The study was led by Christopher J. Lopata, PsyD, and Marcus L. Thomeer, PhD, co-founders and co-directors of the Institute for Autism Research and professors of pediatrics in the Jacobs School of Medicine and Biomedical Sciences at UB. According to Lopata, completion of the five-week summerMAXyc program was associated with significant social, behavioral and autism symptom benefits for the children who took part. He argues that developing such foundational skills early in development sets the stage for the acquisition of more advanced abilities later in childhood, adolescence and adulthood, which in turn can lead to better long-term outcomes across school, work and community settings.

The rationale for targeting this particular age group rests on a well-documented service gap. Thomeer notes that although programs for autistic children ages four to six without intellectual disability do exist, very few provide intensive social programming of the kind delivered in the summer model. The population also tends to participate in significantly fewer group recreational activities than their peers without autism, a disparity that further limits opportunities for social development during a period when such opportunities matter most. In the researchers’ view, this constitutes a significant gap in social intervention development and service provision, and it was the direct motivation for designing a program tailored to younger children rather than simply lowering the age range of an existing curriculum without adaptation.

The structure of summerMAXyc reflects a deliberate engineering of practice opportunities. Each six-hour day was divided into eight cycles of thirty minutes. Every cycle began with roughly ten minutes of explicit instruction in a specific skill, such as how to hold a conversation or how to accept consequences, followed by a twenty-minute cooperative activity in which the children could immediately apply what they had just been taught. This tight pairing of instruction and application is consistent with evidence-based teaching models in which new skills are modeled, rehearsed and reinforced in naturalistic group contexts rather than taught in isolation. Over five weeks, the schedule generated a high density of guided social exchanges, repeated across varied activities and peers, which the researchers consider central to the program’s effects.

The intervention inherits its design from summerMAX, the institute’s evidence-based summer program for older children, which has been refined over twenty-three years and has helped improve the social skills of hundreds of participants. Translating that model downward in age required attention to the developmental capacities of four-to-six-year-olds, including shorter attention spans, emerging emotion-regulation abilities and the need for concrete, teachable coping strategies. One such strategy illustrates the approach: children are taught to squeeze an imaginary orange while taking a deep breath in order to calm themselves. The technique surfaced in a striking way outside the program itself, when the mother of one participant reported that her child not only noticed that she was frustrated but instructed her to squeeze the orange, suggesting that the self-regulation lessons were generalizing from the classroom to family life.

Satisfaction data from the pilot were notably high. The children rated the program an average of 14.9 out of a possible 15, describing it as fun and reporting that it helped them learn skills and make new friends. Parent satisfaction averaged 69.8 out of a possible 70. Parents reported significant improvement in their children’s social skills, behaviors and autism symptoms over the course of participation. Thomeer says family members began to notice changes that extended beyond structured settings: children who had previously played alone were observed playing with others, making eye contact, asking about other people, playing games without becoming upset, and recognizing and understanding different emotions. These everyday markers, he suggests, are often what parents notice first and value most.

Parents, in fact, are frequently the first to recognize the need for intervention. Thomeer describes families reaching out because their child has difficulty navigating the social world, describing autistic children who want to have friends but do not know what to do in social situations. That gap between social motivation and social know-how is a common clinical profile in young autistic children without intellectual disability, and it underscores why interventions that teach explicit, rehearsable skills may be particularly well suited to this group. The broad consensus in the field that earlier intervention is associated with better outcomes lends additional weight to programs designed specifically for the preschool and early elementary years.

One of the study’s major methodological strengths was its use of objective observers to assess the children’s social performance. Lopata explains that while parents are a critical source of information, there is an inherent risk of bias because they know their children are receiving an intervention. Most social skills intervention studies for autistic children rely on parent ratings alone and therefore carry this limitation. To address it, the research team employed masked observers, trained individuals who were unaware that the children had received an intervention, thereby eliminating expectancy effects from the behavioral assessments. This design choice gives the pilot findings a degree of objectivity that is uncommon in early-phase social skills research and strengthens the case for the larger trial the team now plans.

