Learning Psychedelic-Assisted Psychotherapy
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Learning Psychedelic-Assisted
Psychotherapy
Dr. Janis Phelps, Director
Center for Psychedelic Therapies & Research
Presentation for
Meditation and Psychotherapy: Learning from Non-Ordinary States
Cambridge Health Alliance/Harvard Medical School
May 1, 2021
DISCLOSURES
− The presenter certifies that there are no actual
or potential conflicts of interest in relation to
this presentation.
− This presentation discusses only legal and FDA-
approved uses of psychedelic medicines.
WHY CREATE ACADEMIC TRAINING
PROGRAM IN PSYCHEDELICS?
─ Upsurge of clinical & public interest in last 10 years
─ Demonstrated therapeutic efficacy for several medical
indications
─ Need for clinicians trained in this modality
─ Demand for public education on risk minimization with
psychedelic usage
Current State of Research on Psilocybin and MDMA
• FDA has approved Phase 3 research for MDMA for PTSD
o MAPS is approaching the end of the research in this
phase in next 9 months
o Many predict that the FDA is likely to approve this
medicine for PTSD in mid to late 2022
• FDA has approved Phase 2 research for Psilocybin for
Intractable Depression and Major Depression
o Phase 3 research will follow and likely conclude in 2023-
2024
MDMA Long-Term PTSD Outcome Study
Findings
Goals:
• Measured 12-month effects of MDMA-Assisted
Therapy for PTSD in First-Responders and
Veterans
Outcomes: (p
Summary of Psilocybin Findings
• Safety established: • Mystical Experience induced by
• No medical or psychiatric SAEs psilocybin:
• AE: Mild elevation BP • Mystical Experience mediated
• HA 28%; Nausea 14% improved clinical outcomes
• Feasibility established • Spiritually significant and meaningful
• Rapid acting anxiolytic and anti- experiences
depressant effects: • Decreased existential distress:
• Large magnitude of improvement • Demoralization
• Approximately 60-80% of • Hopelessness
participants continued with • Improved quality of life, spiritual well
clinically significant reductions in
depression or anxiety being, mood, behavior; death
transcendence (self-rated positive
• Sustained anxiolytic and anti- attitudes about death)
depressant effects:
• Overwhelmingly positive response from
• at least 7 weeks and up to 4.5
years in second follow-up public and media
• 2016 press release >1.5 billion views
Ross S. et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and
depression in patients with life-threatening cancer: a randomized controlled trial. J of Psychopharmacology.
2016 (12):1165-1180.
Agin-Liebes, G. et al. Long-term follow-up of psilocybin-assisted psychotherapy for psychiatric and existential
distress in patients with life-threatening cancer. J. of Psychopharmacology. 2020, 34(2): 155-166.
ELEMENTS OF AN IDEAL 150-HOUR
TRAINING CURRICULUM
─ Training in FDA-approved legal psychedelic research
and therapy
─ Academically accredited post-graduate training
─ For licensed and ordained mental health trainees
─ Partnered with MDMA and psilocybin research orgs
© CIIS 2020
Guidelines for the Training
Eligibility for Training
in Post-Graduate Certificate
─ Clinical and Counseling Psychologists
─ Physicians and Psychiatrists
─ Ordained/Commissioned Clergy and Chaplains
─ Registered Nurses and Nurse Practitioners
─ Naturopathic Doctors
─ Physician Assistants
─ Licensed Professional Clinical Counselors
─ Marriage and Family Therapists and Clinical Social Workers
─ Occupational Therapists
─ Advanced Alcohol and Drug Counselors
─ Traditional Chinese Medicine practitioners
─ Physical Therapists
12 Domains of Training
1. The history of clinical research and current legal status of
psychedelic-assisted therapy
2. Neurobiology, neuropharmacology, drug disposition and drug
interactions
3. Best practices in sets and settings: Preparation, psychedelic
session and integration
4. Psychedelics and therapeutic relationships: Transference,
boundaries, ethics and self-care
5. Supervised observation of psychedelic session videos
6. Variations in therapeutic models: Client-centered and
psycholytic psychedelic therapy
Phelps (2017 & 2019)12 Domains of Training
7. Complementary therapeutic techniques in psychedelic-
assisted therapy
8. Co-therapy methods and inter-professional skills for working
on multidisciplinary teams
9. Current models of consciousness, transpersonal intelligence
and mystical experiences
10. Ceremonial use of psychedelics in religious and community
settings
11. Individual and group clinical supervision during an internship
12. Personal experience of being guided as a research
participant in an FDA-approved study
Phelps (2017 & 2019)Philosophical Background
Safety in Psychedelic Sessions
Mentoring and Assessment Mentoring with Senior Researchers and Clinicians • 9 hours of group and individual mentor consultation Assessments: Formative and Summative • Trainees assessed at interview • Assessed trainee progress at 6 and 12 months • Mentors and trainees complete program evaluations Required Papers • Trainees write monthly process papers • Final paper summarizing learning or a publishable article
Psychedelic Therapist Competencies ü An empathetic abiding presence ü ü Trust enhancement ü Transpersonal intelligence ü Knowledge of the physical and psychological effects of psychedelics ü Therapist self-awareness and ethical integrity ü Proficiency in complementary techniques
Freud posits an optimal
attentional stance | mindful state
Freud repeatedly admonishes the analyst to
"suspend . . . judgment and give . . . impartial
attention to everything there is to observe”:
a) the absence of reason or deliberate attempts
to select, concentrate or understand
b) even, equal and impartial attention to all that
occurs within the field of awareness
~ Mark Epstein On Evenly Suspended AttentionMindfulness and Meditation:
Key Practices for Therapists and Clients Alike
Meditation is probably the best
preparation for a psychedelic session.
