oregon psilocybin therapy: typical real world results
In This Guide:
Typical Results | Predicting Successful Results | Disappointing Results | Adverse Reactions | Maximizing Success | FAQ
WHAT RESULTS CAN I EXPECT FROM PSILOCYBIN THERAPY?
Psilocybin therapy produces remarkable results for most clients, with professional providers in Oregon reporting 85-95% of clients experience significant positive outcomes when proper protocols are followed. The therapeutic effects often exceed what clients achieve through years of traditional therapy, with many experiencing lasting improvements in depression, anxiety, trauma responses, and overall life satisfaction. However, like any powerful therapeutic intervention, outcomes vary based on individual factors, preparation quality, and post-session integration efforts. Psilocybin therapy should not be viewed exclusively as a replacement to talk therapy - many clients report gaining more benefit from talk therapy after their psilocybin session due to a feeling of getting 'unstuck'.
Understanding realistic expectations, the factors that contribute to successful outcomes, and the less common scenarios where results may be disappointing or problematic helps you approach psilocybin therapy with appropriate preparation and mindset. Most clients report that even challenging sessions ultimately prove therapeutic and transformative when properly supported. This comprehensive guide covers the full spectrum of possible outcomes to help you prepare for your own therapeutic journey.
typical results and timeline
IMMEDIATE POST-SESSION EFFECTS (DAYS 1-7):
Most clients report feeling emotionally open, mentally clear, and physically relaxed in the days immediately following their session, with an afterglow that naturally fades 2-3 days later. Common experiences include:
Emotional Clarity: Reduced anxiety, lifted depression, and increased emotional stability. Many describe feeling "lighter" or "unburdened" after releasing long-held trauma or grief.
Enhanced & More Open-minded Perspective: New insights about relationships, life patterns, career decisions, or personal challenges. Clients often report seeing their problems from completely new angles.
Increased Connectedness: Stronger sense of connection to others, nature, and their own authentic self. Social anxiety often decreases while empathy and compassion increase.
Physical Relaxation: Reduced physical tension, improved sleep quality, and decreased chronic pain or stress-related symptoms.
Cognitive Flexibility: Ability to break out of negative thought patterns, increased creativity, and improved problem-solving abilities.
Medium-Term Integration
(Weeks 2-12):
The real therapeutic work often happens during this integration period as clients implement insights into daily life and learn to focus on self-care vs self-abandonment narratives they may have carried throughout their lives. In order to achieve success in the medium and long term, clients should have a solid grasp on the basics of nervous system regulation and should be taking active steps to resolve chronic nervous system stressors as well as daily steps in 'listening' and active engagement to calm the nervous system and help it retain a feeling of overall safety, while gradually increasing the window of tolerance for stressors. Common benefits during this timeframe include:
Behavioral Changes: Clients commonly report healthier habits around diet, exercise, relationships, and work boundaries. Many reduce or eliminate alcohol and recreational drug use.
Relationship Improvements: Better communication with partners, family members, and friends. Increased ability to set healthy boundaries and resolve conflicts constructively.
Career and Life Transitions: Clarity about life direction often leads to career changes, geographic moves, or major life decisions that align with authentic values.
Reduced Medication Dependence: Many clients work with their healthcare providers to reduce or eliminate psychiatric medications, particularly antidepressants and anxiety medications.
Spiritual and Personal Growth: Increased sense of meaning and purpose, spiritual connection (regardless of religious background), and alignment with personal values.
Long-Term Benefits of psilocybin therapy (6+ Months):
Research and clinical experience show that psilocybin's benefits often persist for 6-12 months or longer, in particular for clients who committed to doing the daily work of nervous system regulation and radical self-awareness in the first 1 to 4 months after their psilocybin session. By month 6, with sobriety and daily action, many systems in the body should be starting to regulate including neurotransmitters, stress hormones, vagus nerve tone and resilience. However, severe and chronic cases of nervous system dysregulation may take 1-2 years to fully heal.
Sustained Mental Health Improvements: Clinical studies show significant reductions in depression and anxiety scores lasting 6 months to over a year after treatment - this is with support systems in place and daily effort by clients.
Personality Changes: Increased open-mindedness, emotional stability, and reduced neuroticism are common after psilocybin therapy, though it does not fundamentally change a person's base personality. These personality 'enhancers' often persist long-term.
Enhanced Resilience: Better ability to handle stress, navigate life challenges, and maintain emotional equilibrium during difficult periods. This is because significant nervous system disruptors can be processed and released in a psilocybin session.
