Acute support

Teaches how to obtain and maintain valid informed consent through clear disclosure, comprehension checks, capacity support, voluntariness, non-coercion, and respect for refusal or withdrawal. The competency also covers consent for screening procedures, recordings, collateral contact, rescue interventions, and documentation of the consent process.

Cluster covering 31 related competencies including: Integration support, Integration therapy, Integration coaching.

Teaches protection of participant identity, sensitive clinical or occupational information, recordings, and research data. The competency covers coded identifiers, restricted access, secure handling, confidentiality safeguards, and privacy-preserving documentation.

Cluster covering 35 related competencies for monitoring acute psychological effects, recognising and managing distress, crisis containment, emergency escalation, and rescue-medication coordination during psychedelic dosing sessions.

Teaches how to detect, elicit, document, and report adverse events and serious adverse events across the participant journey. The focus is accurate source documentation, regulatory reporting discipline, follow-up, and preservation of participant safety and trial integrity.

Teaches structured assessment of suicidal ideation, intent, psychiatric deterioration, and related high-risk presentations. Learners are trained to use appropriate tools, safety planning, emergency contacts, clinician access, and escalation pathways when risk is identified.

Teaches how to assess clinical suitability before psychedelic or ketamine treatment, including medical and psychiatric screening, readiness evaluation, contraindication review, inclusion/exclusion criteria, and ongoing eligibility re-checks before dosing.

Teaches faithful delivery of manualized treatment and protocol-defined procedures while documenting and managing unavoidable deviations. The competency protects participant welfare, treatment consistency, data integrity, and sponsor oversight.

Teaches ongoing participant contact after dosing to support stability, detect delayed adverse effects, maintain therapeutic containment, and sustain adherence to follow-up visits and outcome assessments.

Teaches recognition of medical or psychiatric emergencies and the steps required to escalate care safely. The competency includes de-escalation, clinical consultation, 911 or emergency department transfer, serious-event escalation, and referral to appropriate higher-level care.

Teaches how to determine when a participant is safe to leave after dosing and how to arrange appropriate supervision afterward. The competency covers psychological and physical stability, escort/support-person coordination, discharge restrictions, overnight or post-session support, and follow-up contact when needed.

Teaches review and management of concomitant medications, restricted therapies, prohibited substances, washout periods, tapering requirements, and abstinence expectations. The competency includes participant counseling, medication reconciliation, sponsor notification, and team coordination when restrictions affect safety or interpretability.

Teaches delivery of psychedelic-assisted psychotherapy according to an approved study manual across preparation, dosing, integration, and follow-up. The competency balances standardized structure with non-directive support for the participant’s therapeutic process.

Teaches accurate study documentation, source-record quality, secure data capture, Good Clinical Practice recordkeeping, IRB and sponsor documentation requirements, monitoring readiness, audit support, accountability, and retention obligations.

Teaches how to preserve blinded trial conduct across participant interactions, outcome collection, staff roles, and session procedures. The competency includes preventing accidental unblinding, minimizing bias, and using emergency unblinding only when clinically necessary.

Teaches coordinated practice across co-therapists, physicians, psychiatrists, study coordinators, principal investigators, and other care-team members. The focus is shared responsibility, clear communication, role clarity, and coordinated observation of participant status.

Teaches how to understand ClinicalTrials.gov records and related study information, including glossary terms, registration fields, protocol descriptors, and results-reporting elements used to interpret clinical research records.

Cluster covering 2 related competencies including: Therapeutic alliance building, Therapeutic alliance and rapport building.

Teaches how to maintain clear relational and physical boundaries in emotionally vulnerable treatment settings. This includes professional conduct, rapport without overreach, explicit consent for touch, the right to revoke consent, and strict prohibition of sexual or erotic contact.

Teaches continuous monitoring for distress, confusion, psychotic symptoms, suicidality, agitation, and other acute behavioral risks during and after dosing. The focus is early recognition, documentation, and escalation to clinical support when risk emerges.

Cluster covering 3 related competencies including: Physical safety monitoring, Safety monitoring during dosing sessions, Medical safety monitoring during psilocybin administration.

Provides supportive therapeutic presence while the patient is under the influence of ketamine. Uses calming, noncoercive guidance to help the patient navigate dissociation and emotional material.

Cluster covering 11 related competencies including: Preparation support, Psilocybin preparation, Therapeutic preparation.

Teaches structured pre-dose preparation and post-dose integration as the therapeutic frame for psychedelic-assisted psychotherapy. The therapist supports rapport, intention clarification, meaning-making, emotional processing, and consolidation of insights after dosing.

Teaches monitoring and response for acute physiological risks, including vital signs, temperature, hydration, overheating, excessive fluid intake, and suspected overdose. The competency emphasizes supportive care, medical coordination, documentation, and escalation when needed.

Ability to perform or supervise detailed psychiatric evaluation for diagnosis, eligibility, and ongoing monitoring. The therapist/facilitator must understand symptom presentations relevant to MDD, AUD, suicidality, psychosis, and dissociation.