Equally notable was the consistency of the results across individual differences. The authors report that the intervention was similarly successful in improving social performance and autism features regardless of a child’s age, IQ level, communication ability or level of diagnostic symptoms. That pattern is significant because the field widely recognizes that no single intervention will be effective for all autistic children, and there is a pressing need to determine which children are most likely to benefit from a given approach. Lopata argues that answering this question helps ensure that scarce resources are allocated efficiently and that the children enrolled in a specific intervention are those most likely to gain from it. In a pilot study, uniform responsiveness across subgroups is an encouraging signal, though confirming it requires larger and more controlled samples.

The next step for the research team is to test the intervention in a large-scale randomized clinical trial with a control group, which would be the first such trial for a social intervention of this kind in this population. A randomized controlled design would allow the researchers to separate the effects of the program itself from maturation, concurrent therapies and other environmental influences, and to examine outcomes with the statistical power that a pilot cannot provide. For now, the pilot offers an evidence-informed template for early social intervention: explicit skill instruction, immediate cooperative practice, embedded self-regulation training and objective outcome measurement, delivered at an intensity that matches the developmental urgency of the early childhood years. If the forthcoming trial confirms the pilot’s results, summer programs of this design could become a practical and scalable option for families seeking to support their young autistic children’s social development during the critical years before formal schooling accelerates social demands.

Subject of Research: A pilot study of an intensive summer social skills intervention for young autistic children ages 4-6 without intellectual disability.

Article Title: Autistic children ages 4-6 showed improved social skills after summer program conducted by UB’s Institute for Autism Research

Article References: Autistic children ages 4-6 showed improved social skills after summer program conducted by UB’s Institute for Autism Research. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: autism, social skills intervention, early childhood, summerMAXyc, University at Buffalo, Institute for Autism Research, Advances in Neurodevelopmental Disorders, randomized clinical trial, self-regulation, parent satisfaction, masked observers, developmental outcomes

A new randomized controlled study from the University at Buffalo suggests that the missing ingredient may not be motivation, education, or even money, but logistics. When fresh produce was delivered directly to participants’ homes, redemption rates jumped to nearly 90 percent, a figure that dwarfs the results of the traditional voucher model. The findings, published in Frontiers in Public Health, offer some of the clearest evidence yet that the design of food prescription programs, not just their existence, determines whether they succeed.

The study recruited 67 adults, most of them African American, all over the age of 65, and all of whom had reported experiencing food insecurity at times. Participants were drawn from primary care clinics at Erie County Medical Center in Buffalo and were randomly assigned to one of three groups for 12 weeks. One third received weekly boxes of fresh produce delivered to their doorsteps by FreshFix, a local food delivery company, with the option to customize their orders. Another third received home deliveries of healthy meal kits, which contained produce along with the additional ingredients needed to prepare three meals each week, chosen from five to six rotating options. The final third, serving as the standard-of-care comparison, received vouchers redeemable at the ECMC mobile market or at several FeedMore Western New York markets across Buffalo.

The results were striking. In both home-delivery arms, redemption, defined as the preparation and consumption of the delivered produce, reached 89.2 percent. In the control arm, where participants had to travel to a mobile market to redeem their vouchers, redemption was just 28.3 percent. That gap, more than 60 percentage points, represents the difference between a program that transforms diets and one that largely does not.

Lucia A. Leone, PhD, corresponding author and associate professor of community health and health behavior in the School of Public Health and Health Professions at UB, has spent years studying why food prescription programs underperform. The problem historically, she explains, is that people get the vouchers but do not redeem them. Her team’s goal was to test different versions of home delivery to boost redemption and compare them against the standard approach of handing out vouchers for redemption at a mobile market.

