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 MDMAassisted 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.
Psychedelic therapies intentionally combine a caring/healing environment, psychotherapy, and psychedelic medicine as a powerful means of treating intractable conditions of depression and posttraumatic stress disorder. This article utilizes the nursing theory of human caring science, as articulated by Jean Watson, to describe the essential and fundamental human caring qualities in psychedelic therapy. By mapping these qualities onto the traits of a psychedelic therapist, articulated by Janis Phelps and illustrating them with qualitative, exemplar data from a psilocybin assisted therapy study, we have created a nursing-informed philosophical theoretical framework with which to begin to examine questions related to trust enhancement between patient and therapist, therapeutic communication of openness to patient experiences, mutual learning between therapist and patient, the influence spiritual or psychedelic practices of the therapist on outcomes, optimizing therapeutic healing environments, and care of the physical body during psychedelic therapy sessions. This article is intended to identify themes and generate hypotheses for future nursing-informed psychedelic psychotherapy research.
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