Continued Growth: Many clients report that the session created a foundation for ongoing personal development rather than a one-time fix. Clients who do view psilocybin as a one-time fix or 'drive through' experience, tend not to have lasting benefit. This can manifest as a phenomenon called spiritual or emotional bypassing.
Factors That STRONGLY PREDICT Positive Results in psilocyBin therapy
Based on experience with hundreds of clients, certain factors strongly predict successful outcomes:
Proper Preparation and Mindset
Clear Therapeutic Intentions: Clients who arrive with specific yet flexible areas they want to work on (trauma, depression, life transitions) consistently have better outcomes than those seeking vague "enlightenment" or recreation.
Emotional Readiness: Willingness to face difficult emotions, memories, or insights without resistance. Clients who try to control or fight the experience often struggle and end up feeling as though they 'wasted' their session.
Realistic Expectations: Understanding that psilocybin facilitates healing work rather than providing magical solutions, and also understanding that journeys oftentimes take on a life of their own which may not align with tightly held expectations. The best results come from clients ready to actively participate in their own growth and view the experience as giving the gifts they need, not want.
Life Stability: Having basic needs met (housing, employment, relationships) provides a foundation for processing insights without overwhelming stress.
Professional Support and Setting
Experienced Facilitators: Working with licensed facilitators who have extensive training and client experience significantly impacts outcomes. It gives clients an outside perspective versus being in their own heads as an echo chamber, and it can also be intensely healing as a co-regulation mechanism to have a safe person in the room to witness, hold space for an honor a client's vulnerable moments. Nervous system trust can be built through this process when trust has been violated by others in the past.
Comprehensive Screening: Proper medical and psychological assessment ensures appropriate candidates and dosing strategies (this should not be constituted as medical services as most facilitators do not hold medical licenses).
Safe, Supportive Environment: Professional service centers with proper preparation and integration support along with appropriately comfortable and private rooms create optimal conditions for healing.
Adequate Preparation Time: Rushing into sessions without proper preparation or without taking preparation seriously consistently leads to suboptimal results.
Integration Commitment
Post-Session Support: Clients who engage with integration sessions and ongoing support through therapy or other means maintain benefits longer.
Lifestyle Implementation: Actively implementing insights through therapy, lifestyle changes, or personal development work amplifies and sustains benefits.
Community Connection: Having supportive relationships and community, even just one or two safe close friends or family, helps maintain the positive changes initiated during the psilocybin session.
when results of psilocybin therapy may be disappointing
Predictable Risk Factors for Poor Outcomes
Medication Interference: Clients on multiple serotonin-affecting medications (SSRIs, SNRIs, antipsychotics) may have blunted experiences requiring higher doses or medication timing adjustments. Usually, clients can be on up to 2 such medications and have a satisfying, meaningful psilocybin experience on as much as the State legal max dose of psilocybin (50mg). However, clients who are on 3 or more may struggle to 'launch' (feel much of anything) on psilocybin due to the severity with which their serotonin receptors have been desensitized over time.
Heavy Substance Use: Heavy cannabis use in particular is a known culprit and can significantly reduce psilocybin's effectiveness by disrupting neurotransmitter systems. Daily cannabis use of 20mg or more should be seen as similar in effect to an anti-depressant medication (SSRI).
Resistance to the Experience: Clients who fight the experience, refuse to engage with difficult emotions, or try to maintain control often have limited therapeutic benefit.
Inadequate Preparation: Rushing into sessions without proper screening, intention-setting, or education consistently leads to disappointing results.
Unrealistic Expectations: Expecting psilocybin to solve all life problems without personal effort or believing it will create permanent happiness without ongoing work.
Fractal Health reports that of the roughly 7% of their clients who experience underwhelming or limited benefit, they can be categorized as such:
- 3% who fall prey to resistance, control or refusal to introspect/participate during the session - or they desire to 'pick and choose' what memories/thoughts they will engage with. Clients who are disengaged and tight-lipped during preparation sessions are far more likely to fall into this camp, but sometimes clients can experience unexpected resistance during a session even if they were fully participating in preparation
- 2% have medication or substance interference at a physical level that has nothing to do with their ability, desire or willingness to heal and participate in the session. Often, these clients can work over a period of 3-6 months to titrate off serotonin-impacting substances, allow their serotonergic system to rebalance and re-sensitize, and try again with much greater success
- 2% of clients have totally unrealistic expectations of the experience, have read books, listened to podcast or seen documentaries, and now believe psilocybin will magically fix every element of their life - some even believe they will not have to lift a finger to do so. These clients can sometimes hide their lengthy list of expectations from their facilitator, and listen to a facilitator talking about reasonable expectations during preparation, and still harbor the subconscious belief that psychedelics will 'fix' them in the same way a surgical procedure would. These clients are setting themselves up for severe disappointment after their session, and integration can become solely about disappointment management.
