Family members and/or close others can be engaged in meaningful ways during the preparation, treatment and integration phases of psychedelic therapy to optimize outcomes for all affected. Providing a supportive other with an active role in the process can also decrease the likelihood of dynamics that can contribute to the maintenance of problematic patterns in the dyad or system, especially as the healing work disrupts old patterns. In fact, if not handled skillfully by the clinician, these disruptions can lead to serious distress for those affected, including relational breakdown in some cases. This presentation will introduce the ethical, neurobiological and psychological considerations for family involvement in psychedelic-assisted therapies. Data from a clinical trial with psilocybin for anorexia nervosa with other involvement will also be presented to illustrate how other-engagement can facilitate powerful shared experiences and leverage opportunities to heal and grow in the context of one’s closest relationships, the most fertile ground of all.