Written by, Dr Sara Tookey
Psychedelic substances like psilocybin, LSD and DMT are demonstrating promising therapeutic potential in research trials for treating mental health conditions and supporting personal growth.
Related Article: Exploring the Psychedelic Renaissance: Psychedelic Therapy, a Crucial Conversation for Mental Health.
To harness the potential benefits of psychedelics safely and effectively, proper preparation, ethical and professional guidance, as well as integration practices are essential.
This article explains what psychedelic preparation is, what it involves when supplemented alongside a psychedelic experience, who can benefit, and how it can support positive outcomes.
Related blog articles: Psychedelic Science
Psychedelic Integration: What is it and who can benefit from it? by Dr Sara Tookey
Psychedelic Integration Tools and Techniques by Dr Sara Tookey
Beyond the Hype: A Balanced Look at Psychedelic Therapy Risks by Dr Sara Tookey
Exploring the Psychedelic Renaissance: Psychedelic Therapy, a Crucial Conversation for Mental Health by Dr Sara Tookey
Psychedelic Experiences vs Psychedelic-Assisted Therapy
In my work on psychedelic clinical research trials and in working with people pursuing psychedelic therapies within other legalised contexts, I’ve witnessed how psychedelic-assisted therapy can act as a catalyst for moving toward, rather than away from areas of difficulty and pain in one’s life. For many psychedelic therapy can temporarily dismantle one’s usual defense mechanisms, allowing them the opportunity to view trauma, suffering and their struggles through a lens of openness, compassion and courage. But healing from mental health issues requires vulnerability, commitment, persistence and hard work. Psychedelics remind us that looking straight at our pain, rather than distracting ourselves from it is where true healing begins.
Psychedelic experiences can inspire people to change unhelpful thought patterns, behaviours, and attachments that stand in the way of growth. And when offered with proper guidance and support, one can learn how to turn these insights into real lasting changes in their lives.
There is a common misconception and current debate taking place between the pharmaceutical industry (e.g. companies developing synthetic versions of psychedelics for market and the FDA) and the psychedelic-assisted THERAPY world. One asserts that simply taking a psychedelic IS therapy while the other insists a trained psychotherapist or psychologist is needed to support the unique therapeutic processes required to make change as a result of taking a psychedelic substance. Nevertheless, whether the supporting person or guide is a trained therapist or not, it remains an agreed understanding that proper screening, preparation and integration in psychedelic therapy is crucial.
What is Psychedelic Preparation?
Preparation for a psychedelic experience involves providing individuals with education and tools to help them make the best use of their psychedelic experience and to educate them about how they can reduce the potential risks associated with taking psychedelics (for people with certain predispositions this may include psychosis, mania cardiovascular concerns, worsening mental health). Psychedelic preparation takes an approach known as the harm reduction approach to psychedelic assisted therapy. It is a compassionate and empowering approach, where the therapist prioritises the individual’s agency and autonomy and supports the person in their process (Gorman et al., 2021).
Preparation typically involves a therapist, coach or guide imparting knowledge to enable a person to make decisions that suit their needs and personal intentions for engaging in a therapeutic psychedelic experience. For example preparation sessions can provide a person with tools to help them spot red flags and reduce risks associated with embarking on a psychedelic journey, by attending to the needs of set and setting. Preparation is a process whereby a therapist or coach helps a person to prepare to embrace and learn from their upcoming psychedelic experience.
Given the rapid expansion of the psychedelic industry, the amplified media attention, and the ever-evolving cultural and political contexts, it is crucial to prioritise education regarding the safe and informed navigation of this landscape.
Who is Psychedelic Preparation For?
Who is Psychedelic Preparation for?
Psychedelic preparation support is suitable for:
Any person with interest in altered or expanded states of consciousness.
Any person with an interest or curiosity about psychedelic-assisted therapies, those wanting to prepare for a psychedelic experience. Including:
People preparing for participation in an approved research study involving a psychedelic compound
People seeking to prepare intentionally for an alternative legal psychedelic therapy setting, including independent ceremonial, spiritual or therapeutic use of psychedelics
People wanting to learn about how to navigate the psychedelic therapies landscape, assess for risks and spot red flags
What Does Psychedelic Preparation Involve?
The growing popularity of psychedelic therapies has led to a rapid increase in retreats and clinics offering these treatments. However, many do not establish or follow rigorous clinical standards of care, which can endanger participants and the potential for these therapies. Psychedelic therapy is not without its risks (see more in Jules Evans' Challenging psychedelic experiences project for more details - I plan to write more about valuable work in future). Implementing ethical and clinical standards is critical.
