Abstract
<p>The therapeutic and societal promise often attributed to psychedelic drugs implies meaningful change in real-world behaviour, yet such change is rarely measured directly. Across psychedelic research, outcomes are typically assessed using symptom scales, self-reported psychological states, or retrospective judgments of change, which may capture subjective improvement but do not by themselves demonstrate altered behaviour. Reviewing evidence across health, prosocial, and pro-environmental domains, we show that outside addiction, claims about behavioural transformation remain methodologically ahead of the data. We outline methodological approaches that could help bring the field’s strongest claims into closer alignment with more rigorous tests of real-world change.</p>