Know the medical and psychiatric exclusions that protect participants from foreseeable harm. Facilitators must recognize conditions that make MDMA-assisted psychotherapy unsafe or inappropriate.

Cluster covering 6 related competencies including: Therapeutic support during dosing, Nondirective dosing-session presence, Supportive dosing-session facilitation.

Teaches recognition and management of expected and unexpected side effects during psychedelic or ketamine treatment. The competency emphasizes active observation, supportive response, and clinical escalation when symptoms exceed routine tolerability.

Cluster covering 9 related competencies including: Psilocybin facilitation, Psilocybin session support, Psilocybin facilitation basics.

Therapists must facilitate rather than control the participant's process, using invitations and timing interventions carefully. They should preserve the participant-led unfolding of experience while knowing when gentle direction or safety-based assertiveness is needed.

Teaches practices that support preparation and therapeutic presence, including mindfulness, intention-setting, body-aware attention, environmental preparation, mindset awareness, and regulation through somatic presence.

Cluster covering 7 related competencies including: Physiologic safety awareness, Hallucinogen pharmacology and effects, Hallucinogen-assisted therapy knowledge.

The protocol requires active monitoring for psychedelic-specific adverse events such as hallucinations, psychotic symptoms, dissociation, mood alteration, and cognitive disturbance. These require immediate notification and follow-up.

Cluster covering 12 related competencies including: KAP psychotherapy delivery, Ketamine and KAP knowledge, Ketamine integration planning.

Teaches structured monitoring of depressive symptoms, response, and remission across treatment and follow-up. Learners use standardized scales and clinical review to track change and identify deterioration or non-response.

Clinicians and research staff must clearly educate participants about study procedures, risks, side effects, restrictions, and possible benefits, and obtain written informed consent before screening and study participation. Ethical delivery depends on transparent communication and opportunities for questions.

Teaches recognition and documentation of dissociation, psychosis-like symptoms, mania, and other acute neuropsychiatric effects that can occur after ketamine, psychedelic dosing, or related interventions. The focus is monitoring, reporting, and escalation when symptoms become clinically significant.

Cluster covering 2 related competencies including: Psychedelic-assisted therapy facilitation, Group facilitation in a psychedelic setting.

Teaches culturally responsive psychedelic care, including humility, anti-bias practice, Indigenous and traditional-use awareness, cultural appropriation concerns, diversity and inclusion, and respectful work with marginalized communities.

Therapists must be able to teach and coach grounding practices that help participants regulate during preparation and dosing. These methods are used before medication and during distress.

Teaches clinicians and research staff to understand the purpose, limits, scoring, interpretation, and clinical meaning of psychological measures and study instruments used to evaluate symptoms, functioning, safety, and treatment outcomes.

Understand the pharmacology and interaction risks of 5-MeO-DMT/BPL-003, including serotonergic and cardiovascular concerns. This knowledge informs safe preparation, exclusion screening, and monitoring.

Teaches a trauma-informed stance during psychedelic work, including calm presence, non-verbal reassurance, body-aware support, somatic orientation, and containment through difficult experiences while maintaining safety and boundaries.

The study used standardized anxiety measures and followed patients for 2 months and 12 months, implying competence in tracking outcomes over time. Therapists should be able to assess symptom change and sustained benefit using structured follow-up.

Cluster covering 2 related competencies including: Medical escalation and rescue medication use, Medical escalation and rescue medication coordination.

Cluster covering 4 related competencies including: Therapeutic rapport building, Rapport building and trust development, Therapeutic rapport and trust building.

Therapists must help patients face and work through grief, fear, rage, panic, shame, guilt, and existential distress rather than avoid them. The clinician supports emotional expression while maintaining safety and meaning-making.

Facilitate trauma exposure in a structured, supportive, and protocol-consistent manner. The therapist must be able to initiate, pace, and process exposure work while maintaining adherence to PE methods.

Monitors participant physical status during study visits and identifies concerning changes requiring escalation. Vital signs and symptomatic changes are part of routine safety observation.

Cluster covering 4 related competencies including: Psychedelic therapy workflow, Psilocybin psychotherapy framework, Psilocybin-assisted psychotherapy framework.

Teaches continuous evaluation of clinical risk and maintenance of a safe care environment throughout preparation, dosing, and follow-up. Learners monitor risk signals, apply safety procedures, and escalate care when needed.

Teaches providers to create and maintain a psychologically and physically safe therapeutic setting through clear structure, preparation, boundaries, attunement, environmental design, and ongoing attention to participant safety.

Ability to administer and interpret structured interviews, clinician ratings, and self-report measures used in the study. Therapists contribute to eligibility, safety, and outcome assessment.

Therapists and study clinicians perform detailed biopsychosocial interviewing during preparation and screening. This supports treatment planning, risk assessment, and therapeutic understanding.

Facilitators must be able to contain and support intense psychological distress during the session. The study notes that the experience could be emotionally difficult even when participants felt safe.

