How to Prepare for Psychedelic Therapy: Set & Setting

Learn how to create the ideal internal and external environment for a safe and meaningful psychedelic journey.

As a therapist who helps people prepare for their psychedelic medicine experiences, I often hear this question: “What should I expect?” This is a natural inquiry, but the truth is, the psychedelic experience is highly individual. There’s one factor, however, that significantly impacts the course of your journey: set and setting.

Set refers to your mindset – your intentions, expectations, and emotional state going into the psychedelic experience (also referred to as a journey, session, or ceremony).

Setting encompasses the physical and social environment. 

Together, set and setting act as a container for your psychedelic journey, influencing its direction and depth.

Key Terms

I use the terms “psychedelic therapy,” “psychedelic-assisted therapy,” and “PAT” to refer to the Western psychotherapy model in which a client engages with psychoactive substances (such as psilocybin, ketamine, or cannabis), under the guidance of a qualified care team (therapist, medical provider, facilitator, etc.), within safe, structured, and intentional sessions. 

Psychedelic therapy sessions range from a couple hours to several hours long. Clients may engage in one or multiple sessions. 

Clients may participate in psychedelic-assisted therapy (PAT) for various reasons: healing (anxiety, depression, trauma, chronic pain, grief, burnout), self-reflection, spiritual exploration, nervous system reset, self-connection, and more. 

This is just one context, of many, for psychedelic healing work. PAT can only take place in areas where this model of care is legal (such as the states of Colorado and Oregon). 

Acknowledgment

Before we go any further, I want to acknowledge the extensive history and ongoing practice of plant medicines in indigenous cultures (such as ayahuasca ceremonies in the Shipibo culture, iboga ceremonies in the Bwiti culture, and many more).

While there are both connections and distinct differences between psychedelic-assisted therapy and plant medicine ceremonies, this blog post focuses specifically on the former. 

Please note that this post cannot fully encompass set & setting for plant medicine experiences within their unique cultural contexts, as that is a complex topic worthy of its own extensive blog post.

While some information about set & setting may be broadly applicable to various healing contexts, this is not a complete resource for those engaging with plant medicine work specific to indigenous cultural practices.

How to Prepare Set & Setting

Psychedelic therapy is far more than just consuming a substance. It is a creative exploration of your inner landscape, facilitated by a trained professional.

Psychedelic medicines like ketamine and psilocybin act as catalysts, opening your brain to new perspectives and releasing stuck emotions and energy from the body. The quality of your experience is highly influenced by set and setting.

SET: Preparing your Mind

Imagine entering a psychedelic therapy session feeling anxious and overwhelmed. Maybe you glimpsed a disturbing text on your phone a few minutes ago. Maybe you got in an argument with someone that morning, and the fight is still lingering in your mind.

This negative set is likely to affect your experience, making it more challenging to navigate the introspective journey. Whatever is most present in your awareness right before the PAT session – be it an unpleasant mood or ruminating thoughts – might be amplified by the medicine’s effects, possibly in uncomfortable or unhelpful ways.  

Conversely, a positive set – one characterized by curiosity, openness, and presence – creates an ideal environment for journeying.

Prior to your psychedelic therapy session, we'll work together to prepare your mind. This might involve setting clear intentions for your session, exploring past experiences with psychedelics (if any), and processing any emotions that are coming up for you. We’ll discuss steps you can take to optimize your set, such as journaling, meditation, movement, or mindful time in nature. 

For the days, hours, and minutes leading up to your journey, the goal is to connect with yourself and minimize distractions like phone calls, meetings, and other tasks. Through intentional preparation, you can enter the psychedelic therapy session feeling as clear and present as possible. 

SETTING: Creating the Ideal Environment

While psychedelic journeys delve deep into our inner world, they’re not solitary experiences happening in a vacuum. The physical and social environment play a significant role. Consider these factors as you plan your psychedelic therapy experience. 

Solo vs. Group Experience

Some people find the intimacy of a solo PAT session with a therapist most beneficial, while others enjoy the support and connection of a group setting.

If you choose a group setting, make sure to ask how many people will be in the group, who you will be journeying with, and what level of individual care will be available in this group format. 

Care Team

Your care team may consist of various practitioners: therapist, guide, facilitator, medicine provider/prescriber. They work collaboratively with you to develop a personalized treatment plan and create a safe and supportive environment for your journey. 

Consider what qualities you seek in your care team. Don’t hesitate to interview multiple people and places until you find the right fit. 

Your practitioner(s) should embody the basic qualities of compassion, empathy, and non-judgment. They must have extensive knowledge and experience with psychedelic medicines. Most importantly, there should be a sense of trust, connection, and open communication when you interact with your care team. 

Physical Details of the Space

It’s essential that you feel comfortable in the physical environment of your psychedelic journey. If possible, visit the space beforehand so that you can get a feel for it and confirm if it’s right for you. 

Consider your sensory needs and preferences – sight, sound, smell, and touch. 

Would you prefer soft, calming light or something brighter? What is your preference for visual scenery – nature, a colorfully decorated room, beautiful art? Depending on the practitioner’s approach, the space may incorporate elements that evoke a sense of sacredness or spirituality, such as altars, candles, or symbolic objects.

Music is an essential part of the experience. Ask your practitioner if they will select all the music for your journey, or if you can bring some of your own playlists. If you’re choosing your own music, opt for songs without lyrics – so that your brain can experience the sound waves without getting attached to a storyline.

Let your practitioners know if you have any sensitivities to smells and aromas. 

Consider the comfort of the seating. Where will you be lying down or sitting? Is there space to move around?

Confirm that there will be access to basic needs and comforts – like a bathroom, water, fresh air, blankets, and/or pillows. 

What’s your ideal set & setting?

The ideal set & setting will differ based on each person. What fosters comfort and focus for one individual might be distracting for another.

By carefully considering your unique needs and preferences, you can cultivate a set and setting that allows you to feel comfortable, present, and supported on your journey.

If you’re preparing for a psychedelic experience & need support, let’s connect.

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About the Author

I’m Liz Zhou, a holistic trauma therapist (MA, LPCC, she/her). My work integrates teachings from psychology, neurobiology, multicultural awareness, and spirituality. I provide compassionate therapy for highly sensitive people across Colorado.