sectional study conducted by Low and Earleywine (2024) surveyed a group of 363 individuals who had used a psychedelic substance in the context of bereavement. Most participants endorsed using the psychedelic within 5 years of bereavement in order to address their symptoms of grief. Most respondents went through the experience alone, in a single session (57.6%). The most common psychedelic used was psilocybin, followed by lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA), ketamine, peyote, dimethyltryptamine (DMT), mescaline, salvia, ayahuasca, phencyclidine (PCP) and ibogaine. Most participants reported significant improvements in grief symptoms after their psychedelic experience. Half of these participants reported functional impairment prior to their experience, and less than a third continued to report impairment after. The authors observed a positive correlation between emotional breakthroughs during the psychedelic experience – defined as the overcoming of difficult feelings or memories leading to relief, as measured by the Emotional Breakthrough Inventory (EBI) (Roseman et al., 2019) – and improvement in grief symptoms. Conversely, challenging experiences were negatively correlated with improvement in grief symptoms. Notably, 11% of participants reported worsening symptoms of grief after taking psychedelics.

In Shepard’s ethnographic studies of grief among the Matsigenka people of Hayapaari, Peru, “psychoactive plants” (some of which contain DMT) are reported to treat symptoms of grief persisting beyond cultural norms (that is, beyond the three days allotted for grieving within Matsigenka culture) (Shepard, 1998; Shepard Jr., 2002). Specifically, “ergot compounds…with diverse psychoactivity and diverse physiological activities (noted vasoconstrictors)” are described, along with “pungent tobacco snuff” taken intranasally, or “kaokirontsi” (eye cleanser) medicines that “[sting and burn] the eyes” to control negative emotions that are socially disruptive.

In a review of the history of psychedelics and end-of-life care, Dyck (Dyck, 2019) discusses the case of Aldous Huxley, the famous writer, philosopher, and psychedelic thinker, who supported the death of his wife, Maria Nys, who also studied philosophy and mysticism. Drawing on their psychedelic experiences (notably with mescaline and LSD), Huxley guided Nys to move towards peace in her final moments. As Dyck describes, Nys died surrendering her life without struggle, which was a great comfort that reportedly decreased Huxley’s experience of grief.

Finally, several papers reference the potential use of psychedelics for grief among caregivers of patients who are dying (Beaussant et al., 2021), older adults experiencing grief related to the deaths of spouses and friends (Johnston et al., 2023), and family caregivers of people with serious illness, including parents of young children (Rosa et al., 2022). How psychedelics could support these potential outcomes is not explored in depth in these articles.

Discussion

Main Findings of this Review

This review demonstrates that there is little that can be definitively stated about the benefits of psychedelics to attend to grief following death from advanced illness. The empirical papers included employed a variety of qualitative and quantitative methodologies, although none employed a randomized controlled design that might allow for more definitive conclusions to be drawn about treatment efficacy. That said, positive outcomes were generally reported in terms of grief symptom reduction, with few reported adverse or negative outcomes. Higher rates of poor outcomes (i.e., no improvement or worsened grief symptoms after psychedelics) were reported more among recreational users studied by Low and Earleywine (2024) than among participants in the ceremonial ayahuasca context studied by González et al. (2019). In Low and Earleywine’s (2024) study, worse outcomes among recreational users were associated with more challenging experiences, and most respondents reported using psychedelics alone. While the authors described their sample as recreational users, more than 80% of participants reported having used psychedelics with an intention to address grief. These findings highlight the potential importance of psychological support, whether offered in a clinical or ceremonial milieu.

What this Study Adds

Despite the lack of strong evidence on which to make recommendations or conclusions, based on the number of papers on this topic, there is clearly interest in this approach and growth in research applying psychedelics to the problem of grief.

Several mechanisms of action were proposed by which psychedelics might reduce grief symptoms or enhance grief therapy. Numerous papers suggested that psychedelics facilitate access to, emergence of, and, importantly, acceptance of previously avoided and distressing emotional material. In Low and Earleywine’s (2024) survey study, emotional breakthrough was positively correlated with improved grief symptoms. Several papers suggest that psychedelics promote relational connectedness, including via contact with the deceased during the psychedelic experience itself. Morton found that some participants reported improvements in grief as a function of “increased spirituality and belief in life after death (Morton, 2023)”.

Other cultural or spiritual rituals, psychotherapies, or interventions may be able to stimulate similar shifts but in a slower or more subtle fashion. Studying the combination of psychedelics and other practices known to support those experiencing grief could prove fruitful, especially if there are strong theoretical or empirical reasons for particular combinations. This strategy is being employed by González et al. (2022) in their upcoming non-randomized clinical trial, which compares ayahuasca in combination with constructivist psychotherapy for grief against constructivist psychotherapy alone, with an additional control group that will receive no treatment.