Therapists/investigators must understand the medical suitability requirements for LSD-assisted psychotherapy and coordinate medication washout and concomitant medication review. This includes recognizing drug-drug interaction risks and contraindications.

Prepare participants for the dosing session and guide them through standardized procedures. The facilitator should ensure readiness, adherence to study rules, and smooth progression through the session schedule.

Therapists must ensure continuity of care after the acute session, including overnight observation and next-morning integration before discharge. This reflects a containment and recovery responsibility beyond the dosing period.

Therapists/facilitators must know the psychiatric and medical conditions that make KPT unsafe or inappropriate. Safe practice depends on excluding high-risk individuals.

Knows when to involve physicians, psychologists, and independent safety oversight. Complex psychedelic sessions require clear escalation pathways and team coordination.

Monitor and respond to the expected sympathomimetic effects of MDMA. The therapist/facilitator must be alert to transient increases in blood pressure, pulse, and related cardiac symptoms.

Cluster covering 2 related competencies including: Preparation of set and setting, Client preparation and therapeutic set/setting.

The training includes appropriate use of therapeutic touch as part of safe delivery. Learners are expected to use touch judiciously and within ethical boundaries.

Cluster covering 2 related competencies including: Safety monitoring during ketamine dosing, Physiologic monitoring during ketamine administration.

Therapists should accurately represent the current evidence base and avoid overstating efficacy or durability. The article notes significant short-term benefit but also the need for larger multicenter trials and longer follow-up.

Understand the characteristic acute experiential domains elicited by ayahuasca. This includes perceptual, somatic, cognitive, affective, mystical, and temporal-spatial alterations.

Administer and interpret psychological and psychometric measures relevant to mood, cravings, expectations, mystical experience, ego dissolution, and functioning. Facilitators must accurately support questionnaire-based assessment across time points.

Provide a calm and supportive environment during treatment to reduce distress and support tolerance of the experience. The case report notes food, rest, and a quiet place as part of care.

Create an environment that supports safety, comfort, and relaxation during the session. The setting is deliberately structured to reduce anxiety and facilitate a positive experience.

Ability to evaluate alcohol and other substance use patterns using standardized tools and clinical interview. This is essential for eligibility, safety, and outcome monitoring.

Therapists and study personnel are expected to receive structured training and ongoing supervision. Competence includes both protocol adherence and the ability to work safely and consistently across sites.

Teaches recognition and management of relational dynamics that can intensify in psychedelic-assisted therapy. Learners develop self-awareness around countertransference, projection, attachment, dependency, and other therapeutic-process risks.

Cluster covering 3 related competencies including: Ethical psychedelic facilitation, Safe, legal psychedelic care facilitation, Ethical decision-making in psychedelic facilitation.

Cluster covering 5 related competencies including: Concomitant medication review, Contraindication and interaction awareness, Contraindications, drug effects, and interactions.

The page signals training in managing difficult or high-risk moments, including crisis intervention and trigger management. Learners are expected to respond appropriately when a session becomes destabilizing or unsafe.

The therapist is responsible for giving truthful, individualized preparation and reassurance about the experience, including likely sensations, risks of resistance, and expectations for conduct. The preparation aims to reduce fear, improve cooperation, and support voluntary participation.

Cluster covering 4 related competencies including: Integration and debriefing, Integration and debriefing facilitation, Integration and post-session debriefing.

Facilitators must understand the expected psychological, physiological, and potential adverse effects of MDMA in order to prepare participants, support the session, and detect complications.

Uses motivational interviewing methods to strengthen intrinsic motivation and commitment to change. Tailors discussions to the participant’s ambivalence, goals, and readiness to change drinking behavior.

Facilitators must balance active safety monitoring with minimal interference in the participant’s inner experience. The role includes maintaining continuous presence, periodic check-ins, and preserving the therapeutic container of the session.

Conduct preparatory sessions that orient the subject, assess readiness, and set expectations for MDMA-assisted psychotherapy. These sessions are used to prepare for safety, adherence, and therapeutic engagement.

Administer study measures and structured assessments on schedule, including psychological, spiritual, and neurobehavioral instruments. This includes both paper-based and Storyline-based assessments.

Ability to provide a consistent, supportive therapeutic environment during intensive psychedelic-assisted sessions. The facilitation role depends on maintaining trust and emotional safety.

The facilitator should know how oral and intravenous dosing relate to onset, duration, and peak effects. This knowledge supports proper session planning, monitoring, and integration timing.

Responds respectfully to spiritual, mystical, and value-related themes that may arise during psilocybin sessions and debriefing. Integrates these themes into therapy without imposing interpretations.

Therapists are expected to provide consistent empathic presence, nonjudgmental attunement, and deep listening throughout the process. This includes validating feelings, listening for deeper meaning, and creating psychological permission for openness.

Therapists/facilitators should be able to judge whether therapeutic change reaches clinically meaningful thresholds, not just whether symptoms improve numerically. This supports informed ongoing care and communication about benefits and limitations.

The protocol assumes therapeutic value in insight, catharsis, and peak experiences, so the therapist must support conditions that may allow these to emerge safely and meaningfully. This includes recognizing and working with symbolic and transformative material.

