Trauma-informed Psilocybin Assisted Psychotherapy (TiPAP) for PTSD

Inclusion Criteria: * Age 21-65 years. * Diagnosis of post-traumatic stress disorder (PTSD) according to DSM-5 criteria, as assessed by CAPS-5. * At least 1 year since the traumatic event. * Moderate or greater PTSD severity (CAPS-5 score ≥ 25). * Ability to provide written informed consent. * Ability to read, write, speak, and understand Hebrew. * Prior trauma-focused psychotherapy. * Medically healthy at screening, as determined by a study physician, including: * No exclusionary medical conditions. * Resting blood pressure between 90/60 and 150/90 mmHg and heart rate between 45-100 bpm. * Normal laboratory results (including liver function, renal function, and electrolytes). Exclusion Criteria: * Current or past diagnosis of psychotic disorders, bipolar disorder, schizoaffective disorder, dissociative identity disorder, or borderline personality disorder (as assessed by MINI or SCID-5-SPQ). * Current psychotic features. * First-degree relative with a history of a psychotic disorder. * History of antidepressant-induced mania or hypomania. * Significant suicidal risk as assessed by the Columbia Suicide Severity Rating Scale (C-SSRS), including active suicidal ideation with intent or plan, or suicidal behavior within the past 6 months. * Substance use disorder (excluding nicotine and caffeine); mild-to-moderate alcohol or cannabis use may be permitted under monitoring and PI approval. * Use of psychedelic substances within 3 months before enrollment * Participation in a clinical trial involving administration of a psychedelic substance within the past 12 months. * History of adverse psychological reaction to psychedelics requiring hospitalization. * Significant cardiovascular disease, including ischemic heart disease, uncontrolled hypertension, arrhythmia, or heart failure (NYHA class ≥3). * Dementia or suspected cognitive impairment. * Traumatic brain injury with loss of consciousness \>24 hours or post-traumatic amnesia \>7 days (unless cleared by neurological evaluation). * Pregnancy, breastfeeding, or positive pregnancy/drug test (excluding cannabis) on the day of dosing. * BMI \<18 or \>33 * Abnormal liver or renal function tests. * Use of medications contraindicated with psilocybin. * Changes in psychiatric medication (dose or type) within one month before enrollment. * Needle phobia or inability to undergo blood testing.