Medical and Physiological Factors
Serotonin Receptor Down-regulation: As mentioned throughout this site, clients on complex psychiatric medication regimens may have severely reduced serotonin receptor sensitivity, requiring doses at Oregon's legal maximum (50mg) with still limited effects. Due to this legal limit, there will be a small subsection of clients that Oregon's program cannot effectively serve.
Individual Sensitivity Variations: Clients will naturally vary by sensitivity to psilocybin and serotonin quite substantially. Though 25mg is our standard 'full therapeutic dose', some clients have experienced similar effects on as little as 8mg, and others even not on any medications have a natural high tolerance and may require dosing into the 30-35mg range to achieve similar effects. Because Oregon's program allows for custom dosing plan for each client, client outcomes are often even better than in clinical trials, where dosing is standardized by design. It is our belief that variations in outcomes in clinical trials may be due to in part the natural level of sensitivity various people have to serotonin. More intense experiences correlate with longer positive outcomes - however there is a 'tip over' point at which higher dosing is not only not more helpful, but can become less helpful or even harmful.
Side Effects: Sometimes psilocybin onset will produce undesirable side effects (eg nausea, headache, muscle clenching, twitching or burning sensations) that substantially distract a client from being 'in the experience'. When this happens, the side effects generally do fade within 2 hours of onset, and it is important to note that insights and neuro-plasticity are still relevant in the hours and days following a session. Part of preparation should include physical preparation of eating whole foods with high protein, hydrating in the days leading up to, avoiding toxic substances, and doing one's best to sleep well. We recommend a hearty, high protein breakfast the morning of your session to help sustain your body and blood sugar throughout the day. Contrary to some popular advice we do NOT recommend fasting, as it depletes and weakens the body and can be associated with more adverse physical side effects.
Clients who are severely sleep deprived have been known to fall asleep during their session, sometimes receiving their first good sleep in a long while.
What Disappointing Results Look Like
Clients experiencing underwhelming results typically report:
- Minimal emotional or psychological effects during the session
- Lack of meaningful insights or perspective shifts
- No sustained mood or behavioral changes post-session
- Feeling like they "wasted" their time and investment
- Feeling like psilocybin therapy "doesn't work for them"
- Desire to repeat the experience immediately with higher doses
Important Note: Disappointing results don't indicate personal failure but often point to modifiable factors that can be addressed for future sessions.
Adverse Reactions and Risk Management
Behavioral Adverse Reactions
Disorderly Conduct: Some clients may become agitated, combative, or disruptive during their session. This can include verbal aggression, inappropriate behavior, or inability to follow facilitator guidance.
Dissociative Episodes: Complete disconnection from reality with memory loss of session events. During these episodes, clients may engage in potentially harmful behaviors while having no awareness or later recollection of their actions.
Emergency Service Requirements: In rare cases (less than 0.1% of Oregon sessions), behavioral reactions become severe enough to require emergency medical or psychiatric intervention for client or staff safety.
Risk Factors for Behavioral Reactions:
- Taking doses significantly higher than recommended
- Mixing psilocybin with other substances (alcohol, cannabis, medications)
- Undiagnosed or undisclosed mental health conditions, particularly personality disorders and severe, violent childhood trauma
- High stress or emotional instability at the time of treatment
- Poor facilitator-client rapport or inadequate preparation
Medical Adverse Reactions
Cardiovascular Effects: Temporary increases in heart rate and blood pressure can be problematic for clients with severe pre-existing heart conditions or uncontrolled high blood pressure, and cardiovascular conditions should always be fully disclosed during intake for a client's own safety and dosing considerations.
Psychological Distress: While not medically dangerous, intense fear, panic, or emotional overwhelm can be traumatizing without proper support. Conservative dosing strategies help circumvent this and if clients are inordinately frightened of this occurring, they are welcome to bring a Xanax prescription with them which would effectively sedate them and end the journey early.
Physical Symptoms: Nausea, vomiting, dizziness, or headaches, though these are typically manageable and temporary. It is extremely rare to need to call emergency services for typical physical side effects with psilocybin.
Risk Minimization Strategies
Conservative, Thoughtful Dosing: Starting with slightly to significantly more conservative doses (depending on client factors) and offering optional "booster" amounts after 45-60 minutes allows for individualized dosing without over-medicating initially.
