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**Psilocybin** is a naturally occurring serotonergic psychedelic tryptamine and prodrug of psilocin. In the Roots to Thrive Society for Psychedelic Therapy feasibility program for end-of-life distress, participants with terminal illness receive a single 25 mg psilocybin capsule during a group psilocybin-assisted therapy session embedded within a 10-week resilience-focused community-of-practice program. Psilocin, the active metabolite, principally activates serotonin 2A receptors, producing acute alterations in perception, cognition, emotion, and self-processing that are intended to support psychotherapy for existential distress related to terminal illness.
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