Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology

J Psychopharmacol. 2016 Dec;30(12):1259-1267. doi: 10.1177/0269881116677852. Epub 2016 Nov 16.


Placebo response theory and set and setting theory are two fields which examine how non-biological factors shape the response to therapy. Both consider factors such as expectancy, preparation and beliefs to be crucial for understanding the extra-pharmacological processes which shape the response to drugs. Yet there are also fundamental differences between the two theories. Set and setting concerns itself with response to psychoactive drugs only; placebo theory relates to all therapeutic interventions. Placebo theory is aimed at medical professionals; set and setting theory is aimed at professionals and drug users alike. Placebo theory is primarily descriptive, describing how placebo acts; set and setting theory is primarily prescriptive, educating therapists and users on how to control and optimize the effects of drugs. This paper examines how placebo theory and set and setting theory can complement and benefit each other, broadening our understanding of how non-biological factors shape response to drugs and other treatment interventions.

Keywords: Placebo; expectancy; hallucinogens; non-drug factors; psychedelics; set and setting; social pharmacology.

Publication types

  • Review

MeSH terms

  • Animals
  • Hallucinogens / pharmacology*
  • Hallucinogens / therapeutic use*
  • Humans
  • Psychopharmacology / methods
  • Psychotropic Drugs / pharmacology
  • Psychotropic Drugs / therapeutic use


  • Hallucinogens
  • Psychotropic Drugs