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I think that's the point.

Isn't the high level plan for this treatment: 1)The psilocybin breaks down the patients ego and 2) the psycho therapist molds it hopefully for the better?

"people who have done a lot of mushrooms..." In my experience those people also take just about anything. How could one say it was the psilocybin

The article glosses over how the spores could expect to respond during the highly saturated setting phase. It is reasonable to assume they could cause deformations or web-like weak points in new concrete by being too active well before they are intended to be active. I think getting a predictable outcome during setting is probably the challenge.