Ethics and Boundaries

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.

Touch and relational boundaries

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

Touch and relational boundaries

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

Consultation and accountability

Therapists may record sessions only with explicit participant consent and must handle recordings for training and research within protocol limits. Recording is part of the therapeutic and scientific framework, not routine clinical use.

Therapists must protect voluntariness when potential participants are also their patients. Independent evaluation should be used to reduce pressure or perceived coercion in recruitment and consent.

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.

Competence in delivering online psychotherapy through secure platforms consistent with privacy requirements. The protocol specifies secure videoconferencing in compliance with HIPAA guidelines.

Document participant experiences and relevant observations to support continuity, recall, and study integrity. Notes may also serve as a participant memory aid after dosing sessions.

Because the paper notes limited conclusions about efficacy due to the crossover design, clinicians have an ethical responsibility to avoid overstating treatment effects. Competence includes accurately presenting the evidence base, uncertainty, and limits of inference to patients and colleagues.

Work within an approved research framework that has institutional review board authorization. Ethical practice requires adherence to the approved study protocol and oversight requirements.

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

Distinguish psychotherapy/facilitation functions from outcome assessment and other research tasks. Separation reduces bias and protects the integrity of blinded assessments.

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.

Therapists must help participants manage disclosure, social support, and media contact carefully to protect privacy and emotional safety. They should advise discretion without controlling the participant's choices.

Responsibility to practice ethically in a psychedelic-assisted therapy research context. Given the use of MDMA in a clinical trial, therapists must prioritize participant welfare, informed participation, and protocol integrity.

The review explicitly discourages clinical development based on toad venom because of ethical and ecological concerns. Facilitators should favor synthetic sources and avoid practices that could harm wildlife or ecosystems.

Ensure that administration occurs within an ethically supervised research or clinical framework with informed oversight and careful risk-benefit consideration. Hallucinogenic agents require especially cautious use in vulnerable psychiatric populations.

Therapists should be aware of transference and countertransference, which may be intensified in non-ordinary states. They are expected to respond with honesty, self-awareness, and openness rather than leaving important relational dynamics unspoken.

Therapists and research facilitators should evaluate how participants experienced study involvement, including perceived costs, benefits, and pressure to participate. This reflects an ethical responsibility to monitor the quality and voluntariness of participation over time.

Navigate the combination of psychedelic support and AUD therapy while preserving clear therapeutic boundaries. The facilitator must deliver supportive care without role confusion or undue influence.

Trainers and mentors observe therapists for conduct that could place participants at risk. Therapists must be receptive to correction and able to modify problematic behavior or seek additional training.

Manage optional future-contact procedures ethically and separately from current study participation. Participants may choose whether to authorize future contact without affecting present enrollment decisions.

The handbook emphasizes straightforward, honest dealing with subjects, especially when they feel suspicious, followed, or influenced. Trust is built by avoiding manipulation, deception, or concealed motives.

Organizers should clarify the purpose of the session and the ethical means of achieving it. They should also encourage participants to prepare an intention in an ethical and responsible way.

Communicates the experimental and unregulated nature of ibogaine treatment honestly. The source highlights an ibogaine subculture offering unregulated preparations, which creates an ethical duty to disclose uncertainty and risks.

Uses a cautious, transparent ethical approach when working with an experimental or non-approved addiction treatment context.

Responsibility to use LSD only within an ethically justified, clinically supervised framework. The source does not specify safeguards, but the therapeutic use of a potent psychoactive substance requires careful ethical oversight.

Explains the boundaries of confidentiality so patients understand when information may be disclosed without permission. Applies legal and ethical duties related to safety, abuse, and mandated reporting.

Non-medical facilitators must not present themselves as medical professionals or provide medical advice. They should clearly state their limitations and encourage participants to consult their own healthcare providers when needed.

Therapists are expected to offer deep acceptance of the person while not necessarily endorsing all acts or rationalizations. The handbook portrays therapeutic acceptance as compatible with clear interpersonal limits and reality-based feedback.

Attendants and facilitators must maintain clear role boundaries, distinguishing supportive presence from psychotherapy or interpretation during overnight care.

Facilitators must uphold the Ibogaine Patient’s Bill of Rights, including dignity, privacy, access to information, and complaint processes. The provider should support interpretation and grievance handling when needed.

