MDMA Training
Curriculum Overview

• MDMA-Assisted Psychotherapy Overview
• History and development
• Ethical considerations
• Patient-rights advocacy in MDMA therapy
• Assessment and referral processes
• Legal aspects of MDMA therapy in Canada
• How to fill out the SAP form
• How to connect with a treatment hub
• Legal status of MDMA therapy in different jurisdictions
• Compliance with regulatory requirements
• Liability and risk management

• Ongoing and completed studies
• Clinical outcomes and patient experiences
• Safety protocols and risk mitigation
• Managing adverse events
• Emergency protocols
• Current clinical trials and research findings

• Neurochemical effects
• Neurobiological basis
• Metabolism and half-lives
• Safety considerations
• Integrating neuropharmacology into therapy
• Dosage and administration
• Contraindications
• Interactions
• Considerations for the medicine session

• Patient assessment and screening
• Setting intentions and goals
• Pre-session preparation
• Ensuring patient comfort and safety
• Navigating safe touch
• Building rapport and trust
• Transference and countertransference
• Maintaining healthy boundaries
• The importance of integration sessions
• Long-term follow-up and care
• Supporting patients in their healing journey
• Ethical considerations in aftercare

• Using a multidimensional bio/psycho/social/spiritual/earth eco understanding of patients. 
• Procuring MDMA;
• Assessing patient readiness;
• Preparing patients for a medicine journey;
• Helping patients formulate intentions; 
• Applying concepts of set and setting;
• Integration groups

• The Dosing Session
• Preparing the journey space;
• The role of music and how to create playlists;
• Roles of primary and secondary therapists;
• “Holding space” for the patient;
• Understanding the flow of the journey experience;
• When to act, when to refrain;
• Sitting vs. guiding
• Safety Issues;
• Challenging or “bad” trips;
• Patient stories and perspectives
• Observing an MDMA session

• The impact on the brain, including the amygdala and prefrontal cortex
• Dysregulation of the autonomic nervous system
• Trauma's link to conditions such as PTSD, anxiety, depression, and substance use disorders
• Understanding trauma triggers and flashbacks
• Assessment and diagnosis
• Working with dissociation and borderline features
• Safety considerations in treating trauma with MDMA
• Integration of MDMA sessions into trauma-focused treatment plans

• Unique challenges faced by marginalized communities, including LGBTQ+, BIPOC, and differently-abled individuals
• Intergenerational trauma and colonial legacy of Western medicine
• Ethnocultural transference and countertransference in the therapeutic relationship
• Cultural competence in MDMA-assisted psychotherapy
• Addressing disparities and access issues
• Ensuring inclusivity in practice

• Bodywork and somatic approaches
• Breathwork techniques
• Creative arts therapies
• EMDR
• Narrative therapy
• IFS

• Ethical guidelines for MDMA therapy
• Informed consent and patient rights
• Ethical dilemmas in practice
• Case presentations and ethical scenarios

TheraPsil believes that a trainee psychedelic experience significantly contributes to a therapist’s ability to empathize with patients and understand their experience. Patients may also feel more comfortable with therapists who they know have had their own psychedelic experience.

The desired outcome for Unit 10 is that when graduates receive referrals to practice psychedelic psychotherapy professionally, graduates:

• Are familiar and comfortable with a broad range of psychedelic experiences that occur with full-strength therapeutic doses; 
• Can identify, understand and empathize with a broad range of client psychedelic experiences - from the transcendent to the difficult or challenging;
• Have worked through their own inner material to the point that they do not get triggered by what their clients may experience.

To complete this Unit, trainees will work in both a “patient” and “primary therapist” capacity. Trainees will apply clinical concepts of psychedelic therapy to their own personal experience.

There are two possible options for completing Unit 10:

1. Decriminalized use of MDMA in a group retreat setting in British Columbia

Trainees will undergo a minimum of one MDMA session using a standard therapeutic dose: 125 mg with a potential top-up dose of 40mg at the 60-minute mark if required. Trainees undergo this experience with their designated learning partner in a supervised group format during a learning seminar.

Together, they will complete the psychedelic psychotherapy preparation process according to the TheraPsil protocol. This will include:

• A minimum of three preparatory sessions in the role of client and three in the role of therapist.  These will take place prior to the training seminar; learning partners will be introduced by TheraPsil prior to the training. 
• Use of Intake Questionnaire 
• Use of SAP Form
• Use of Patient Inclusion Form
• Use of Consent Form 2
• Use of four psychometric questionnaires pre- and post-session:
  • Clinician-Administered PTSD Scale (CAPS)
  • Beck Depression Inventory (BDI) or Hamilton Depression Rating Scale (HAM-D)
  • State-Trait Anxiety Inventory (STAI)
  • WHO Quality of Life-BREF (WHOQOL-BREF)
• Discuss the role of music with your “client”.