Comprehensive Screening: Thorough medical, psychiatric, and substance use history helps identify high-risk clients who may need modified approaches.
Trained Staff: Licensed facilitators trained in crisis intervention, de-escalation techniques, and emergency procedures can manage most challenging situations safely.
Safe Environment: Controlled settings with limited stimulation, comfortable furnishings, and emergency protocols minimize risks and complications.
Emergency Preparedness: Clear protocols for contacting medical services, client safety procedures, and follow-up care for any adverse events.
What About the So-Called 'Bad Trip'?
Psilocybin professionals define a bad trip as one that devolves into panic, overwhelm or complete dissociation (temporarily induced psychosis). A true 'bad trip' is differentiated from a challenging therapeutic journey, the latter of which a client may face challenging memories, 'shadow' (repressed) parts of their personality or prior actions in order to process, integrate and/or release them (which are all profoundly healing activities).
'Bad trips' happen out in the wild - aka with DIY users or underground practices vs regulated, licensed settings - because of a few predictable factors: unreliable/unintended too-high dosing, combination with other illicit substances and adulterants that amplify effects, and environments that feel overwhelming or unsafe through strong stimuli (eg music/lights) or people (strangers, those with negative associations).
Because all of these factors are accounted for or eliminated in a controlled professional setting, bad trips tend not to occur except when a client is far more sensitive to psilocybin than anticipated and did not display any warning signs or known factors ahead of time. When clients have histories of violent trauma or complex trauma, or have certain personality or mood disorders, experienced providers will always design a more conservative dosing plan with the option to boost if the client is progressing well at the one-hour mark.
maximizing your chances of success
During Intake & Preparation...
- Be fully honest in intake forms and medical screening. Intake coordinators are not trying to gate-keep you from services...they are trying to keep you safe. They cannot do that if they receive inaccurate or misleading information.
- Engage fully in preparation sessions with your facilitator - take responsibility, ask questions, begin the process of self introspection if you haven't already
- Set clear, specific therapeutic intentions - but hold them loosely to allow for flexibility without tipping over into control
- Ensure life stability and adequate support systems. Remember you'll have a life to return to after your session! If you can put plans and changes in place ahead of time, you'll have a smoother recovery. Learn the basics about nervous system regulation and healing ahead of time, if possible.
During Your Session...
- Trust your facilitator and follow their gentle guidance (facilitators are required by law to be non-directive and encourage clients to follow their own internal guidance. Thus if a facilitator is providing guidance to a client, it is generally a pretty important topic)
- Surrender to the experience rather than trying to control it. Some clients find the word 'surrender' to be difficult, and find it helpful to reframe as "fully choosing to participate" - like stepping into the current of a soft-flowing river
- Engage with whatever emotions or insights arise. Be curious about minds-eye visuals, objects or even beings which appear
- Communicate openly about your experience and any concerns
- Remember that challenging moments often contain the most therapeutic value
- Understand that mystical type experiences happen sporadically and regardless of client intent. For example, a strongly non-spiritual client may have an intensely spiritual experience, and vice versa: a highly spiritual person desiring a mystical experience may find themselves being presented with very practical emotions, memories and problems.
Post-Session Integration...
- Attend all recommended integration sessions - you've paid for them and it's helpful to connect with your facilitator, even if you aren't sure what to say or feel negatively about the experience. Not all integration has to be sunshine and rainbows! Sometimes integration can feel dark and shadowy. These are times it is even more important to get support.
- Implement insights through concrete actions and lifestyle changes
- Consider ongoing therapy or psychedelic support groups for sustained growth
- Maintain healthy lifestyle practices that support nervous system recovery
- Be patient with the integration process, as benefits often unfold over months, not days. Even a disappointing administration session can be integrated well into permanent lasting change!
think psilocybin therapy in oregon might be beneficial to your mental health goals?
Most clients achieve significant results from a single session, with benefits lasting 6-12 months or longer. Some people with treatment-resistant conditions may benefit from 2-3 sessions spaced several months apart, but this is determined individually based on response to the initial session results.
6. Can I do another session if the first one doesn't work as expected?
5. What if I don't feel much during my psilocybin session?
4. How long do the effects of psilocybin therapy last?
3. Do cannabis or alcohol use impact my therapy results?
A
Q
As discussed above, the main factors that reduce effectiveness are multiple serotonin-affecting medications, heavy alcohol or cannabis use within days of the session, resistance to the therapeutic process, inadequate preparation, and unrealistic expectations about what psilocybin can accomplish without ongoing personal effort.