This should include:
Ensuring Participant Safety: Careful screening, medical supervision and appropriate dosing guidelines to minimise risks and promote safe environments.
Promoting Ethical Practices: Clear informed consent, confidentiality and professionalism protocols to prevent potential for exploitation and to build patient trust.
Facilitating Effective Treatment: While it’s important to understand how psychedelic-assisted therapies can be applied across various settings (like in clinics, retreats, etc), clinical research trials need to continue to develop and implement clearly defined protocols and allow for controlled comparisons to learn how psychedelic-assisted therapies can be most effective and for whom.
Preparation will typically include the following:
Thorough Screening: Studies show that psychedelic substances pose very little risk of fatal overdose or addiction. Due to their low potential for harm, experts categorize them among the least dangerous recreational substances. But that doesn’t mean they are entirely without risk. Because of this, psilocybin trials and ketamine clinics have strict exclusion criteria in an attempt to protect people who have physical or psychological vulnerabilities.
Encouraging the Development of an Intention: Peter Addy, PhD says, “Your intention is the purpose you set for your psychedelic experience. It’s your conscious reason for taking this profound inner journey in the first place. A psychedelic intention provides a focus point to guide your thoughts, emotions, and visions during the experience.”
Establishing a Trusting Therapeutic Relationship: Psychedelics amplify suggestibility and lower defenses, so set and setting shape experiences profoundly. A safe, comfortable environment and a trusting relationship (i.e a therapeutic alliance) with a compassionate guide(s) can help support this vulnerability and increase the likelihood of someone having a meaningful psychedelic experience.
Conclusion & Summary
Proper preparation is an essential component of safe and effective psychedelic-assisted therapy. Preparation typically involves screening participants for risks, establishing therapeutic intentions, cultivating openness, strengthening self-awareness, and committing to integration practices afterwards. While psychedelics show promise in treating mental health conditions, they also carry risks if not facilitated appropriately. By implementing careful protocols around screening, setting, dosing, and follow-up care, practitioners can help participants minimise harms and maximise benefits from these powerful catalysts for healing and growth. Ultimately, with proper standards of care in place, psychedelic-assisted therapy can provide opportunities to confront pain courageously and catalyse meaningful, lasting change.
Note: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified mental health professional for personalised guidance.
We welcome your thoughts and reflections on this article.
FREE Resources on Psychedelic Harm reduction:
Free video series on psychedelic-harm reduction, by Robin Carhart-Harris
At TNP, our preparation and integration therapists are a part of the Psychedelic Support Professionals Community. The Psychedelic Support website is a useful resource and provides FREE courses on harm reduction, substances guides and other information to help people make informed decisions about engaging in psychedelic therapies.
F.I.V.E, is an organisation providing necessary education for individuals to make informed decisions when considering taking 5-MeO-DMT, has provided key resources to learn more about red flags and what to look for in a safe facilitator.
See further resources on our integration therapy page (scroll to the bottom).
Related blog articles: Psychedelic Science
Psychedelic Integration: What is it and who can benefit from it? by Dr Sara Tookey
Psychedelic Integration Tools and Techniques by Dr Sara Tookey
Beyond the Hype: A Balanced Look at Psychedelic Therapy Risks by Dr Sara Tookey
Exploring the Psychedelic Renaissance: Psychedelic Therapy, a Crucial Conversation for Mental Health by Dr Sara Tookey
Stay Connected
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Visit our Integration Therapy Page to learn more about preparing for, making sense of, integrating, and coping with the residual effects and impact of a psychedelic experiences.
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Our TNP DISCLAIMER:
Our site provides information for educational purposes only, and is a platform to connect people with qualified therapists. It does not provide professional mental health or medical advice.
We do not offer psychedelic-assisted therapies or access to illegal substances. Requesting such services is prohibited.
We cannot help locate psychedelic-assisted therapy, guided sessions, or retreats.
We may provide publicly available information about eligible clinical research trials for research participation purposes only.
Our therapists provide support which adopts a harm reduction perspective and does not encourage illicit substance use.
We do not work with individuals experiencing active psychosis, although we can assist in making sense of past psychotic episodes for those under professional care.
We do not act as experts on psychedelics or altered states, nor provide advice on their use.
We are not liable for risks associated with using information from our site.
References
References from research cited:
Aaronson ST, van der Vaart A, Miller T, et al. Single-Dose Synthetic Psilocybin With Psychotherapy for Treatment-Resistant Bipolar Type II Major Depressive Episodes: A Nonrandomized Controlled Trial. JAMA Psychiatry. Published online December 06, 2023. doi:10.1001/jamapsychiatry.2023.4685.
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