The facilitator must administer and coordinate patient-rated and clinician-rated measures while minimizing bias. Assessments should be completed independently and in the correct order.

Cluster covering 5 related competencies including: Cardiac safety monitoring, Ketamine infusion monitoring, Ketamine infusion administration.

Understand the basic pharmacology and clinical effects of ayahuasca to inform safe facilitation and interpretation of responses. The source identifies dimethyltryptamine as a 5-HT2A agonist and harmine as a monoamine-oxidase A inhibitor.

Teaches monitoring during down-titration or discontinuation of psychiatric medications before dosing. Learners track withdrawal symptoms, symptom worsening, suicidality, and other risks that may emerge during tapering.

Can identify and involve support persons, attendants, and outside providers to enhance safety. The facilitator must coordinate practical supports while respecting confidentiality and protocol boundaries.

Cluster covering 2 related competencies including: Psilocybin psychoeducation, Psychedelic psychoeducation and expectation management.

Therapists should support evaluation, emotional processing, and integration after the acute experience. This includes helping patients reflect without over-directing or interrupting the process.

Possess sufficient knowledge of chronic treatment-resistant PTSD to support subject selection, psychotherapy, and symptom monitoring. The protocol situates the intervention within established PTSD symptom and treatment frameworks.

Adapt language and interpersonal style to the patient’s preferences to promote dignity and comfort. The therapist should also respect the patient’s autonomy within safety limits.

The therapist must create an atmosphere of confidence and mutual understanding before ketamine administration. This relationship is treated as a key therapeutic factor in the protocol.

Cluster covering 2 related competencies including: Session facilitation and therapeutic holding, Session facilitation and support during intense experiences.

The protocol implies that facilitators should have specific psychiatric, psychotherapeutic, or psycholytic therapy training relevant to altered-state treatment. Specialized experience supports safe and effective delivery of LSD-assisted psychotherapy.

Understand how treatment expectations can influence treatment response and study interpretation. Facilitation must avoid inadvertently shaping expectations in a biased or misleading way.

Cluster covering 2 related competencies including: Integration of psychedelic experience with behavior change, Facilitate integration of experience into behavioral change.

Facilitators are responsible for ensuring that participants have provided informed consent before receiving MDMA-assisted therapy. This reflects an ethical and regulatory duty central to work with investigational treatments.

Therapists/facilitators need judgment about dosing and setting so experiences remain tolerable and therapeutically useful. The paper repeatedly notes that when dose and setting are appropriate, emerging material remains within the patient’s capacity to cope.

Study clinicians are responsible for administering study drug, ensuring correct dose assignment, and supervising safe oral ingestion during blinded sessions. This includes verifying visit-specific randomization information and ensuring dosing is delivered under the blinded workflow.

Coordinate effectively with the study clinician, medical monitor, rater team, and MRI staff. Facilitation is embedded in a broader clinical-research workflow requiring timely communication.

The course teaches how to work with the 'Inner Healing Intelligence,' indicating a non-directive or facilitative stance toward client-led healing processes. This is framed as a core therapeutic concept in psychedelic work.

Teaches sustainable self-care practices for clinicians and facilitators working in emotionally intense settings. The competency supports emotional resilience, ethical boundaries, reflective practice, and burnout prevention.

Teaches clinicians to recognise their role boundaries, align services with training, licensure, supervision, and organisational policy, and refer or escalate when participant needs fall outside their scope of competence.

The program includes facilitator development and self-care, and it explicitly calls on learners to recognize personal limitations and seek support. This suggests training in reflective practice and professional self-management.

The course explicitly mentions the role of music and therapist variables in treatment. Learners are expected to understand how these elements influence the PAP experience and therapeutic outcome.

The page points to checklists and a guide to basic medical emergencies, indicating that learners should be able to monitor safety and recognize urgent issues. The overall training context also stresses keeping both client and practitioner safe.

Therapists should support an appropriate rhythm between inward experiential focus and verbal interaction, with either therapist or participant able to initiate shifts.

Respond to agitation or attempts to leave the room in a way that preserves safety for the patient and others. The therapist should use containment, redirection, and escalation protocols when needed.

Therapists must prepare the subject for residual effects after the main session and provide practical safeguards for sleep, transportation, and home support. This includes framing recurrence of symptoms in a non-alarming way.

The study emphasizes the absence of acute or chronic adverse effects persisting beyond 1 day and no treatment-related serious adverse events, indicating the need for active monitoring during and after treatment. Facilitators must be able to observe, document, and respond to adverse reactions.

Understands the drug’s rapid absorption profile and lack of accumulation with repeated dosing. Uses this knowledge to anticipate timing of effects and safety observations.

Follows the study's operational rules for dose timing, progression, and stopping conditions. Reliable execution is necessary for both safety and interpretability of results.

Understand and apply a therapeutic framework centered on psychological flexibility. The intervention was explicitly described as time-limited and relational, with this focus guiding therapist work.