Those who have spent time in the
solitary attempt to manage the mind, to
eliminate thought, and to reach higher
states of concentration, are the best
candidates.
When the ego-loss state occurs, they are
ready. They recognize the process as an
end eagerly awaited.
— Leary, Metzner and Alpert (1962)Mindfulness and Mystical Experiences:
Protective Factors against Self-Importance
The mystical experience, whether induced by
chemicals or other means, enables the
individual to be so peculiarly open and
sensitive to organic reality that the ego begins
to be seen for the transparent abstraction that
it is.
— Alan Watts in The Joyous Cosmology
(1962)Huxley’s Ontological Response
Maybe it is private and there’s no unitive knowledge of
anything but one’s own physiology.
Who cares?
The fact remains that the experience can open one’s
eyes and make one blessed and transform one’s whole
life.
~ Aldous Huxley in IslandsDemographics of 2016 - 2020 Trainees
98 MDs, NDs, PAs, and Pharmacists
50 Clinical Psychologists
61 Marriage/Family Therapists and LPCCs
296 Professionals 35 Nurses
Licensed average of 15 years 41 Social Workers
7 Clergy and Chaplains
2 Traditional Chinese Medical Doctors
2 Physical / Occupational Therapists
Average Age: 41 years
Trainees Identified as People of Color: 28%
Women: 51% Men: 45% Non-Binary: 4%
Trainees Identified as LGBTQi: 21%Expanded Access and
Risk Evaluation and Mitigation Strategies
MDMA PsilocybinLikely Risk Evaluation and Mitigation Strategies
for Psilocybin and MDMA
• Designated clinics with certified clinicians
• Dyads of clinicians will provide therapies
• Licensed clinician will be dyadic lead with a
facilitator with a clinical BA, MS, and above
• New models of delivery will be explored:
e.g., groups, more integration therapy, family
assessmentNecessary Training Initiatives • Expansion of training programs to sites across the country • Licensed curricular material to share with other universities • FDA-approved training research for students in psilocybin and MDMA-assisted sessions • Online Public Education programs on risk mitigation for psychedelics, particularly in decriminalized regions
The most beautiful and profound emotion we can
experience is the sensation of the mystical. It is the sower
of all true science.
… for whom this emotion is a stranger, who can no longer
wonder and stand rapt in awe, is as good as dead.
To know that what is impenetrable to us really exists,
manifesting itself as the highest wisdom and the most
radiant beauty, which our dull faculties can comprehend
only in their primitive forms.
~ Albert Einstein, The Merging of SpiritIt is my great concern to separate psychedelics from the
ongoing debates about drugs, and to highlight the potential
inherent to these substances for self-awareness, as an
adjunct in therapy, and for fundamental research into the
human mind.
It is my wish that a modern Eleusis will emerge, in which
seeking humans can learn to have transcendent experiences
with sacred substances in a safe setting.
I am convinced that these soul-opening, mind-revealing
substances will find their appropriate place in our society
and our culture.
~ Albert Hofmann, in a letter from April, 2007THANK YOU
Dr. Janis Phelps, Director
Center for Psychedelic Therapies and Research
www.ciis.edu/cptr
Information: lpustarfi@ciis.eduYou can also read