Participants must be given complete permission to express what arises without shame, fear, or guilt. The facilitator should accept the unfolding nonjudgmentally and avoid pathologizing it.

Facilitators may witness intense sensual, sexual, or kundalini energy but must respond professionally and without reciprocation or exploitation. Emotional maturity and decorum are required to protect participant vulnerability.

Because participants may be more suggestible during psychedelic sessions, therapists must actively protect against manipulation and unsafe influence. This requires vigilance and careful conduct.

Use supervision, debriefing, and personal reflection to manage the intensity and complexity of IMAP work. Therapists need support to stay effective and ethically grounded.

Therapists should understand multiplicity, parts, selves, and related phenomena as often normal and especially relevant in trauma work. They must respond without pathologizing the participant’s awareness of different parts of self.

Respect patient autonomy while maintaining safety boundaries during a high-risk intervention. The protocol allowed return to opioid substitution therapy when clinically needed.

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

Teaches practitioners how to translate psychedelic-informed training into professional practice, including applied skill development, scope awareness, practice-building considerations, and integration of competencies into real clinical or wellness settings.

Teaches work with clinically complex contexts such as trauma, palliative care, and other nuanced presentations where ethical judgment, scope discipline, careful assessment, and individualized support are required.

Learners are expected to follow the North Star Ethics Pledge and practice non-discrimination, equity, and inclusion. Ethical responsibility is positioned as a core professional competency.

The practicum explicitly says sites cover ethical considerations such as confidentiality, privacy, professional conduct, and ethical decision-making. Ethical alignment is also part of site approval.

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.

Each trainee works with a mentor, and mentoring includes professional development discussions, role plays, and networking. This indicates structured support for building practice readiness and professional identity.

Students are expected to complete personal growth work outside the program, including therapy, guided entheogenic work, or meditation retreats. This signals the importance of self-awareness and personal preparation for facilitation work.

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.

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.

Autonomy and ongoing consent

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.

Able to practice ethically in a clinical trial environment involving a Schedule-sensitive psychoactive intervention. This includes protecting participants, adhering to protocol, and supporting valid informed participation.

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.

Maintain a contained therapeutic environment that protects the patient’s privacy and minimizes unwanted exposure. The session structure emphasizes confidentiality and controlled access to stimulation and outside contact.

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.

Therapists and facilitators should communicate treatment effects responsibly and acknowledge methodological limitations. The paper notes small sample size, lack of long-term control group, and need for further study of mechanisms.

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.

Power, transference, and influence

Where co-therapy is used, therapists should work cohesively, remain present, and respect participant preferences within the dyad.

A core competency is following rather than steering the participant’s process, intervening only in service of the unfolding inner-directed experience.

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.

Autonomy and ongoing consent

Therapists must meet licensure requirements and work within supervision structures appropriate to their training and role. Unlicensed or PAP-inexperienced staff require direct supervision.

Lead therapists must hold appropriate licensure and regulatory registration to provide psychotherapy, and have prior PAP experience. Unlicensed or inexperienced therapists may participate only under direct supervision.

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.

Power, transference, and influence

Engages in ongoing supervision and accepts feedback to maintain treatment quality. Supports corrective action when performance is unsatisfactory.

Facilitators must support the bereaved person in rebuilding identity and future orientation after loss. The protocol uses values clarification to help participants orient life around their own goals and surviving self.

Therapists must ensure attendants are appropriately selected and instructed for overnight monitoring. Attendants provide supportive care and observation without taking on psychotherapeutic functions.

Therapists must coordinate with prescribing clinicians and existing psychotherapists when relevant, while respecting consent and confidentiality. Communication should support safety, continuity, and protocol integrity.

The facilitator must minimize bias in how assessments are administered and in how participant responses are handled. This is important because the trial is open-label and relies heavily on patient-reported outcomes.

The handbook explicitly states that the experience should be fully explained and that the subject should accept it voluntarily. Coercion is framed as both unethical and therapeutically counterproductive.

The investigator/therapist has ethical responsibility to explain study goals, course, expected effects, possible advantages and disadvantages, risks, and alternative treatments in verbal and written form. This includes ensuring participant questions are answered satisfactorily and that there is enough time for decision-making.