Monitors for potential adverse effects associated with ibogaine administration and the detoxification period, even though the abstract primarily reports outcomes rather than specific events.

At least one therapist must be able to teach stress inoculation methods, especially diaphragmatic breathing, and apply breath-based interventions during sessions. Breath is used both for relaxation and for staying present with difficult experience.

Facilitators must competently administer and interpret clinician-rated ADHD and global severity measures. Accurate scoring is essential because these scales determine eligibility and outcomes.

Therapists must have a thorough understanding of MDMA’s subjective, relational, and physiological effects, including the non-linear way these may support healing. This knowledge is necessary for preparation, in-session decisions, and normalization of participant experiences.

Therapists should orient to and explore the participant’s somatic experience, both in experimental and integrative sessions, as a central channel of processing.

Students learn to use language and questions that deepen a client’s inner experience and support healing. This is a practical communication competency for facilitation and integration work.

Understand the proposed mechanisms, phases of effect, and common subjective and physical effects of ibogaine relevant to clinical supervision. This knowledge informs safe monitoring and therapeutic pacing.

Use brief mindfulness practices and grounding strategies to stabilize attention and reduce distress before and during the session. These techniques help the patient reconnect to present-moment awareness and bodily sensation.

Focused bodywork is an optional advanced intervention used to facilitate release of blocked emotion or somatic tension when spontaneous processing has stalled. Therapists need specific judgment and skill to apply it safely and only when indicated.

Facilitator can teach and cue mindfulness practices consistent with the study protocol. Mindfulness is presented as present-moment, nonjudgmental awareness.

Evaluates opioid withdrawal symptoms and tracks changes over time in participants discontinuing methadone OST. Uses standardized withdrawal ratings to assess potential treatment effects and safety.

Ability to observe and respond to participants during MDMA medicine sessions, including both psychological experience and physiological change. The protocol indicates an interest in psychological and physiological processes of change during treatment.

The protocol explicitly addresses the risk of undue influence when investigators recruit current or former patients, requiring safeguards and ongoing monitoring for coercion.

Therapists must understand MDMA’s expected subjective, interpersonal, and physiological effects and prepare participants accordingly. This knowledge supports normalization, reassurance, and effective use of the medicine within therapy.

Facilitators need practical skills in preparing participants emotionally for ketamine administration and reducing distress. The protocol highlights relaxation, breathing, and grounding strategies to reduce anxiety or discomfort associated with the drug experience.

Because the protocol involved specific LSD doses, active placebo control, and session spacing, facilitators need applied skill in implementing dosing-session procedures safely and consistently. This includes maintaining therapeutic support while adhering to protocol constraints.

Therapists should identify or teach in-session coping tools and collaboratively plan how anxiety states will be recognized and supported.

Help patients engage in emotionally intense trauma-focused treatment and reduce dropout risk. The therapist should recognize comorbid depression or anxiety that may interfere with adherence and response.

Therapists must be specifically trained in psilocybin-assisted psychotherapy and in the study’s manualized procedures. Competence includes familiarity with the therapeutic model and difficult-state management guidance.

Cluster covering 5 related competencies including: Harm-reduction orientation, Harm reduction and risk awareness, Harm reduction for client support.

Cluster covering 2 related competencies including: Trauma-informed care, Trauma-informed psychedelic care.

Teaches practitioners to identify and apply relevant legal, regulatory, ethical, and institutional requirements, including documentation, consent, reporting, controlled-substance, and jurisdiction-specific obligations.

Cluster covering 2 related competencies including: Facilitation of psychedelic journeys, Psychotherapeutic facilitation methods.

Learners are explicitly offered Basic Life Support training, indicating emergency readiness and medical safety preparation. The page notes DORA-required status, signaling regulatory safety relevance.

The course explicitly discusses confidentiality, especially in underground practice and with anonymous practitioners. Learners are expected to understand confidentiality as a core part of maintaining safe and effective psychedelic care relationships.

Cluster covering 2 related competencies including: Dosing-day facilitation, Dosing-session facilitation.

Responds to distressing anxious or psychotic reactions with verbal de-escalation and, if needed, rescue medications. Escalates intervention in a stepwise manner based on clinical response.

Track the participant’s subjective drug intensity during the active phase of the session. This includes recognizing when the participant cannot respond and how to document maximum intensity.

Develop follow-up care after the acute ibogaine period to support behavior change and relapse prevention. The manual emphasizes that the treatment session alone is not enough for long-term recovery.

Ability to contribute to evaluation of the effectiveness of LSD-assisted psychotherapy. The study is explicitly described as investigating safety and effectiveness.

Track onset, duration, and phases of ibogaine effects as part of clinical monitoring. The manual describes multiple stages of effect and expects the provider to observe them carefully.

Collect and interpret baseline behavioral, psychiatric, and medical history relevant to psilocybin research. This information is used to determine eligibility and contextualize outcomes.

Use physical contact only when necessary, explicitly permitted, and minimal. The facilitator must respect participant autonomy and avoid any contact that is not justified for safety or grounding.