The barriers that suppress redemption in traditional programs are well documented but rarely addressed in program design. Many older adults lack reliable transportation to the markets where vouchers can be redeemed. Others avoid those settings altogether because the markets often operate out of food pantries, and recipients may feel stigmatized by being seen seeking assistance. By making home delivery the default, the Buffalo study removed both obstacles at once. Participants did not have to arrange a ride, stand in line, or explain themselves to anyone. The food simply arrived.

Two design choices appear to have been particularly important. First, delivery was automatic. Participants were not required to take any action to redeem their prescription, which eliminated the behavioral friction that causes so many voucher programs to fail. Second, the program allowed customization. Participants could tailor their produce orders to their preferences rather than receiving identical boxes. Leone notes that in many delivery programs, everybody gets the same food, and that partnering with FreshFix allowed the research team to combine delivery with personalization. A one-size-fits-all approach, she suggests, is less effective than one tailored to specific populations.

Interestingly, adding meal kits to the delivery model did not further increase produce consumption. Leone attributes this to the study population: adults over 65 generally already know how to cook with fresh produce, so providing recipes and supplementary ingredients did not change their behavior in the kitchen. The meal kits did, however, increase the overall quantity of food in the household, which helped improve food security. Redemption fell short of 100 percent mainly for mundane reasons, such as participants being out of town or feeling they already had sufficient food on hand.

Participants rated both delivery-based programs higher than 9 out of 10 and said they would recommend them to others. They also singled out the FreshFix delivery driver, Charles Humphrey, a community outreach coordinator with prior experience at mobile markets including the UB Veggie Van, for praise. Leone describes him as a wonderful, personable person who made every delivery throughout the study. That human connection, she says, is something the research team sees across their work: when a program has a good ambassador, it can substantially improve the program’s success. The finding adds a social dimension to what might otherwise seem like a purely logistical intervention.

The implications extend well beyond Buffalo. Large food prescription programs, including those offered through Medicaid, could potentially adopt home delivery as a default, though Leone cautions that large programs may find it harder to customize offerings for specific populations. The research team has already secured funding from the National Institutes of Health to test the model in a more challenging population: families on Medicaid experiencing food insecurity with children ages 2 to 6, in partnership with local pediatric practices. If the dramatic redemption gains seen among older adults hold for younger families, home delivery could reshape how food prescriptions are written and filled across the country. The study was funded by the American Heart Association, with preliminary work supported by UB’s Civic Engagement Research Fund, and partners included FreshFix, FeedMore WNY, and the UB Veggie Van. Co-authors include Anne Lally Mathiebe, Jennifer A. Stoll, the late Jill Tirabassi, and Rocco A. Paluch.

Subject of Research: Home delivery of fresh produce in food prescription programs for food-insecure older adults

Article Title: Study: Food prescription programs for food-insecure, older adults work best when fresh food is delivered to their door

Article References: Study: Food prescription programs for food-insecure, older adults work best when fresh food is delivered to their door. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: food prescription, food insecurity, fresh produce, home delivery, older adults, randomized controlled trial, University at Buffalo, Frontiers in Public Health, meal kits, mobile market, Medicaid, public health

The award, part of NSF’s Fire Science Innovations through Research and Education program, runs from September 2026 through August 2029 and brings together a multidisciplinary team from the University at Buffalo, the University of California, Berkeley, Northeastern University and the U.S. Department of Energy’s Pacific Northwest National Laboratory. The study, titled Collaborative Research: FIRE-WUI: REKINDLE: Resilient Engineering through Knowledge Integration for NetworkeD Lifelines and Ecosystem, will focus on communities in the wildland-urban interface, the zone where housing, power lines and other human development meet or intermingle with forests, grasslands and other natural vegetation. These are precisely the places where the destructive potential of wildfire and its aftermath is growing fastest.