1. Trainee-therapists will conduct their dosing session at the retreat as a dyad with their learning partner. Dyads will conduct their sessions either in a common shared space or in individual treatment rooms. If a common group space is used, a “break-out” room will be available as necessary.
2. The retreat and the psychedelic sessions will be supervised throughout by a TheraPsil trainer and one or more TheraPsil-approved assistants. Two assistants will be present for a group of more than 8 trainees.
3. A nurse or physician will be in attendance or on call throughout the retreat for medical support as required.
4. All trainers and supervisors will fully attend the experiential sessions. 
5. One-two weeks after the experiential training, trainees will meet the trainers for follow-up meeting on Zoom regarding any matters of interest or concern, and discuss suggestions for further development. This would count towards one hour of supervision. 
6. Trainees will have a minimum of three Integration sessions with their learning partners following the experiential retreat (three hours in the role of client, three hours in the role of therapist). 

• Integration session #1 will take place with your learning partner the day following the dosing session;
• Integration session #2 within two weeks of dosing session.
• Integration session #3 within three-six weeks of dosing session.  

1. Responsibilities of Retreat Participants

Trainer and Experiential Supervisor responsibilities:

• The trainer and assistants will be fully present to provide safety, harm reduction, coaching, consultation and assistance to anyone requesting it (though each will take several short breaks);

• The trainer and assistants will proactively intervene in any psychedelic session if they believe it to be required it for the welfare of a journeyer;
• The trainer and assistants will be available anytime through the experiential experience for individual support or consultation as requested; 
• In addition to the experiential sessions, the trainer will facilitate group circle sessions each day for preparation and integration of experience.

Trainee-Therapist Responsibilities to Trainee-Client:

• This retreat is your opportunity to fully experience the roles of both client and primary psychedelic therapist. The primary therapists (in consultation with their clients) will be completely responsible for the planning, preparation and conduct their sessions;
• Administer the four psychometric instruments pre- and post-dosing session;
  • Clinician-Administered PTSD Scale (CAPS)
  • Beck Depression Inventory (BDI) or Hamilton Depression Rating Scale (HDRS)
  • State-Trait Anxiety Inventory (STAI)
  • WHO Quality of Life-BREF (WHOQOL-BREF)
• Administer Consent Form 2 to your client;
• Setting up the journey site with client: alter, personal objects, photos, etc. at 
• the retreat;
• Negotiating agreements re: touch, breath prompt etc.;
• Holding space throughout the session,
• Supporting post-session art
• Conduct initial post-session integration 
• A minimum of two integration sessions within three-twelve weeks of the retreat (the integration work done at the seminar will count as the first of the three integration sessions required by TheraPsil protocol);

Trainee Client/Patient Responsibilities:

• You agree to take full responsibility for the outcomes of your experiential session, including any adverse effects;
• You have a plan for adequately processing personal material that includes your learning partner, or another therapist if necessary;
• You will not leave the session without the consent of your learning partner and trainer;
• You will not have any romantic or sexual relationships with other trainees;
• You will accept the trainer’s judgement as the ultimate clinical authority during the retreat.  Trainers will, of course, defer to the attending medical professional regarding any medical issue.

1. Experiential sessions will take place in full compliance with COVID-19 or other medical precautions in effect at the time.
2. The completion of preparation, the experiential session, and integration will satisfy the trainee’s ability to be onboarded as a Co-Sitter, Medical Associate, or Provisional Associate
3. Legal use of MDMA in a clinical trial setting [CURRENTLY PENDING APPROVAL]

TheraPsil is currently working in partnership with a TheraPsil-affiliated physician on a clinical trial to support experiential learning opportunities. If this route becomes available, all trainees will be notified on the trial’s parameters and eligibility criteria.

• TheraPsil seeks to develop supportive ongoing mentoring relationships with our trainees as they move into psychedelic practice;
• Following completion of the seminar, trainees receive a minimum of 10 hours of clinical supervision of psychedelic psychotherapy casework from a TheraPsil-approved supervisor.  
• Supervision may occur in either individual or group formats.  Arrangements for individual supervision may be negotiated with the training team.
• Supervision may occur on-line or in-person;
• Supervision sessions may involve review of video sessions of consenting patients.
• Supervision will involve fees ($150/hr) beyond those of the seminar.
• This fee of $150 may be divided among participants in a small group supervision format. Group supervision sessions are also available for registration on the training portal, contact support@therapsil.ca for details.  

OPTIONAL: 

• Trainees can volunteer time pro-bono as part of Unit 10 at a 2-day experiential session as an assistant to gain hands-on experience holding space during a psychedelic experience.
• Participation at one of these experiences will give the trainee 2 hours of supervision credit. 8 more hours of supervision supporting the trainee's own client or patient will be required to complete this unit.

Program Learning materials: texts, readings and videos

Throughout the training program, learning materials, including texts, readings, and videos specific to MDMA-assisted psychotherapy, should be provided through an online training portal. Additionally, trainees should have access to resources for continued education and professional development.