Therapists must skillfully time check-ins and interventions to sustain process without unnecessary intrusion. They monitor silence, talking, avoidance, and signs of internal engagement to decide when to inquire, redirect, or simply witness.

Tracks dose-dependent changes without assuming full psychedelic effects. This includes recognizing that low-dose exposure may modulate brain activity while remaining sub-psychedelic.

Understand the role of serotonergic mechanisms and the implications of receptor antagonism for acute psychedelic effects. Use this knowledge to interpret responses and co-administration effects.

Understand that classic psychedelics can cause moderate increases in blood pressure, heart rate, temperature, and pupil size without necessarily indicating severe toxicity. Proper interpretation helps avoid overreaction while remaining vigilant.

The therapist/facilitator should know the expected onset, peak, and persistence of effects to guide monitoring and interpretation. The source reports acute effects with follow-up improvements lasting days.

Therapists must provide continuity, availability, and clear support structures after MDMA sessions to reduce anxiety and manage emerging difficulties. This safety net extends beyond the dosing day.

Therapists should cultivate openness about both the participant’s process and their own interpretations. This prevents forcing experience into rigid theoretical frames and supports curiosity and compassion.

Help patients develop coherent, values-consistent meaning from difficult experiences and MDMA session material. Meaning-making is treated as a core ingredient of recovery and post-traumatic growth.

Recognizes medical factors that may increase risk during inhaled 5-MeO-DMT administration. Medical clearance is required before dosing.

Elicit and strengthen motivation to quit smoking and remain abstinent. Facilitators use sessions to explore values, reasons for quitting, and treatment commitment.

Use music intentionally as part of the therapeutic environment and processing sequence. Music should support, not direct, the patient’s unfolding internal experience.

Facilitators must protect participants and others from harm without unnecessarily restraining the participant. The guidance emphasizes containing danger rather than restraining movement.

A study physician with psychiatric and cardiovascular emergency expertise must be available during dosing. This reflects a requirement for advanced emergency readiness and clinical judgment.

Treat consent as a continuing process rather than a one-time event. Patients must understand the treatment and retain the ability to revoke consent, with special procedures during the medication session for safety.

Knowledge of the trial’s primary, secondary, and exploratory endpoints and the instruments used to assess them. This enables accurate administration and interpretation of study procedures.

The therapist must recognize confusion, paranoia, referential thinking, withdrawal, or grandiosity and respond with steady trust, containment, and continued presence. Management skill is particularly important because these reactions may still be workable and may shift with proper handling.

Monitors patients closely during treatment because serious adverse outcomes may occur. Safety monitoring is essential given that one participant died during treatment in the study.

Ability to assess whether the target acute psychedelic experience has occurred using the study-defined scale and threshold. This was used to guide individualized dosing.

A major therapist competency is preparing patients extensively for the ketamine session, including the nature of the special state of consciousness and possible ego dissolution or separation from the body. Preparation is both educational and psychotherapeutic.

Conduct or support psychiatric screening using clinical interviews and structured diagnostic tools. The goal is to establish baseline mental health status and detect exclusionary disorders or instability.

Facilitators should understand that treatment aims include symptom reduction and improved functioning. Support work should attend to both emotional processing and real-world disability.

Facilitators must watch for slowed breathing, sleep apnea-related hypoxia, disordered breathing, and oxygen desaturation. Oxygenation needs ongoing assessment during the acute and post-acute periods.

Carry out baseline medical safety checks prior to intervention initiation. These assessments reduce risk and support participant suitability.

Recognize when post-session exhaustion or discomfort may warrant supportive symptom management and understand the limited use of sedatives in the protocol. The facilitator must balance comfort with safety and document any sedating agents used.

The facilitator should be able to manage a brief but intense treatment window. The source suggests a shorter-acting psychedelic may enable rapid onset of response and reduce burden compared with longer-acting agents.

Therapists must assess the participant’s social support network and help plan appropriate use of supportive relationships during treatment. They should guide participants about the potential benefits and risks of sharing their experiences with others.

Ability to facilitate long-duration psychotherapy sessions in a controlled research setting. The study used two 8-hour psychotherapy sessions, requiring sustained therapeutic presence and session management.

Use Subjective Units of Distress Scale ratings to track fear activation and extinction during PE sessions. This requires eliciting reliable distress ratings and using them to guide exposure processing.

Therapists must understand that parts, selves, subpersonalities, or dissociative-like multiplicity can emerge normally, especially in trauma. They should not pathologize these experiences and should help use them therapeutically.

The curriculum explicitly includes therapist self-regulation as a therapeutic skill. This suggests learners are expected to maintain steadiness and presence while supporting clients in altered states.

The therapist should assess both the immediate experience and longer-term change, using structured observation, self-report, and reports from others where possible. The handbook treats evaluation as difficult but necessary for understanding therapeutic effects.

Understand the expected acute physiological effects of BPL-003 and monitor for clinically meaningful changes. The facilitator should recognize that transient blood pressure and heart rate increases may occur.