As wildfires become more frequent and severe across the American West and beyond, wildland-urban interface communities face escalating risks that extend well beyond the immediate destruction of the fire itself. Burned landscapes lose the vegetation and soil structure that once absorbed rainfall, making them dramatically more prone to debris flows and flash floods during subsequent storms. At the same time, fires and their secondary hazards can inflict significant disruptions on lifeline infrastructure, including power grids, water systems and transportation networks. Current approaches to wildfire resilience planning, however, typically consider these interconnected risks in isolation, which makes it difficult to see how they interact with one another and how people actually respond when multiple hazards strike in sequence.

REKINDLE is designed to close that gap by combining artificial intelligence, infrastructure modeling and social science to assess wildfire-related risks together and to identify concrete ways to bolster public safety and community resilience. Sayanti Mukherjee, PhD, the project’s lead principal investigator and an associate professor in UB’s Department of Industrial and Systems Engineering, explained the central problem the team hopes to solve. People are familiar with wildfire risk, she noted, but what is often overlooked are the additional hazards and cascading effects that can follow. A region affected by wildfire can become more vulnerable to subsequent hazards like debris flows and flash floods, and when those events cut off roads or interrupt power or water service, the impacts can quickly compound for communities already struggling to recover.

Mukherjee, who is also an affiliate faculty member with UB’s Department of Electrical and Computer Engineering and the Institute for Artificial Intelligence and Data Science, is joined by co-principal investigator Susan Spierre Clark, PhD, of UB’s Department of Environment and Sustainability. The broader investigative team includes Auroop R. Ganguly, PhD, of Northeastern University; Marta González, PhD, and Anna Serra-Llobet, PhD, of UC Berkeley; and Andre Coleman, PhD, and Sam Chatterjee, PhD, of Pacific Northwest National Laboratory. This mix of expertise in engineering, environmental science, data science and social systems reflects the project’s core premise: that understanding cascading wildfire disasters requires simultaneously modeling the physical hazards, the engineered networks they damage and the human decisions those damage cascades trigger.

Through REKINDLE, researchers will investigate how wildfires and the hazards they set in motion can compromise key infrastructure, producing disruptions that ripple through the essential services people depend on for daily life and well-being. Clark emphasized that the team wants to understand not only how infrastructure systems are affected, but how those disruptions shape household decisions and community response. Bringing those pieces together, she said, can help communities build resilience, restore critical infrastructure and recover faster from future disasters. The framing matters because infrastructure failures are rarely just technical problems; a closed road can prevent evacuation, a lost power connection can disable water pumping, and a prolonged outage can determine whether a family can remain in or return to a damaged neighborhood.

Artificial intelligence will play a central role in the technical core of the project. The researchers plan to build a physics-informed, geospatial-AI model that fuses Earth observation data with wildfire expertise to generate maps showing where wildfires and related hazards such as debris flows and flash floods are most likely to occur. By anchoring machine learning in physical processes, the team aims to produce hazard predictions that are both data-driven and scientifically interpretable, an increasingly important consideration for tools intended to inform emergency management decisions. In parallel, the researchers will deploy machine learning models to trace how failures could propagate across interconnected power, water and transportation systems, capturing the dependency structures that turn a localized fire damage into a region-wide service disruption.

The human dimension of the cascade will receive equal attention. Using household surveys, focus groups and simulation games, the research team will examine how infrastructure failures affect families’ livelihoods and their ability to recover from cascading disasters. These social science methods are intended to reveal how households weigh risks, make evacuation and recovery decisions, and cope when multiple services fail at once. The team will then use these findings to help determine where investments in stronger infrastructure could deliver the greatest protective impact before a fire occurs, and how recovery efforts should be prioritized in the aftermath. Mukherjee noted that deciding where to invest resources, whether through hardening infrastructure or increasing community engagement and outreach, will be an important part of the project, and that AI and optimization can help assess different strategies and pinpoint where investments would have the most value. That kind of insight, she said, can support emergency managers, infrastructure operators and environmental planners in making more informed decisions for their communities.