Tying the possible mechanisms of change identified in this scoping review to prominent psychological theories of grief or grief therapies can help researchers develop targeted interventions as well as hypotheses about change mechanisms that can be tested empirically. For example, the finding that psychedelics facilitate acceptance is noteworthy, as acceptance has long been identified as an important task for those experiencing grief (Kübler-Ross, 1969; Worden, 1996). Next, reconnecting with the presence of the deceased – a feature common to the ayahuasca experience, as noted by González et al. (2019; 2022), – also appears significant and suggests the potential relevance of continuing bonds theory (Klass et al., 1996) to psychedelic-assisted psychotherapy for grief. Relatedly, connection with the presence of the deceased during the psychedelic experience may also promote a new representation or internal working model of the loved one, which highlights the relevance of attachment theory (Bowlby, 1982). Finally, the possibility that psychedelics may support the grieving process by altering metaphysical beliefs (e.g. about the persistence of life after death) raises the potential relevance of Letheby’s Metaphysical Belief Theory (Letheby, 2024), which argues that when psychedelics reduce the fear of death, they do so by inducing or increasing non-physicalist beliefs.

Methodological Critiques and Considerations

The papers identified in this review used a wide variety of research methodologies, addressed different types of loss in different populations, and examined different treatment approaches in different settings with a variety of psychedelic compounds. Perhaps what is most striking about this review is this variety, and the convergence of different epistemologies, ontologies, cultures, paradigms, and interests. The diversity of theories and grief conceptualizations, sometimes within a single paper, highlights the many approaches and interests aimed at both psychedelic and grief studies. This diversity complicates the synthesis of this material and highlights potential conflicts that may arise based on differing values and priorities. However, it also creates potential for added richness and depth. As Dyck (Dyck, 2019) points out, “psychedelic experiences invoke a variety of reactions that often rely on a more expansive vocabulary to render them meaningful, whether that vocabulary borrows from a spiritual realm, an anthropological one, or a philosophical dimension” (p. 5), and the literature on grief has a similar history.

The interests driving the rapid growth in this field may include a wish to address suffering with a novel and promising approach, but may also include other interests, such as profit motives, interest in elevating “alternative” approaches to mental health and healing, and the interests of individual researchers (e.g., power, prestige, etc.). There is often a creative interplay between motives that nonetheless may lead to important discoveries and advancements. There is also, however, the risk of creating an industry around problematizing normative distress or creating iatrogenic issues such as those seen with the opioid crisis or prescription of antidepressants (Whitaker, 2010). At this early stage – as grief is being conceptualized as a potential target for psychedelic-assisted psychotherapy – there is an opportunity to consider the interests driving this work with a critical eye. Numerous authors have explored these dynamics with respect to grief, including whether it ought to be considered a normative human experience, how it ought to be supported, and where the line may be between normative and “pathological” grief (Aftab, 2024; Zachar et al., 2023). Similarly, there is a growing field of critical psychedelic studies that can inform these issues as they relate to the development and study of psychedelic-assisted psychotherapy (Devenot, 2024; Hauskeller & Schwarz, 2023).

In many of the papers reviewed, psychedelics were used by non-clinicians in non-clinical settings (or by individuals without formal support), rather than by healthcare providers in hospitals or clinics. Many papers were written by authors without clear expertise in the problem of grief. As this field grows, we will likely see further tensions between “medical” (or “expert”) versus “lay” practitioners, and “normal” versus “abnormal” conditions. Again, there may be valuable and novel directions arising from these tensions, but also potential harm if new and “unproven” treatments are hastily promoted without the input of experienced clinicians, experts, or individuals with long histories and established practices using psychedelic and related substances for healing (Celidwen et al., 2023; Urrutia et al., 2023). Here we should note our position as academic clinicians and researchers who tend to give weight to evidence-based medicine and the kind of knowledge it generates. However, we also acknowledge that this apparatus has significant limitations and technical biases, preferring methods such as randomized controlled trials that are challenging to conduct with complex interventions like psychotherapies (Gupta, 2014) and especially psychedelic-assisted psychotherapy (Schenberg, 2021). We also acknowledge the inherent biases in this form of knowledge-making that ignores or dismisses Indigenous knowledge and ways of knowing that could inform clinical approaches to psychedelic use, both in the area of grief and beyond (Hauskeller et al., 2023; Marcus & Dakwar, 2023; Williams et al., 2022).

Strengths and Limitations

Strengths of this scoping review include working with an information specialist to design and carry out the search strategy, employing a diverse team with experience conducting scoping reviews, and adhering to PRISM-ScR. Limitations include consulting databases focused on medicine, health sciences, psychology, social sciences, and interdisciplinary health studies, while omitting the anthropological or religious studies literature. Our scoping review protocol was not registered in advance. This review is also limited by the quality of the included reports. For example, while our aim was to explore what is known about using psychedelics to attend to grief following death due to advanced illness, many of the included reports looked at other types of losses (e.g., loss due to suicide, other sudden death, or accidental death). We did not exclude reports that included discussion of grief following these other kinds of loss, provided that there was also discussion about grief following loss due to advanced illness. The amount of psychedelic research published is rapidly growing, and it is possible that a similar scoping review in the next few years will lead to clearer conclusions and recommendations.

