We’re all wondering what psychedelic medicine will look like in the real world. Let’s take a look at who the key players in the co-therapy team will be and what their roles will entail. Here’s Who’s on First? Breaking Down the Co-Therapy Team in Psychedelic Medicine.
We’re excited to watch psychedelic therapy move from experimental research into real-world application. We’ve gotten to see ketamine therapy make this transition – and we’re hoping that MDMA will move into commercialization soon.
At Psychedelic Support, we want widespread access for patients who can benefit from psychedelic therapy. By getting clear about who will implement psychedelic therapy, we can start educating those professionals.
According to the Multidisciplinary Association for Psychedelic Studies, we need to train about 30,000 therapists in the next two years to implement MDMA therapy for PTSD. The market for psychedelic medicine is projected to grow by over 16% in the next five years.[1] This means there’s a massive need for educated providers in this growing sector of therapy.
So, who will be part of the groundbreaking introduction of psychedelics in medicine? How will they foster life-changing benefits for their patients? What will their backgrounds and roles be within this new field? Here’s what we think this co-therapy team in psychedelic medicine should look like.
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MDs and DOs will be leaders in bringing psychedelic interventions to their patients. By using their skills of diagnosing, prescribing, and evaluating outcomes, doctors will build care plans that include psychedelics.
In many cases, the physician will be the first touch-point for patients along their psychedelic medicine journey. Patients may receive a new diagnosis, such as PTSD, from a physician, which could qualify them for MDMA therapy. From a new or existing diagnosis, the physician may prescribe psychedelic therapy.
The physician will likely refer patients to a psychedelic therapist or co-therapy group for therapy and integration. While the physician may oversee the care team, they likely won’t be present for active psychedelic sessions. They may be on call during active sessions, so the psychedelic nurse or therapist can provide updates.
Psychiatrists
We expect that psychiatrists will be key leaders in identifying patients who can benefit from a prescription of psychedelic therapy. Diagnoses relating to mental health have been the most responsive to psychedelic therapy, including:
- PTSD
- depression
- substance addiction
- anxiety
Psychiatrists will also help manage medications for patients whose existing prescriptions may interfere with psychedelics. SSRIs, for instance, may interfere with the effects of psychedelic therapy.[2] Psychiatrists’ expertise with medication and symptom management will make them vital leaders in integrating psychedelic therapy into a patient’s larger care plan.
Psychedelic therapy is an option for patients who’ve only experienced limited, short-term benefits from pharmacological treatment. Psychedelic medicine may offer these patients breakthroughs that medication alone hasn’t.[3] Psychiatrists will help guide patients through their treatment plans and monitor the outcomes of psychedelic therapy.
Palliative Care and Hospice Physicians
Psychedelics are showing great promise to be effective at relieving suffering caused by chronic illness and end-of-life decline.[4] Palliative care and hospice physicians who witness suffering in their patients daily can help them experience the benefits of psychedelic therapy.
Palliative care patients can be complex, requiring multiple therapies and interventions. Palliative care physicians may coordinate with a psychedelic therapist and nurse to help ease the weight of depression and stress from chronic disease.
The plan of care for hospice patients has moved from treatment to comfort. Timing and early intervention are crucial aspects of providing hospice patients the comfort they deserve in their final days. Hospice physicians will help identify patients who could benefit from psychedelic therapy and refer them to therapists in a timely manner.
Psychedelic Therapists
As experts in empathy and emotional intelligence, therapists are leaders in psychedelic therapy and integration. We expect that psychedelic therapy will become a specialty in itself – and we hope that therapists will integrate psychedelics into their practice.
Psychedelic therapists come from a range of backgrounds. Therapists and counselors typically have a masters degree. They may be credentialed as Licensed Clinical Social Workers (LCSWs), Licensed Clinical Mental Health Counselors (LCMHCs), Licensed Professional Counselors (LPCs), and Clinical Psychologists (PhD/PsyD).
Therapists do not diagnose or prescribe like psychiatrists. Instead, they’ll establish a deep emotional rapport with patients and coach them as they prepare for, experience, and integrate psychedelic therapy.
Therapists will prepare patients by establishing rapport before they undergo psychedelics. Patients will need to understand expectations for their session in order to feel safe and secure. Establishing rapport with patients also helps them feel comfortable as they undergo psychedelic therapy.
Unlike MDs, psychedelic therapists will be present during active psychedelic sessions. They’ll have specific training to help mitigate harm for patients. They’ll supervise and ensure patient safety during sessions that can be emotionally turbulent. During these sessions they may be assisted by a psychedelic nurse or facilitator.