To keep the work grounded in real conditions, the researchers will build and test REKINDLE through case studies in the Los Angeles and Montecito regions of California, both of which have experienced major wildfires and devastating post-fire debris flows in recent years. Montecito in particular has become a sobering reference point for cascading wildfire hazards, having seen destructive debris flows sweep through burned terrain after intense rainfall. The research team will collaborate with government agencies, utility providers and community stakeholders throughout the project to help ensure that the tools they develop reflect the practical needs of the people and institutions that will ultimately use them, from county emergency planners deciding where to pre-position resources to utilities weighing which assets to reinforce first.

The project also carries a substantial education and workforce development mission. Researchers will create wildfire-focused educational materials for students ranging from middle school through graduate school, introducing a new generation to the science of wildfire resilience and the related hazards that follow fires. Undergraduate and graduate students will have opportunities to gain hands-on experience through internships with industry partners and national laboratories, building career pathways in a field where demand for expertise continues to grow. The team will make its educational resources and research data publicly available so that other researchers, practitioners and communities can build on the work. If REKINDLE succeeds, its integrated view of fire, flood, infrastructure and human response could reshape how at-risk communities plan for the full arc of a wildfire disaster, not just the day the flames arrive.

Subject of Research: AI-based modeling of cascading wildfire hazards and infrastructure resilience in wildland-urban interface communities

Article Title: University at Buffalo to lead $2 million National Science Foundation project on wildfire resilience

Article References: University at Buffalo to lead $2 million National Science Foundation project on wildfire resilience. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: wildfire, cascading disasters, artificial intelligence, infrastructure resilience, wildland-urban interface, debris flows, flash floods, National Science Foundation, University at Buffalo, geospatial AI, community resilience, lifeline infrastructure

The study, published on September 17 in the journal Nature Communications, describes how the researchers guided human pluripotent stem cells, or PSCs, through a sequence of developmental steps that mirror the way salivary glands form naturally during human embryonic development. Stelios Andreadis, PhD, SUNY Distinguished Professor in the Department of Chemical and Biological Engineering in the School of Engineering and Applied Sciences at the University at Buffalo, serves as co-principal investigator on the study alongside Olga Baker, PhD, DDS, a professor in the Department of Otolaryngology at the University of Missouri School of Medicine in Columbia. Andreadis also directs UB’s Center of Cell, Gene and Tissue Engineering and is a member of the UB Center of Excellence in Bioinformatics and Life Sciences.

The appeal of pluripotent stem cells as a starting material lies in their remarkable accessibility and versatility. Human pluripotent stem cells can be derived from easily obtainable adult somatic cells, such as skin or blood cells, and then reprogrammed into a state in which they retain the potential to become almost any cell type in the body. That reprogramming concept earned Shinya Yamanaka of Japan and the late British biologist John Gurdon the Nobel Prize in 2012, and in the years since, researchers have used the technique to generate vascular cells, brain cells and kidney cells for study and potential therapy. Salivary gland tissue, however, had remained an elusive target, largely because of the intricate architecture and multiple specialized cell types that a working gland requires.

The Buffalo team’s approach centers on coaxing the pluripotent stem cells into becoming salivary gland epithelial progenitor cells, abbreviated SGEPs. These progenitors then organize themselves spontaneously into tiny three-dimensional structures known as organoids, miniature versions of organs that recapitulate key features of native tissue in the laboratory. Organoids have become one of the most powerful tools in modern biomedical research because they allow scientists to study organ development, disease progression and drug responses in a dish, using human-derived tissue rather than simplified cell cultures. According to Andreadis, the findings suggest that salivary gland organoids may hold promise not only for studying salivary gland development, disease progression and drug screening, but also for the development of cell therapies aimed at regenerating the glands themselves.

Generating the organoids in culture, however, is only half of the challenge. A replacement gland must survive inside a living body, integrate with surrounding tissue and mature into the full complement of functional cell types. To test whether the lab-grown structures could meet that bar, Baker’s research team in Missouri transplanted the organoids into the submandibular salivary glands of immunodeficient mice. The use of immunodeficient animals was a deliberate methodological choice: it allowed the human-derived tissue to be studied in vivo without the complication of immune rejection, giving the researchers a clear window into how the transplanted cells behave in a living glandular environment.

