Psilocybin with ACT and the Accept-Connect-Embody model

Domain VII · Transpersonal, psychedelic & altered states · Rosalind Watts, Luoma, Jeffrey Guss · 2019 · London (Imperial) and Connecticut (Yale/VA), per text

What it is

These are not stand-alone psychotherapies. They are psychological-support frames for psilocybin trials that borrow the psychological flexibility model of Acceptance and Commitment Therapy (ACT) to structure preparation, conduct during the medicine session and integration. The ACE model (Accept,…

Format

• Both manuals use the standard three-part structure: preparation, medicine session(s), integration. The number and spacing of medicine sessions are set by each trial protocol and are not given here.
• Preparation day. A shared lunch with both guides, then a preparation session of about three hours. It has four parts: catch-up and personal history; "session tips" (stance and practicalities); intention work; and a guided rehearsal including the P-ACE ocean-dive visualisation.

Who practises it, and how they are trained or regulated

• Scope and legal status. Both manuals describe research protocols run under regulatory approval with medical teams. The ACE manual states it "should not be used as an instruction for studies or clinical trials". It describes what was done in Psilodep. As of the APPA/BrainFutures guidelines (August 2023), psilocybin was a US federal Schedule I substance and no psilocybin therapy was FDA-approved. Other jurisdictions…

Evidence status, as the guide reports it

• What it is. These are not stand-alone psychotherapies. They are psychological-support frames for psilocybin trials that borrow the psychological flexibility model of Acceptance and Commitment Therapy (ACT) to structure preparation, conduct during the medicine session and integration. The ACE model…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Shame afterwards. Bring it up gently in integration.
• Over-reliance on the guide to steer. Hand the paddle back gently.
• Any reluctance about specific agreements. Explore it before proceeding.
• Journaling that becomes rumination. Narrow the prompt to a single question.
• Treating TLO as a performance demand. Pair it with "it is your journey" (4.13).

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.