After active sessions, therapists will work with patients to integrate their psychedelic experiences. They’ll explore memories and emotions that were brought up in therapy – and help patients understand the changes they may have experienced. Helping patients make sense of their experiences will allow them to have the best outcomes possible.
Psychedelic Nurses
Their focus on patient care and outcomes makes nurses primed for assisting with psychedelic therapy. Nurses will likely evaluate patients for therapy, assist in active sessions, and track patient outcomes.
Nurses are key safety advocates. They’ll help evaluate a patient’s risk of adverse effects. They may also assist the physician with taking a detailed patient history before recommending them for therapy. A recent history of psychosis, certain medications, or active substance addiction may tip off the psychedelic nurse that a patient is not ready for therapy.[5]
Specific nursing specialties may require psychedelic therapy administration more than others. Hospice and palliative care nurses, for instance, may play a large role in flagging patients for therapy, assisting in sessions, and monitoring outcomes. Check out our blog on psychedelic nurses for more information about this fascinating new nursing specialty.
Advanced Practice Nurses
As they’ve done in other specialties, APRNs like Nurse Practitioners (NPs) and Doctorates in Nursing Practice (DNPs) will broaden patients’ access to the care they need – in this case, psychedelics. APRNs with a specialty in psychiatric, hospice, or palliative care will help patients with psychedelic prescriptions.
NPs and DNPs often practice under the supervision of a doctor, but in some states, this is not required. In these states, an APRN may assume the role of primary prescriber within the co-therapy team.
Psychedelic Facilitators
Psychedelic facilitators will help patients through psychedelic sessions by offering emotional support and guidance. Much like Nurses Assistants and Doulas, they’ll assist both the clinical team and the patient during sessions. This exciting role is an opportunity for non-clinical staff to contribute to creating accessible therapy.
Facilitators will likely not need a specific clinical or academic background – but they will need to be certified through an accredited organization. The Multidisciplinary Association for Psychedelic Studies plans to create a standard for facilitator education that can be used by other educating bodies – like Psychedelic Support.
Under their new psilocybin bill, the state of Oregon plans to create standardized education for psilocybin facilitators. Psilocybin training programs will help people from a range of professions administer psilocybin within licensed service centers.
The Psychedelic Co-Therapy Team Needs YOU!
Psychedelic medicine delivery will require an interdisciplinary co-therapy team. By bringing together clinicians from a range of backgrounds, we’ll create a model of care that helps patients achieve a new level of mental wellness through psychedelics. Doctors, therapists, nurses, and facilitators will collaborate to help patients heal from PTSD, depression, substance addiction, and more.
The psychedelic co-therapy team needs you! In order to achieve our goal of making psychedelic therapy accessible, we’ll need to train thousands of doctors, nurses, therapists, and facilitators. Your skills and compassion can help bring innovative, evidence-based psychedelic therapy to patients.
We offer training and professional resources for every member of the psychedelic co-therapy team. If you’re interested in learning from experts on psychedelic medicine, join our professional community of practitioners, researchers, and educators. Use our Professional Connect to find a co-therapist or MD, offer and find supervisors. Sign up for one of our training programs to learn how you can be a part of this groundbreaking new field of medicine.
References:
- Data Bridge Market Research. US psychedelic drugs market – industry trends and forecast to 2027 (2021). www.databridgemarketresearch.com/reports/us-psychedelic-drugs-market
- Becker, A. M., Holze, F., Grandinetti, T., Klaiber, A., Toedtli, V. E., Kolaczynska, K. E., Duthaler, U., Varghese, N., Eckert, A., Grünblatt, E., & Liechti, M. E. (2021). Acute effects of Psilocybin after escitalopram or placebo pretreatment in a randomized, double‐blind, placebo‐controlled, crossover study in healthy subjects. Clinical Pharmacology & Therapeutics, 111(4), 886–895. https://doi.org/10.1002/cpt.2487
- Peritore, C. S. (2022). The promise of Psychedelic Research. Future Drug Discovery. https://doi.org/10.4155/fdd-2021-0012
- Garcia, A. C., & Maia, L. de. (2022). The therapeutic potential of psychedelic substances in hospice and Palliative Care. Progress in Palliative Care, 30(1), 1–3. https://doi.org/10.1080/09699260.2022.2001140
- Penn, A., Dorsen, C. G., Hope, S., & Rosa, W. E. (2021). Psychedelic-Assisted Therapy: Emerging Treatments in Mental Health Disorders. The American journal of nursing, 121(6), 34–40. https://doi.org/10.1097/01.NAJ.0000753464.35523.29