Measure opioid withdrawal severity using standardized instruments and interpret symptom severity over time. Facilitators must be able to collect both objective observation and patient-reported data.

Teaches how to interpret the psychedelic clinical evidence base, compare strength of evidence across indications, understand mechanism theories, and critically appraise research claims. The competency supports evidence-informed practice rather than relying on general field narratives.

Cluster covering 2 related competencies including: Preparation and therapeutic alliance, Preparation and therapeutic alliance building.

Cluster covering 2 related competencies including: Psychedelic integration support, Psychedelic knowledge integration.

Cluster covering 2 related competencies including: Trauma-informed practice, Trauma-informed clinical practice.

Clinicians must recognize the life-threatening nature of alcohol withdrawal and ensure adequate detoxification before treatment. Postponement and medical supervision are required when withdrawal risk is present.

Use supportive anxiolytic or hypnotic medication only when allowed and clinically indicated. This requires careful judgment to balance comfort, safety, and preservation of the session’s integrity.

Assistant facilitators require practical clinical experience in a licensed healthcare setting. Their role supports safety, containment, and session logistics rather than independent psychotherapy practice.

At least one therapist in the dyad must be a clinician with capability to assess and manage medical or psychiatric adverse events during the dosing session. This reflects a required competency boundary between general support and clinical responsibility.

Ketamine-assisted treatment in this protocol is multidisciplinary, so facilitators must work closely with study doctors and nurses. This includes coordinating preparation, understanding monitoring responsibilities, and escalating concerns appropriately.

Work collaboratively with the patient, sharing observations and options while preserving the patient’s authority over their process. This supports empowerment in the context of trauma-related loss of control.

Facilitators may use ritual, music, prayer, altar work, or minimalist approaches to frame the experience. Whatever the style, they should use contextualization intentionally and in service of the participant’s process.

The training framework explicitly includes cultural awareness and inclusion, and examples identify culturally insensitive behavior as clinically inappropriate.

Interprets mescaline responses in light of the study population and design. Understands that findings from healthy subjects may not directly generalize to clinical populations or unsupervised use.

Therapists should guide participants toward practices that support reflection, grounding, and continuing integration between visits. These activities extend the therapeutic process beyond formal sessions.

Help participants form and revise therapeutic goals in a way that stays aligned with the intervention. Goals are one of the core dimensions of working alliance measured in the trial.

Therapists must teach patients to reactivate the acceptance, reduced fear, and interpersonal openness experienced during MDMA sessions when confronting later stressors. This helps convert acute session experiences into durable coping skills.

During ketamine administration, the therapist provides continuous emotional support while the patient reclines with eyeshades and music. This support helps the patient tolerate and make use of the psychedelic experience.

Works with the combined clinical picture of chronic pain, depression, anxiety, and PTSD symptoms. Provides psychotherapy that is responsive to both somatic and psychiatric suffering.

Providers must be able to recognize and safely manage acute confusional states, which may look like a psychological break from reality. The emphasis is on physical safety, constant supervision, and avoiding abrupt antipsychotic intervention.

Plans and maintains support for sessions that may last many hours. Duration of effects can be substantial and requires sustained facilitator availability and structured observation.

Therapists/facilitators must monitor for adverse medical signs during sessions and obtain targeted testing when clinically indicated. Safety practice should balance participant comfort with symptom-triggered medical evaluation.

During onset, therapists must help the subject stay relaxed, accept changes, and avoid fixation on somatic discomfort or irrelevant ideation. Music and reassurance are highlighted as practical tools for reducing fear and helping the subject welcome altered perception.

Therapists should have standard training in psychotherapy for anxiety associated with medical illness and would benefit substantially from personal familiarity with non-ordinary states of consciousness. Such understanding improves empathy, confidence, and process navigation.

Before symptoms begin, the therapist must prevent boredom, over-monitoring for effects, and escalating apprehension. This phase is treated as crucial because the psychological set established here shapes much of what follows.

The facilitator should understand that effects observed in a controlled clinical setting may differ from those in ceremonial or ritual contexts. This awareness shapes interpretation and informs safer translation to other settings.

Understands that mescaline is a classic serotonergic psychedelic with substantial acute psychoactive effects. Uses this knowledge to prepare for altered perception and prolonged subjective responses.

Recognizes that a study involving a psychoactive compound requires careful attention to participant safety during screening and participation. Even though the source does not detail procedures, a facilitator must anticipate risk-aware monitoring and escalation.

Know that ayahuasca composition can vary and that chemical characterization matters. Facilitators or clinical teams should understand the potency and stability of the administered brew.

Participants may express the medicine through shaking, curling, dancing, screaming, glossolalia, orgasm, or other intense bodily responses. The facilitator should recognize these as possible natural responses and support them appropriately.

The article indicates that a structured, supportive context is associated with more positive acute and enduring effects and fewer challenging experiences. Facilitators should actively design the session context around safety and support.

Therapists must create and maintain a calm, supportive setting during MDMA administration. The session environment is intended to maximize comfort and facilitate therapeutic work while minimizing risk.