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.

The protocol explicitly frames equity, diversity, and inclusion as ethical requirements. Facilitators should deliver care and study procedures without discrimination on race, ethnicity, religion, sex, or gender.

Therapists must be prepared for an extensive and sometimes unpredictable commitment of time and support. Ethical delivery includes reliable availability beyond scheduled sessions when participants need additional help.

Therapists should respect defenses, protectors, and resistance as potentially adaptive rather than obstacles to be forcibly overcome. The skill lies in fostering awareness and curiosity about protection while minimizing retraumatization.

Teaches practitioners to use experiential exercises, embodied awareness, supervision, and structured self-reflection to examine their own reactions, assumptions, limits, and relational patterns in clinical work.

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.

Therapists should obtain agreement that trauma may be gently brought up if not spontaneously addressed, while preserving participant choice and collaborative exploration.

Experimental sessions are conducted by a male physician-investigator and an experienced female nurse, indicating competency in co-therapy, complementary roles, and continuous therapeutic presence.

Provide reassurance when it helps establish safety, while avoiding invalidation or minimization. Reassurance should support rather than dismiss the patient’s experience.

A major therapist task is detecting and not reinforcing rationalizations that protect the existing self-concept. The handbook portrays resistance as subtle and expects the therapist to respond firmly but without hostility.

Therapist/facilitator practice in the study must align with equity, diversity, and inclusion commitments by avoiding exclusions based on protected or social identity characteristics outside protocol-defined scientific/safety criteria. This supports ethically sound participant engagement.

Use ibogaine only after a careful discussion of uncertain efficacy, limited research, and known risks. Ethical practice requires transparent communication about the experimental nature of treatment and the absence of robust clinical standards.

Study personnel involved with participants must understand informed consent responsibilities and boundaries. Consent is an ongoing process, and appropriately trained staff without an existing clinical relationship obtain consent, not the PI.

The therapist must support the subject through difficult self-scrutiny without taking over the process, distracting prematurely, or colluding with avoidance. This phase is described as the central therapeutic component where emotional insight and acceptance emerge.

Adheres to organizational code of ethics, privacy policy, electronic communication policy, and applicable laws. Maintains professional conduct across contractor and clinic arrangements.

Provides required discussion of psychotherapy before randomization and supports continuation of clinically indicated non-study psychotherapy. Documents participant choice and any psychotherapy-related decisions.

Facilitators should be aware that outcome variability may reflect both drug effects and psychological support effects. The source notes that fidelity was not assessed, underscoring the need for humility and careful practice.

Ability to recruit participants using approved procedures while respecting privacy, documented preferences, and limits on contact attempts. Recruitment must avoid coercion and unauthorized disclosure.

Attend closely to the therapeutic relationship as an active part of the healing process. IMAP treats the relational field as a primary site where trauma, repair, trust, and connection unfold.

Maintain physical, emotional, and relational safety as the primary guiding principle throughout IMAP. Therapists continuously monitor risk, reinforce boundaries, and intervene more directly when safety is compromised.

Understands the screening instruments and the respective roles of site staff and independent raters. The facilitator must collaborate with rater findings while maintaining appropriate boundaries and blinding.

Therapists should validate positive, affirming, and resourcing experiences as meaningful components of healing, growth, and meaning-making.

Therapists should frame difficult emotions, challenging material, and distressing experiences as potentially meaningful parts of healing rather than signs of failure.

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.

Consultation and accountability

Learners are taught how to work with clients who already have an outside therapist and to coordinate closely with existing treatment. The course also mentions treatment flow for groups and couples.

The program emphasizes that it prepares people for therapeutic and facilitative roles within a collaborative care framework, not independent medical practice. Learners are expected to understand role boundaries, especially around prescribing and administration.

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.

The course emphasizes learning from experienced trainers and a community of peers, suggesting development of clinical judgment through discussion, feedback, and shared practice. This is framed as part of building competence in an evolving field.

Reciprocity and ecological awareness are named as a core knowledge domain. This indicates training in relational responsibility, environmental context, and respectful exchange with communities and traditions.

The page includes explicit warnings about what graduates can and cannot legally do. Learners are expected to understand scope limits, licensure requirements, and when consultation supervision is needed.

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 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.