Discover more from The Trip Report by Beckley Waves
Future Careers: Psychedelic Therapist
How to become a psychedelic therapist
A few days ago I wrote about the transition from a pharmaceutical based system to a relationship based system which will be required if Psychedelic Assisted Therapy is going to work.
Because of the unique mechanism of action (Mystical Experience) the delivery will require a complete overhaul in how the psychiatry profession doles out pills.
Psychedelics are not to be ‘slung’ in the conventional way that psychiatrists ‘slang’ paxil, prozac, et al.
Rick Doblin spoke with Rob Reid on his recent appearance on the After On Podcast and one thing stuck out to me in particular. In discussing the results of the MDMA Phase II trials that MAPS has been sponsoring they used the word “scaleable” to describe the schema that they developed of using co-therapists to guide the trips.
This stood out to me because the one thing that I keep coming back to is the the unscaleable nature of this kind of therapy. The scaleability of pills is what makes psychiatry so lucrative for drug companies and such an entrenched system.
Psychedelic assisted therapy is perhaps the furthest from “scaleable” in this economic sense. It requires two therapists, both trained in the specific domain, one male, one female and lasts 7 hours and 10 minutes longer than the conventional 50 minute psychotherapy session.
Let’s imagine a current psychotherapy clinic that employs 6 therapists who can see, conservatively 6 patients per day, 5 days a week. That is 180 patient visits per week.
That same number of therapists, in a psychedelic clinic will only be able to see 15 patients per week.
This is one challenge I see for the Psychedelic Clinics of the future.
However, the obvious argument against this perceived unscalability is that it actually works. I think I agree.
Let’s look at this potential career.
A Future Career?
The study design that MAPS and perhaps others have used in the research is the creation of a potentially new profession: Psychedelic Therapist
This presents an interesting set of questions about creating systems that can train and support this kind of work, like:
What professions will be allowed to be psychedelic therapists? (MD/PhD only? Lc.SW, clergy, massage therapists, etc?)
Who will credential psychedelic therapists?
Who will train psychedelic therapists?
What does a Psychedelic clinic look like?
Will increasing calls for decriminalization change this?
There are many ways one can become a therapist and work with clients in this context. A Ph.D. in clinical psychology to my mind is the standard. But there are also therapists who have a masters degree and many of the therapists I see in NYC are social workers, so there are options.
Psychedelic Therapist Training Programs
At the moment there only a few programs that offer training for psychedelic assisted therapy but it is still early and there is not much in the way of credentialing that is legally mandated and this will be a rapidly changing and unfolding profession over the next few years.
The two main avenues are the California Institute for Integral Studies (CIIS) and MAPS.
I have major issues with the way that Alternative Medicine Institutes like schools of acupuncture, chiropractic and naturopathy structure their programs to cost exactly the amount that Federal Student Loans allow, collect tuition on the front end and have no skin in the game on the back end putting students in a hole.
Given these issues and the assumption that CIIS operates on the same premise, it would appear that if you are serious about this line of work MAPS is the only game in town.
It seems that the priority for MAPS is the upcoming Expanded Access Program and ensuring that there are 1) enough trained therapists and 2) enough sites that meet the FDA criteria for hosting Expanded Access.
This appears to be a golden opportunity.
Expanded Access is a program through the FDA that allows for pre-approval access to treatments that have shown to be really effective for conditions that don’t have many or any treatment options. In this case the FDA is considering MDMA for treatment of PTSD.
My first job out of college was managing an Expanded Access Program for a novel HIV drug offered to patients whose virus had mutated and became treatment resistant. The novel mechanism of action of the new drugs was literally a silver bullet for these patients, many of whom were the first to not die from and HIV diagnosis.
It was really rewarding work and I imagine the the upcoming EAP program for psychedelics will be equally rewarding.
That said, there are going to be requirements for this program that far exceeded those of my trial and MAPS has made the requirements for clinics hoping to participate available here.
I have been irked by my inability to find out what prior training and credentialing one needs to participate in the MAPS training, at this point it appears that they have left it open ended. Here is what I have found to this end in the training Manual:
“In addition to this specific training, it is required that participating therapists have a proper background, education, and experience as therapists. An important element of this background is experience with therapy for PTSD, which likely will include widely recognized therapies such as Prolonged Exposure (PE), Cognitive Processing (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and psychodynamic psychotherapyIn addition to this specific training, it is required that participating therapists have a proper background, education, and experience as therapists. An important element of this background is experience with therapy for PTSD, which likely will include widely recognized therapies such as Prolonged Exposure (PE), Cognitive Processing (CPT), Eye Movement Desensitization and Reprocessing (EMDR), and psychodynamic psychotherapy”
It is not clear what they mean by “proper background, education and experience as therapists”.
Below is the outline that MAPS provides for it’s MDMA Training Progam. To be eligible
MDMA Therapy Training Program Outline: (subject to change)
Part A: Online Course, online course outlines chemistry and history of MDMA, common reactions, possible mechanisms of action, and study design. The online course was developed out of content from the Treatment Manual, study protocols, and scientific literature on the subject.
Part B: Training Retreat (7 days), therapy video review and live dialogue with Senior MDMA-assisted Psychotherapy Researchers, covers topics in the Treatment Manual. Trainees are taught how to conduct study sessions, provide non-directive therapy, and adhere to treatment protocol.
Part C: Experiential Learning (3+ days), MAPS PBC is developing a protocol that would provide trainees with the opportunity to work alongside a senior MDMA therapist during an MDMA therapy session, in the spirit of apprenticeship. Additionally, the protocol would provide an opportunity for trainees to receive MDMA-assisted psychotherapy, if they choose to volunteer and are eligible. The experiential opportunity in psychedelic therapy training has proven invaluable according to previous trainees.
Part D: Role Play (1 day), Therapy Teams from a given site gather to conduct role play didactic training. Role play scenarios are provided, and each trainee gets a chance to play the role of provider, participant, and observer. Total time: approximately 6 hours. The role plays will be video and audio recorded so that recording may be reviewed by a Supervisor.
Part E: Supervision and Evaluation, trainees receive in-depth video review and clinical supervision during the treatment of their first participant receiving MDMA-assisted psychotherapy. Therapy video recordings are rated for adherence to the treatment method. Supervision is provided by Senior MDMA-assisted Psychotherapy Researchers. Timely feedback is given to trainees to maximize learning and enhance the quality of treatment. All therapy sessions for that participant must be audio and video recorded so that recordings may be viewed by a Supervision. Supervisors evaluate trainees based on adherence criteria, observation of therapy videos, and participation in training modules. A final evaluation is provided in the form of a narrative summary from the Supervisor. Trainees who have satisfied all the training requirements will be granted a certificate of completion.
What to do?
At this juncture it appears that if you’re serious about getting into the field clinically you will want to have at least the most basic counselor training available, perhaps a Masters degree. This will probably make you eligible for MAPS training, which if psychedelic therapy is your main thing, is THE training that you want to get.
From there going for further training like a Ph.D or MD or whatever will be a possiblity, but this training is likely not going to be psychedelic focused.
Or who knows maybe one day soon it will be.