Conclusion

This scoping review, exploring what is known about using psychedelics to attend to grief following death due to an advanced illness, found that there is not a strong evidence base upon which to make clinical recommendations at this time. The literature is informed by different epistemologies, ontologies, and paradigms, as well as theories, models, and psychological concepts, adding a layer of complexity and a challenge for consensus building. That said, our findings do suggest potential positive impact of psychedelics in supporting people experiencing grief when offered in appropriate contexts with adequate psychological support. Our recommendations for future research, given the diversity of perspectives noted, are for authors and researchers to: (1) explicitly situate their work within theoretical traditions; (2) comment on their background, position, and interests in order to assist with the interpretability of their work; and (3) clearly describe their study population (i.e., what kinds of loss have participants experienced) and consider the particular psychological needs of people who have experienced different kinds of losses. Finally, and more generally, it would significantly strengthen research in this field if experts in grief joined with experts in psychedelic medicine in the development of grief-focused psychedelic interventions and in the associated research.

Supplemental Material

Supplemental Material - Exploring what is Known About Using Psychedelics to Attend to Grief Following Death due to Advanced Illness: A Scoping Review

Supplemental Material for Exploring what is Known About Using Psychedelics to Attend to Grief Following Death due to Advanced Illness: A Scoping Review by Daniel Rosenbaum, Celina Carter, Brandon A. Cirella, Matthew Cho, Melanie Anderson, and Sarah Hales in OMEGA - Journal of Death and Dying

Footnotes

Authors Contributions

All authors drafted, revised, and approved the final version of this article. Authors DR, CC, and SH contributed to the concept, design, acquisition, analysis, and interpretation of data. MA contributed to the design and data acquisition. Authors BC and MC contributed to data analysis, and BC provided editorial support.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by a grant from an anonymous not-for-profit donor to the UHN Foundation.

ORCID iDs

Daniel Rosenbaum

Melanie Anderson

Data Availability Statement

Full preliminary search results can be made available upon request.*

Supplemental Material

Supplemental material for this article is available online.

Author Biographies

Daniel Rosenbaum MD, FRCPC is a psychiatrist at the University Health Network (UHN) in Toronto. He is a Clinical Lecturer in the Department of Psychiatry at the University of Toronto. Daniel is co-Principal Investigator with the Psilocybin-assisted Existential, Attachment, and RelationaL (PEARL) therapy research program at UHN for patients and families facing life-threatening illness.

Celina Carter RN, PhD is a registered nurse and research scientist with a PhD in Public Health who conducts critical qualitative research focused on improving experiences of dying, death, and grief for clients, caregivers, and care providers through innovative interventions, policy changes, and public engagement.

Brandon A. Cirella received his BSc. Hon. in Neuroscience from Carleton University. He is a co-founder of Mapping the Mind, a grassroots non-profit dedicated to drug science advocacy and education. As an independent scientist, he researches the structure-activity relationships of novel psychoactive substances.

Matthew Cho is a first-year psychiatry resident at the University of Toronto. He previously completed his medical school training at the University of Toronto and undergraduate degree at Northwestern University. His academic interests currently lie in end-of-life mental health, psychedelic assisted therapy, and clinical ethics.

Melanie Anderson is a health sciences librarian with over ten years of experience working with health sciences researchers in neurology, rheumatology, health professions education, and mental health on knowledge synthesis projects. Her professional and research interests include knowledge synthesis methodologies, search expertise, library accessibility, and information literacy instruction in healthcare settings.

Sarah Hales MD PhD is a psychiatrist and researcher in the Division of Psychosocial Oncology at the Princess Margaret Cancer Centre in Toronto and Associate Professor in the Department of Psychiatry at the University of Toronto. Her clinical and research interests include the advanced cancer experience as it affects patients and families, and psychotherapeutic interventions aimed at alleviating their distress.

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Supplementary Material

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The Use of Psychedelics for Grief Following Death due to Advanced Illness: A Scoping Review

Abstract

Keywords

Key statements

What is already known about the topic?

What this Paper adds

Implications for practice, theory or policy

Introduction

Grief

Method: Scoping Review

Stage 1: Identifying the Research Question

Stage 2: Identifying the Relevant Studies

Stage 3: Study Selection

Stage 4: Charting the Data

Stage 5: Collating, Summarizing, and Reporting the Results

Results

Methodological Approaches

Conceptualizations of Grief and Theoretical Frameworks

What is “Known” About Using Psychedelics to Attend to Grief following Death due to Advanced Illness?

Ayahuasca

Psilocybin

Other

Discussion

Main Findings of this Review

What this Study Adds

Methodological Critiques and Considerations

Strengths and Limitations

Conclusion

Supplemental Material

Supplemental Material - Exploring what is Known About Using Psychedelics to Attend to Grief Following Death due to Advanced Illness: A Scoping Review

Footnotes

Authors Contributions

Declaration of Conflicting Interests

Funding

ORCID iDs

Data Availability Statement

Supplemental Material

Author Biographies

References

Supplementary Material