The results were striking. After more than 40 days inside the mice, the transplanted organoids had not merely survived; they had integrated into the existing salivary gland tissue of their hosts. Andreadis and the UB team performed the immunostaining and analyzed how well the grafts had incorporated and differentiated within the host tissue. Further analysis revealed that the organoids contained the cell types found in more mature glands, including acinar cells, which are the workhorses of saliva production; ductal cells, which form the channels that carry saliva from the gland into the mouth; and myoepithelial cells, specialized contractile cells that help squeeze saliva out of the glands and into the ductal network. The presence of all three lineages indicates that the organoids were recapitulating the essential cellular architecture of a functioning gland.

Perhaps most encouraging was the structural maturity the grafts achieved. Andreadis noted that the newly formed glands looked similar to native salivary glands and even developed lumens, the hollow interior spaces through which saliva would normally flow. Lumens are a hallmark of organized epithelial tissue and a prerequisite for any gland that hopes to secrete fluid in a directed way. Their appearance in the transplanted organoids suggests that the developmental program the researchers initiated in culture continued to unfold once the cells were placed in a living environment, driven by cues from the surrounding host tissue.

Laura Sherwood, a PhD candidate in biomedical engineering and a member of Andreadis’s research group, was first author on the paper together with Ronel Samuel, who completed his doctorate in 2024. Sherwood, who earned an award for this research at the 2025 Salivary Glands and Exocrine Biology Gordon Research Conference, summarized the significance of the transplantation experiments plainly. The experiments so far showed that the transplanted organoids have the potential to survive in vivo, she explained, and they integrated with the mouse gland and differentiated to include major salivary gland structures. That combination of survival, integration and differentiation, she noted, means the organoids could potentially become a renewable source of replacement cells for patients in the future.

Considerable work remains before such a therapy could reach the clinic, and the team is pursuing several parallel lines of refinement. One priority is to improve the differentiation process so that the cells composing the organoids become more mature and their developmental fate can be controlled with greater precision. The researchers are also working to determine the optimal stage of organoid development for transplantation and to improve the culture conditions in which the organoids grow. The ultimate functional goals are demanding: the engineered tissue must produce saliva in useful quantities, connect properly with the existing ducts that carry saliva into the mouth, and establish connections with the nerves that regulate salivary gland function. Each of these requirements represents a distinct biological hurdle, from vascularization and innervation to mechanical coupling with the recipient’s own ductal system.

Even with those challenges ahead, the implications of the work extend well beyond a single future therapy. Andreadis observed that while using these cells in humans is a long way off, the research suggests that one day scientists could repair salivary glands damaged by radiation therapy, restore saliva production in people with chronic dry mouth, study diseases of the salivary glands in the laboratory and test potential new drugs on human salivary tissue. For the patients whose quality of life is most eroded by xerostomia, particularly survivors of head and neck cancer and people living with Sjögren’s disease, the study offers something that has been missing from the field for decades: credible evidence that replacement salivary tissue can be built from a patient-accessible cell source and can take root in a living gland. Other participating researchers included graduate student Sai Harsha Bhamidipati in the UB Department of Chemical and Biomedical Engineering; Kihoon Nam, Frank Maslow and Travis Small with the University of Missouri; and Yali Zhang, Jianmin Wang and Song Liu with the Department of Biostatistics and Bioinformatics at Roswell Park Comprehensive Cancer Center. The researchers reported no conflict of interest.