6. Can I do another session if the first one doesn't work as expected?
5. What if I don't feel much during my psilocybin session?
4. How long do the effects of psilocybin therapy last?
3. Do cannabis or alcohol use impact my therapy results?
A
Q
Yes, both substances significantly impact results but in different ways. Heavy cannabis use "turns down the volume" on serotonin neurotransmitters, often requiring higher doses for therapeutic effect. Alcohol disrupts all neurotransmitter systems, keeps the nervous system in a chronic state of forced dysregulation, spikes cortisol, can damage nerves, and interferes with emotional processing.
We recommend abstinence periods before sessions to optimize outcomes - please see greater detail in our Eligibility section which discusses substance use in detail.
6. Can I do another session if the first one doesn't work as expected?
5. What if I don't feel much during my psilocybin session?
4. How long do the effects of psilocybin therapy last?
3. Do cannabis or alcohol use impact my therapy results?
A
Q
While a small subset of clients feel like nothing much has changed by 1-2 months post-session, most clients report sustained improvements lasting 6-12 months or longer from a single session. Some benefits, particularly personality enhancements and perspective shifts, can be permanent. However, maintaining results often requires ongoing integration work and lifestyle implementation of insights. A more intense experience is correlated with length of benefit, but there is also a tipover point at which a stronger dose is harmful rather than helpful. This is why dosing must be considered carefully and curated for each client's individual factors and needs.
6. Can I do another session if the first one doesn't work as expected?
5. What if I don't feel much during my psilocybin session?
4. How long do the effects of psilocybin therapy last?
3. Do cannabis or alcohol use impact my therapy results?
A
Q
Underwhelming experiences are usually due to medication interference, recent substance use, or insufficient dosing. Your facilitator can help identify factors that may have reduced effectiveness and adjust approaches for future sessions if needed.
Some clients are so chronically sleep deprived they fall asleep during their session. Facilitators can be given permission to wake clients, but keep in mind the neuroplastic effects in the brain are still happening in the weeks following a session even if a client falls asleep for a portion of it.
6. Can I do another session if the first one doesn't work as expected?
5. What if I don't feel much during my psilocybin session?
4. How long do the effects of psilocybin therapy last?
3. Do cannabis or alcohol use impact my therapy results?
A
Q
Yes, follow-up sessions can be scheduled after evaluating what factors may have contributed to disappointing results. Often, adjusting medication timing, increasing doses, or addressing preparation issues can significantly improve outcomes in subsequent sessions.
Ethical providers will strongly encourage clients to let their nervous systems rest in between administration sessions and fully implement any insights received before seeking another session. Clients are warned against quick-succession psilocybin experiences due to the risk of escapism or perfectionism to achieve the 'perfect' trip.
Sometimes when the nervous system is not ready for another big experience it can rebel, leading to an unproductive follow up session - this is why timing is crucial when considering follow-up sessions and client emotional readiness.
6. Can I do another session if the first one doesn't work as expected?
5. What if I don't feel much during my psilocybin session?
4. How long do the effects of psilocybin therapy last?
3. Do cannabis or alcohol use impact my therapy results?
A
Q
Kat Thompson leads Fractal Soul and Fractal Health with over 20 years of strategic and operational experience from Fortune 500 companies including Nike, Twitter, and Intel. After discovering how psilocybin therapy transformed her own mental health—addressing chronic anxiety, childhood trauma, and executive burnout that traditional approaches couldn't reach—Kat pivoted her career to bring this breakthrough treatment to the public.
As a licensed facilitator who has personally guided dozens of clients through transformative sessions, Kat combines deep personal experience with professional expertise to create Oregon's leading psilocybin therapy programs. Her unique background in corporate strategy and lived experience with psychedelic healing allows her to design services specifically for busy professionals and others who need results-driven mental health solutions.
Kat is a sought-after public speaker and educator, passionate about bringing science-based psychedelic therapy into mainstream professional wellness. She regularly presents to corporate audiences, healthcare organizations, and industry conferences, helping to destigmatize and democratize access to legal psilocybin therapy. When she's not facilitating breakthroughs for clients, Kat enjoys traveling, parenting, cooking, and continuing her own journey of growth and healing.
education
Bachelor's of Computer Science, Master's of Science in Tech & Healthcare Business Mgmt
specialties
Relationship Grief & Loss, Single Parenting, Alcohol Use, Generalized Anxiety & Burnout
AVAILABILITY
Available for complementary public speaking & workshops globally.
Taking limited facilitation clients in 2025 - also manages a wonderful team of highly skilled facilitators.
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