Psilocybin Training
Curriculum Overview

• TheraPsil roles involving patient-rights advocacy, patient assessment, and referral for treatment;
• Current legal aspects of psychedelic medicine in Canada;
  • Health Canada approval of Section 56 exemptions for legal use;
  • Health Canada approval process for research/clinical study using psilocybin;
• TheraPsil patient inclusion criteria;
• TheraPsil intake/assessment/treatment/follow-up protocol;
• TheraPsil psychometric assessment instruments;
• Intake questionnaire, Fee-rate sheets & consent forms;
• Taking a full psychiatric history;
• Professional association/college stance on psychedelic therapy;
• Process for becoming a TheraPsil Affiliate and Clinical Associate.

• Discovery and development of LSD and psilocybin as therapeutic agents;
• Microdosing, psycholytic and psychedelic therapy;
• Dark side of psychedelic research (MK Ultra, psychiatric hospital patients);
• Recent and current research re end-of-life distress, anxiety, depression, addictions, PTSD, &
  pain management; directions for future

• How Psilocybin and Psilocin resemble serotonin.
• Anatomy of the serotonin projections in the brain.
• Importance of 5HT2A receptor.
• How arc of a psilocybin journey is related to absorption and metabolism.
• 1/2 lives of drugs.
• How drugs are metabolized.
• Common drug/drug interactions with psilocybin.
• How and where to look up possible drug/drug interactions.
• Importance of de-prescribing prior to psychedelic medicine.

• The effects of psychedelics and psychedelic therapy;
• Grof's cartography of the psyche;
• Systems of Condensed Experience (COEX);
• Mystical experience;
• Spiritual intelligence; 
• Carhart-Harris’s REBUS model

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

• Preparing the journey space; 
• Music and 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;
• Safety Issues;
• Challenging or “bad” trips;
• Trainees may view a variety of case study videos of clinical psychedelic sessions and/or roleplay situations, and discuss in group format with a trainer.

• The special therapeutic relationship that develops when working with someone in a psychedelic state;
• Apply the following concepts to self and patients: 
  • transference; 
  • countertransference;
  • projective identification;
  • healthy interpersonal boundaries;
• Therapist issues: self-care, supervision, peer support;
• Ethical principles and issues relating to psychedelic practice;
• Working with a co-therapist, multidisciplinary teams, and other therapists.

• Special issues relating to end-of-life patients;
• Importance of peak (mystical-type) experience in treatment of patients with terminal diagnosis;
• Providing support to, and enlisting support from patient family members;
• Therapist’s own personal relationship with death and dying.

• The unique challenges faced by marginalized communities, including LGBTQ+, racial/ethnic minorities, and differently-abled individuals
• Power imbalances and promoting client autonomy within sessions
• Intergenerational trauma and the colonial legacy of Western medicine
• Ethnocultural transference and countertransference in the therapeutic relationship
• Effective cross-cultural communication skills
• Identity & Implicit Bias 
• Cultural Competence and Culturally Responsible Care 
• Privilege: Earned and Unearned
• Racial and other microaggressions
• Inclusion of people of colour in psychedelic-assisted psychotherapy and research

• Introduction to basic concepts and techniques of adjunctive clinical modalities including
  • Bodywork; 
  • Breathwork; 
  • Creative arts therapies;

and their role in the psychedelic psychotherapy session. 

• Trainees understand the role of adjunctive theoretical frameworks including Internal Family Systems (IFS) therapy and Logotherapy to psychedelic therapy, and can apply those frameworks in their practice.

• We believe that trainee psychedelic experience deeply contributes to a therapist’s ability to empathize with patients and understand their experience.
• We also understand that patients feel more comfortable with therapists who they know have had their own psychedelic experience.
• Our desired outcome for Unit 11 is that when our graduates receive referrals to practice psychedelic psychotherapy professionally:
• They are familiar and comfortable with a broad enough range of psychedelic experiences that occur with full-strength therapeutic doses; 
• They can identify, understand and empathize with a broad range of client psychedelic experiences  - from the transcendent to the difficult or challenging;
• They have worked through their own inner material to the point that their issues do not get triggered by what their clients may go through.
• To complete this Unit, trainees will fully experience the role of a patient in psychedelic psychotherapy, and reflect on it from personal and professional perspectives.  Trainees experience the therapeutic effects of the psychedelic experience, and the impact of therapist interventions in medicine sessions.  They develop their clinical intuitions about intervention practices.  
• Trainees also fully experience the role of primary therapist working under supervision, and will take their learning partner “client” right through the TheraPsil clinical protocol from intake through follow-up. 
• Trainees will apply clinical concepts of psychedelic therapy to their own personal experience.