Subject of Research: Derivation of transplantable salivary gland organoids from human pluripotent stem cells for treating dry mouth

Article Title: UB researchers grow salivary glands from pluripotent stem cells

Article References: UB researchers grow salivary glands from pluripotent stem cells. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: pluripotent stem cells, salivary glands, organoids, xerostomia, Sjögren's disease, regenerative medicine, tissue engineering, radiation therapy, acinar cells, Nature Communications, cell therapy, University at Buffalo

The study, led by Daniel Kruger, research associate professor in the School of Public Health and Health Professions at the University at Buffalo, together with Paul Gillis-Smith, program lead at the Center for the Study of World Religious Studies at Harvard Divinity School, was published in the journal Psychedelics. Additional co-authors are affiliated with the Michigan Psychedelic Center at the University of Michigan, Blue Sage Health Consulting in Ann Arbor, the Michigan Psychedelic Society and the Radical Well-Being Center in Southfield, Michigan. The research team set out to test whether a document written in the early days of the psychedelic counterculture could still speak to a generation of users who, in many cases, are experimenting far outside any clinical or regulated setting.

Bieberman’s pamphlet stood apart from the era’s more flamboyant psychedelic rhetoric. While Leary urged a generation to “turn on, tune in, and drop out” and spoke in esoteric terms such as “surrender to the void,” Bieberman focused on something far more mundane and, arguably, more enduring: how to keep a psychedelic session from going badly wrong. She established the Psychedelic Information Center in Cambridge, Massachusetts, and used the pamphlet to offer best practices for all types of psychedelics, with particular attention to first-time users. She also addressed what might go wrong during an LSD or psilocybin mushroom trip, cataloguing the psychological traps that can turn an evening of exploration into a frightening ordeal.

Among her warnings were several that will sound familiar to anyone versed in modern harm reduction. Kruger notes that Bieberman highlighted a number of “games” that may be better avoided during an LSD session, such as running away from one’s companions or becoming convinced that one has unlocked the deepest truths of the universe and must immediately tell the world about them. She recommended that users stay with people they like and trust, avoid going out in public, and clear their minds of negative emotions before beginning. When Kruger first encountered these pragmatic teachings, he wanted to know whether they would hold up today, a timely question given that psychedelic use now exceeds what was seen during the countercultural 1960s.

To find out, the researchers surveyed almost 600 self-identified psychedelic users, recruited through online advertisements and in-person outreach at a psychedelic advocacy event in Ann Arbor, Michigan. The anonymous respondents reported using LSD and psilocybin mushrooms, mescaline, ayahuasca, ketamine and MDMA, also known as ecstasy or molly, primarily within the previous year. They ranged in age from 18 to 85, with an average age of 43, and some identified as psychedelic guides or educators. The breadth of the sample matters, because it captures not only casual experimenters but also people who occupy informal teaching and facilitation roles within a growing community that operates largely beyond the reach of formal medicine.

The results were striking in their consistency. On preparation, the majority of respondents agreed with Bieberman’s statements that one should “be with people who know, like, and trust each other” and “be aware that, even with a guide, you have to do most of the work yourself.” For overall advice, the strongest agreement went to two statements that speak to the emotional arc of a psychedelic experience: “Recognize that the experience will eventually end,” and “Recognize that you may experience anxiety, which does not mean that something is wrong.” Kruger says participants strongly endorsed advice emphasizing interpersonal trust, personal responsibility and psychological preparation, principles that are thought to be foundations of safe and meaningful psychedelic experiences in clinical research.

Not every recommendation found universal favor. Participants neither uniformly agreed nor disagreed with Bieberman’s advice to avoid looking in the mirror during a psychedelic trip, an experience that over the decades has proven frightening for some users. That single point of ambivalence, out of nineteen, underscores how closely the rest of her guidance tracks with contemporary expectations. It also hints at the ways subjective culture around psychedelics has shifted: what was a widely shared caution in 1967 is now a matter of individual preference, while her core counsel about companions, setting and mindset remains close to consensus.