Monitor body temperature during sessions and intervene if it rises beyond expected limits. The protocol specifies active cooling steps and escalation thresholds.

The handbook describes skillful use of music, images, mirrors, and simple comforts to guide attention, reduce distress, and deepen self-examination. These supports are not incidental but part of the structured method.

A key applied skill is knowing when to remain silently present, when to inquire, and when to offer more active guidance. Effective work depends on moment-to-moment attunement to verbal, nonverbal, historical, and pharmacological cues.

Therapists should respond as though whatever arises in session—pleasant, difficult, peripheral, symbolic, or practical—may have relevance to healing.

Facilitators may use sound and scent intentionally to support launch, peak, and re-entry, but these modalities must never become distracting. They need judgment about timing, dosage, and participant responsiveness.

Help participants direct attention to their own present-moment internal experience and explore it from multiple perspectives. This is practiced in preparation and used to support participants if challenging material emerges during dosing.

Support patients through acute opioid withdrawal during ibogaine treatment when withdrawal symptoms are present. The source describes use of oral hydromorphone for symptom relief within the protocol.

Teaches applied competence through role play, case discussion, peer consultation, seminars, mentorship, and learning-community structures. The emphasis is translating theory into practice, receiving feedback, and developing reflective clinical judgment with peers.

Cluster covering 4 related competencies including: Ethical practice, Ethics in psychedelic care, Ethics and ethical practice.

Teaches the neurobiological basis of psychedelic and non-ordinary states, including default mode, salience, fear, and related brain-network models. The competency links altered-state phenomenology with therapeutic mechanisms and clinical implications.

Cluster covering 2 related competencies including: Dosing-session framework, Dosing-session framework use.

Teaches how participants move through lawful access routes and coordinated care pathways. The competency covers referral navigation, team handoffs, and the practical steps needed to connect eligible participants with appropriate treatment or study settings.

The course also teaches a more active guiding style, especially through Ralph Metzner’s approach, where guides may introduce focused inquiries, somatic practices, or other interventions. Learners are shown how interventions can shape the trajectory of a session when used skillfully.

The program includes supervised apprenticeship hours with pre-approved mentors. Learners are expected to observe, assist, and translate training into supervised practice.

The page highlights best-in-class clinical training for drug trials and AI-supported evaluation. Learners are expected to refine skills quickly and receive targeted feedback in training or evaluation contexts.

The practicum includes retreat team debriefs, supervisor meetings, and assessment presentations. This signals an expectation that learners can reflect on practice, receive feedback, and integrate learning.

The course repeatedly emphasizes ethical considerations, safety, and integrity in practice. Learners are expected to develop a grounded professional stance that respects legal boundaries and participant welfare.

The course explicitly teaches techniques for working with patients in altered states, including grounding, breathwork, and mindfulness. These are presented as tools for supporting expanded and ordinary states of consciousness.

Faculty and program structure emphasize leadership, coaching presence, and personal transformation as part of practitioner development. Students are expected to become more skillful in guiding high-achieving and growth-oriented clients.

Learners are expected to develop the ability to witness clients and processes calmly, without overreacting or trying to control the experience. The course explicitly frames this as foundational to practitioner development.

The course explicitly includes ethical and relational considerations in crisis response. This suggests learners are trained to act with care, boundaries, and attunement when responding to acute distress.

The training includes practices for cleansing and closing psychedelic sessions appropriately. This signals competence in ending sessions in a structured, culturally responsive way.

The course explicitly states that facilitators are guided in safety, ethics, and responsibility. Learners are expected to recognize and manage the unique risks of working with altered states.

Practicum hours may include operational tasks like preparing rooms, setting up altars, and arranging ceremonial spaces. These are treated as part of hands-on professional competence.

The course teaches the overall PAP workflow from screening through follow-up. Learners are expected to understand and explain each phase of treatment in a structured way.

A defining feature of the training is hands-on experiential practice in both non-substance and substance-based modalities under supervision. Learners practice patient and therapist roles, facilitating and undergoing sessions in a structured learning context.

Students complete 50 supervised practicum hours and receive expert feedback while working with real clients. This is intended to translate theory into competent applied practice.

Vital says learners will expand their skills and enhance therapeutic techniques. This suggests training in improving how they support clients in psychedelic-related therapeutic work.

The Colorado practicum site explicitly teaches relational competence, including tracking nervous systems, power, and consent dynamics moment by moment. This is presented as a core facilitation capability.

The course teaches students to guide both in-person and online sessions, including the technical skills needed for virtual facilitation. It explicitly notes that online training includes learning tech skills to become a confident virtual guide.

The program states that the virtual training has been streamlined so students feel safe and supported no matter what arises. This signals competency in maintaining safety in online psychedelic support contexts.

Catch-all cluster covering 189 general competencies for psychedelic-assisted clinical practice that did not group into a more specific category — including miscellaneous facilitation, monitoring, ethics, safety, regulatory awareness, group support, and program-specific skills not captured by dedicated clusters elsewhere.