Also, dosing matters. Can the apparent positive effects occur at low doses where possibly it isn’t very perceptible? This is important and a double blind approach is warranted.
I don't think it's as important for the attending scientists, who are also going to have a pretty accurate guess. What's more important is that they have some training in 'trip sitting' and that the experimental environment be appropriately designed, DMT: the Spirit Molecule has a number of stories about how things go poorly when this aspect is neglected.
Doesn't help: any normal person can tell the difference between a full dose of psilocybin and a low dose of amphetamines.
"You'll be given either a psychedelic or a stimulent, followed by x testing" - then knowing which drug you're getting doesn't mean you know if you're in the placebo group or not?
That does mean there are certain assurances of neutrality we simply can't have. It doesn't mean that efficacy and safety can't be studied: they can.