Equity and EthicsMDMAPsilocybin

Developing Guidelines and Competencies for the Training of Psychedelic Therapists

This article is the first review to compile core competencies for psychedelic therapists, identifying six: empathetic abiding presence; trust enhancement; spiritual intelligence; knowledge of the physical and psychological effects of psychedelics; therapist self‑awareness and ethical integrity; and proficiency in complementary techniques. It also delineates 12 fundamental curricular domains for training these competencies and argues such guidelines are urgently needed as psilocybin‑ and MDMA‑assisted therapies progress to Phase 3 trials and possible wider clinical availability.

Authors

  • Phelps, J.

Published

Journal of Humanistic Psychology
meta Study

Abstract

Research since the 1950s has shown that psychedelic-assisted psychotherapy has had significant positive effects in reductions of specific clinical symptoms and increases in quality of life as measured on a variety of indices. The intensity of focus on evidence-based outcomes, however, has resulted in a paucity of active discussions and research on the core competencies of the therapists themselves. The context of the history of psychedelic research reveals how this neglect of therapist variables occurred. With current discussions of Phase 3 and expanded access research programs for psilocybin-assisted and MDMA-assisted psychotherapies, there will be a great need for competent therapists trained in this clinical specialty. This is particularly the case if less restricted, legal medical use is approved within the next 6 to 10 years. This article is the first review and compilation of psychedelic therapist competencies derived from the psychedelic literature. These six therapist competencies are empathetic abiding presence; trust enhancement; spiritual intelligence; knowledge of the physical and psychological effects of psychedelics; therapist self-awareness and ethical integrity; and proficiency in complementary techniques. A further contribution of this review is a delineation of the 12 fundamental curricular domains of study for the training and development of these therapist competencies. As current legal restrictions evolve, aspects of these training guidelines will develop accordingly.

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Research Summary of 'Developing Guidelines and Competencies for the Training of Psychedelic Therapists'

Introduction

Phelps situates this paper in the context of a renewed ‘‘renaissance’’ of clinical research on psychedelic-assisted psychotherapy and argues that, despite substantial outcome-focused evidence since the 1950s and especially in the last 20 years, therapist variables have been relatively neglected. Earlier decades produced extensive clinical and conference literature showing strong clinical effects for substances such as LSD, mescaline, psilocybin and, more recently, MDMA, but political and regulatory restrictions curtailed systematic inquiry into therapist competencies. Contemporary FDA-directed Phase I–III research prioritises standardised protocols and control of therapist effects, which has limited scholarship about which therapist qualities and training elements matter for optimal psychedelic-assisted care. The paper sets out to fill that gap by reviewing the extant (though sparse) literature, clinical trial reports, treatment manuals and historical writings to compile a set of core therapist competencies for psychedelic-assisted psychotherapy and to propose curricular domains for training. Phelps presents six umbrella competencies and twelve curricular domains as a first synthesis intended to inform future training, empirical inquiry, and ethical discussion as legal and clinical access to these therapies evolves.

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