The renewed interest in Bieberman’s work arrives at a moment of extraordinary momentum for psychedelic science. Kruger points out that these drugs are gaining new traction through hundreds of clinical trials and through legal pathways in states such as Oregon and Colorado. The idea, he explains, is to medicalize psychedelics for psychiatric conditions such as severe PTSD and depression, a field he describes as overdue for innovation. There really has not been any big innovation in mental health medications since the selective serotonin reuptake inhibitors were introduced in the 1980s, he notes, and those drugs do not work as well as originally thought. Psychedelics have even been explored for physical conditions such as cluster headaches, which are so painful that some sufferers have reported suicidal ideation.

The clinical evidence emerging from this wave of research is encouraging, according to Kruger. Trials show people are getting better across a range of conditions, and some participants report finding more meaning in life, having greater spiritual connections and improving their relationships. Yet he cautions that while these trials may offer promise to millions, the majority of people experimenting with psychedelics today are doing so outside of any regulated context and with little prevention education. As a public health professional, he argues, the priority is to protect these users. When Bieberman’s pamphlet was published, there were few resources for novice users, and although the term “harm reduction” was still decades from entering the vernacular of drug education and safety, Kruger and his colleagues propose that “Session Games” and Bieberman’s larger body of work are precursors to that approach.

History gives the argument additional weight. Psychedelics were considered a promising therapeutic tool in the mid-20th century, when they were used to treat conditions including neurosis and schizophrenia, alongside general psychotherapy. By the late 1960s, however, the drugs became criminalized and psychedelic therapy waned, leaving a gap of roughly five decades during which informal guides, pamphlets and word-of-mouth wisdom filled the void left by formal medicine. Bieberman’s manual is a surviving artifact from that gap, and the new survey suggests its practical wisdom survived alongside it.

The regulatory landscape is now shifting again. While classic psychedelic drugs remain illegal in the United States at the federal level, Colorado and Oregon have established state-regulated frameworks for supervised therapeutic use, and Kruger predicts that New Mexico is not far behind. He expects more psychedelics-based medications to enter the marketplace in the not-too-distant future, and he frames the challenge in vivid terms: it is a freight train coming down the tracks, he says, so society had better build a train station to safely load passengers on board, or else they will simply try to jump on while the train is moving. In other words, the demand is arriving whether or not the infrastructure exists to meet it safely.

That is where a 59-year-old pamphlet becomes unexpectedly relevant. Bieberman’s guidance anticipated many of the principles now embedded in clinical protocols: screened and trusted companions, careful psychological preparation, an acceptance that difficult emotions may arise without signaling catastrophe, and the reminder that even the most intense experience is temporary. The fact that modern users, surveyed anonymously across a wide age range, endorse nearly all of it suggests that harm reduction for psychedelics is less a novel invention than a rediscovered discipline. For Kruger and his collaborators, the lesson is that public health efforts aimed at recreational and unregulated users need not start from scratch. The tools were drafted decades ago, in a one-dollar Cambridge pamphlet, by a woman history nearly overlooked, and the people most likely to benefit from them appear ready to listen.

Researchers hope the findings will encourage both clinicians and community educators to draw on historical resources as psychedelic use continues to expand. Kruger notes that the 2026 Psychedelic Community Survey is now available for anyone to take, regardless of whether they have experienced psychedelics, with all answers anonymous. He recommends that participants complete the survey on a private computer or device in a private location. As the science advances and legal frameworks multiply, the study stands as a reminder that the conversation about how to use psychedelics safely began long before the current renaissance, and that some of its earliest voices still have something to teach.

Subject of Research: Contemporary agreement with 1967 psychedelic harm reduction advice from Lisa Bieberman's LSD manual

Article Title: Study: Obscure 1967 guide for LSD use still relevant as psychedelics gain in popularity

Article References: Study: Obscure 1967 guide for LSD use still relevant as psychedelics gain in popularity. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: psychedelics, LSD, harm reduction, Lisa Bieberman, Timothy Leary, psilocybin, psychedelic-assisted therapy, PTSD, depression, public health, University at Buffalo, survey research