There are three possible options for completing Unit 11:

• Legal use of psilocybin in a group retreat setting 

[NOT CURRENTLY AVAILABLE]

1. Trainees will undergo a minimum of one psilocybin session using a standard therapeutic dose: 25 mg. psilocybin or documented equivalence in dried organic mushrooms).  Trainees undergo this experience with their designated learning partner in a supervised group format at an extended-weekend retreat.
2. Following their seminar, trainees will advance toward their experiential retreat by continuing work with their learning partner in their therapist and client roles.   Together, they will complete the psychedelic psychotherapy preparation process according to the TheraPsil protocol.  This will include:

• Two preparatory sessions in the role of client and two in the role of therapist.  These may take place online. This will count towards 6 hours of credit. (Your work with your LP in your seminar will count as your first preparation session, if you are working with a new learning partner, you must complete three preparatory sessions in the role of client and therapist.)
• Use of Intake Questionnaire 
• Use of Patient Inclusion Form (PIC);
• Use of Consent Form 2
• Use of 3 psychometric questionnaires pre- and post-session:
  • PHQ-9 Scale
  • GAD-7 Scale
  • Demoralization Scale
• Prepare music playlist in consultation with your “client”;

1. Changing Learning Partners   We generally expect that seminar learning partners will continue together beyond the seminar week through the retreat weekend, and through the post-retreat integration sessions, and final follow-up contact.  However, there are sometimes good reasons for changing learning partners in post-seminar learning.  In the event that trainees are not able to proceed with their original partner, they may choose to use an alternative partner in consultation with their trainer.  That alternate trainee may be from the trainee’s original cohort or from another TheraPsil cohort.
2. Choose an Experiential Retreat   It would be ideal if a whole cohort was able to do the experiential retreat together with their seminar trainer and originally-designated learning partners; however, many factors may prevent that from happening.  In the event that you are unable to attend with your full cohort, your original trainer, or your original LP, you will have the opportunity to form a sub-group from trainees within your cohort or external to it.  Ideally, your retreat will be supervised by your original trainer.  In some cases, it will involve another trainer, or other experiential supervisors approved by TheraPsil.
3. Experiential training events will take place in a group format over an extended weekend (30 hours of credit per weekend)

Suggested timetable for retreat weekend:

Friday Afternoon

3:00 arrive at site, settle in to accommodations, begin preparation of journey space

5:00 prepare and eat dinner together

7:00 group circle: connection; review, intentions, anticipating journeys

Saturday & Sunday

8:15 meditation/ forest walk

8:30 light breakfast

9:00 participants prepare personal journey  space as desired

9:30 group assembles for journeys: check-in,

opening ceremony, ingestion.

10:00 one member of dyad ingests psilocybin, other in therapist role;

4:00 quiet time with partner or group in nature

6:00 dinner

7:00 group circle debrief and integration

Monday Morning

8:15 meditative practices together

8:30 breakfast

9:00 group integration & closure on personal

level; professional reflection on process 

12:00 retreat ends.

• A retreat will have a minimum of 6 trainees and a maximum of 12.
• Trainee-therapists will conduct their medicine 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.
• 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.
• A nurse or physician will be in attendance or on call throughout the retreat for medical support as required.
• All trainers and supervisors will fully attend the retreat weekend, including overnights. 
• One week after each experiential weekend, 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 will count for 1 hour of credit. 

• Trainees will have three Integration sessions with their learning partners following the experiential retreat.   
• This will count towards 6 hours of credit (3 hours as the client, 3 hours as the therapist).
  • Integration session #1 will take place with learning partner within one week following medicine session;
  • Integration session #2 within two weeks of medicine session.
  • Integration session #3 within 3-12 weeks of medicine session.  

• 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 weekend 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:

1. • This weekend 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;
     1. Administer the three psychometric instruments pre- and post-medicine session;
     2. Administer Consent Form 2 to your client;
     3. Setting up the journey site with client: alter, personal objects, photos, etc. at 
     4. the retreat;
     5. Negotiating agreements re: touch, breath prompt etc.;
     6. Holding space throughout the session,
     7. Supporting post-session art
     8. 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 or weekend 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.

Experiential sessions will take place in full compliance with COVID-19 or other medical precautions in effect at the time.

•  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

2. Legal use of psilocybin 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. A No Objection Letter has been received from Health Canada as well as a section 56 exemption and REB approval. If this route becomes available, all trainees will be notified on the trial’s parameters and eligibility criteria.

3. Alternative Routes to Completion

We regret that Health Canada has curtailed TheraPsil’s program of providing legal access for our trainees to psilocybin experience as part of their professional development, and we are actively working towards expanding the accessibility of our program.

In the absence of legal approval, TheraPsil cannot plan or conduct psychedelic medicine sessions for trainees.  However, a training cohort or sub-group within a cohort may decide among themselves to conduct their own group experiential sessions for training purposes, and contract with support services independently of TheraPsil.  

Trainees will receive credit for Unit 11 if they participate in a weekend retreat conducted in accord with the retreat description given in option 1 above.

• 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.  
• Two hours of supervision/year are required to maintain Psychotherapy Associate status
• OPTIONAL:
  • Trainees can volunteer time pro-bono as part of unit 12 at a full weekend retreat 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.

Learning materials (including texts, other readings, and videos) for each cohort will be determined by the instructor(s) assigned to the cohort via TheraPsil’s online training portal.