Developing Methods for Observing Awe Narration in Psilocybin-Assisted Therapy

Area of Science:

• Psychiatry
• Psychology
• Clinical Research

Background:

• Understanding psychedelic-assisted therapy (PAT) benefits necessitates studying the interaction between therapeutic context and process.
• Measuring in-session events during PAT is crucial for large-scale scientific investigation.
• Awe experiences are a hypothesized therapeutic mechanism in PAT.

Purpose of the Study:

• To develop and evaluate a direct observation coding system for awe narrations during PAT.
• To assess the feasibility and reliability of this coding system.
• To operationalize observable characteristics of awe experiences within the PAT context.

Main Methods:

• Analysis of 32 encounter recordings from a Phase 2 psilocybin-assisted therapy trial for advanced cancer.
• Independent coding by two researchers using a structured codebook to identify moments of awe narration (vastness, accommodation, ineffability).
• Refinement of the coding system based on inter-coder agreement and confidence levels.

Main Results:

• 246 moments of awe narration were identified across 16,760 minutes of video.
• Inter-coder agreement was established, with 58% of awe moments identified by both coders.
• Coder confidence in identifying awe was significantly higher when 'vastness' was present (OR: 4.3).

Conclusions:

• Awe narration during PAT is directly observable and codable using explicit criteria.
• The developed coding system demonstrates feasibility and reliability for measuring awe.
• This research provides an empirical foundation for scalable systems to code awe narration in PAT studies.