A Career in Psychedelic Psychotherapy? 10 Questions To Consider

The emerging research on psychedelics is conclusive: psychedelic psychotherapy is an extremely effective treatment for many mental health disorders. If your clients are anything like mine, they are asking questions about MDMA, psilocybin, LSD, and microdosing. The scientific research is also clear that it is not the psychedelic substance itself that is the agent of change – it is the psychotherapeutic support a participant receives before and after the experience that translates into real change.

With the growing interest in using psychedelics to treat conditions such as depression, anxiety, PTSD, chronic pain, and many others, you may be wondering if a career in psychedelic psychotherapy is a good fit for you.

With many countries posed to legalize the use of psychedelics in psychotherapy, there will be a need for experienced therapists to enter the field of psychedelics.

Ask yourself these 10 questions:

1. What is your training?

Are you already a licenced professional with the capacity and experience to deliver psychotherapy? Are you a social worker, counsellor, psychotherapist, psychologist, psychiatrist, or other professional? With many countries posed to legalize the use of psychedelics in psychotherapy, there will be a need for experienced therapists to enter the field of psychedelics. Experience in working with attachment and trauma-related injuries is particularly useful, along with basic training in neurobiology and polyvagal theory.

2. Are you familiar with the recent research on psychedelic psychotherapy?

In the last two decades, many prominent academic and research institutions have undertaken clinical trials using psychedelics to treat a wide range of mental health disorders. These include Johns Hopkins, New York University, Imperial College London, and the Multidisciplinary Association for Psychedelic Studies. We now know that much of the reporting on psychedelics in the 1970s and 1980s during The War on Drugs was inaccurate at best and propaganda at worst. This misinformation created a great deal of stigma and fear about psychedelics that has proven to be unfounded. Are you prepared to challenge these myths and help educate your clients using current and accurate information?

3. What is your knowledge of psychedelics?

There are many kinds of psychedelics on the planet. Some occur organically in nature, and some have been synthesized in laboratories. Plants, roots, mushrooms, seeds, berries, and even one reptile have been discovered to have psychedelic properties. More than 180 varieties of psilocybin mushrooms have been identified and found to grow on every continent. Each psychedelic substance has its own unique properties, providing a variety of benefits. Having a basic knowledge of psychedelics and their applications is crucial for the psychedelic psychotherapist.

4. Are you a team player?

Most settings offering psychedelic psychotherapy involve a team approach. Medical practitioner screen for psychological and physical contraindications; intake coordinators and office managers often take care of the practical details of scheduling and payment; and social workers and psychotherapists offer preparation and integration sessions before and after the use of the psychedelic. The dosing sessions also include medical professionals as well as mental health clinicians. The ability to work effectively within a collaborative model is a definite asset for a psychedelic psychotherapist.

5. Do you have experience with altered states of consciousness?

Psychedelics are just one way to experience an alternative state of consciousness. Some occur as a natural part of life – such as a runner’s high or the blissful state some women reach in childbirth. Others occur with deliberate practice, such as through dance, prayer, or breathwork. Being comfortable working with consciousness is essential for psychedelic work. Many participants have consciousness-expanding experiences that can involve aliens, angels, and ancestors to name a few. Does your worldview allow for this leap in perceptions of reality?

6. Just how ethical are you?

Those of us doing therapeutic work are required to adhere to standards of practice, including high ethical principles, as part of belonging to a regulatory college. The therapeutic relationship already invites the possibility of significant ethics dilemmas. The nature of psychedelic work creates even more possibility of ethical breaches and therefore requires even higher ethical standards. Depending on the substance, some psychedelic dosing sessions can last for many hours or even days. There is a different kind of intimacy created when, for instance, during a dosing session, you have had to remind a client how to pee. There is often some level of consensual touch involved in a session, which can create the potential for boundary violations. The exploration of mystical and altered states of consciousness can intensify our connection with clients, taking it beyond the typical therapist/client relationship. Peer and clinical supervision, a high level of self-awareness, as well as scrupulous standards are indispensable for ethical practice.

7. Do you trust in the inner healer?

Psychedelic psychotherapy requires learning a new way of being with clients. It is much more collaborative than many other kinds of therapy. Clients determine their therapeutic goals and intentions for treatment. Many people have mystical experiences as part of their journey. In the Johns Hopkins studies, two thirds of participants rate their psilocybin journey as one of the top five spiritual experiences of their lives, along with the birth of a child or the death of a parent. The remaining third of participants rate their psilocybin experience as the most significant spiritual event of their lives. Trusting in our client’s innate wisdom and ability to self-heal is essential for this work.

8. What other psychotherapy skills do you have in your toolbox?

The integration process (the time following a dosing session) is assisted by the addition of somatic and experiential therapies. Training in models such as Internal Family Systems, Sensorimotor Psychotherapy, and Somatic Experiencing complement psychedelic work. Experience in play, art, dance, music, and nature therapies provide valuable skills for helping participants integrate their psychedelic experiences that go beyond talk therapy.

9. How respectful are you of Indigenous wisdom and healing methods?

Much of what we know about the use of psychedelics comes to us from Indigenous cultures around the globe. Ayahuasca, iboga, and peyote have been used for centuries as part of traditional healing practices. There is a great deal of concern about the appropriation of ancient wisdom and the commercialization of psychedelics. Are you able to work respectfully within this field, honouring the generations of shamans and healers who have passed on their cultural practices and traditions?

10. Do you have the time, money, and patience to learn yet another therapy model?

Most of my colleagues spend countless hours and money enhancing their psychotherapy skills every year.  The capacity for psychedelics to radically transform our clients also comes with the risk of doing harm when they are at their most vulnerable. Training specific to psychedelic psychotherapy is essential. Given the considerable investment of both time and money needed to acquire the necessary skills and experience to become a psychedelic psychotherapist, do your homework and make sure this is a model that fits with your interest and skill set.

The capacity for psychedelics to radically transform our clients also comes with the risk of doing harm when they are at their most vulnerable. Training specific to psychedelic psychotherapy is essential.

Providing psychedelic psychotherapy is incredibly rewarding as a clinician. Witnessing the dissolution of preciously held patterns of rigid thinking, watching the resolution of long-held trauma stories, and being a part of transformative and healing experiences is a great honour and privilege. It also requires extensive training and experience. I hope this blog has helped you determine whether a career in psychedelics is in your future.

Be sure to check out our CTRI podcast, Psychedelics and Counselling, as Kelly discusses the growing interest and research around psychedelic-assisted counselling. 


Kelly Smith

MSW, RSW – Trainer, Crisis & Trauma Resource Institute

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