EMBARK model

Domain VII · Transpersonal, psychedelic & altered states · William Brennan, Alexander Belser · 2021

What it is

EMBARK is a framework for psychological support during psychedelic-assisted treatment, not a stand-alone therapy and not a drug protocol. It was built by William (Bill) Brennan and Alexander (Alex) Belser at Cybin, Inc., for Cybin-sponsored trials and for training "session monitors"/study…

Format

• Goals: build rapport and trust; explain what to expect before, during and after the medicine session (including aftercare and practical requirements); explore and articulate intentions; teach a skill set covering all six domains so that the participant has tools ready whatever arises.
• Session count: three preparation sessions has been the standard in EMBARK protocols to date, but the authors say this may change per protocol. In the University of Washington clinician trial whose therapists were EMBARK-trained, two preparation sessions were reported.

Who practises it, and how they are trained or regulated

• Goals: a safe, supported, inner-directed experience; therapist responds to what arises using the matching domain's training.
• Training and fidelity (for clinicians joining an EMBARK programme)
• Original programme (2022-2023 trials): manual review, 12 video modules by subject-matter experts with live Q&A, a 3-day in-person training (including a group Holotropic Breathwork day), clinical-trial/ICH-GCP training, then consultation on the first case and monthly peer consultation. The 2022 paper describes a 60-hour curriculum with optional experiential retreat.

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

• dependency on the study team as the trial ends; prepare the transition early.
• practice slipping after the glow of the session fades; adjust frequency and form.
• impatience, wanting the participant to 'have' a certain experience, boundary looseness.
• the ritual feeling imposed or performative; therapists' spiritual preferences shaping it.
• somatic trauma memories surfacing after the session; refer for trauma-specific therapy if needed.

Problems the guide addresses

• Eligibility and screening (before anything else)
• Overwhelm and difficult experiences during the session
• 'Nothing happened', disappointment or stuckness in integration
• Resistance, ambivalence and non-adherence to practice
• Ruptures and relational difficulties
• Distressing post-session sequelae
• Boundary, suggestibility and ethics problems
• Therapist overload with the six-domain model
• Clients who use psychedelics outside legal programmes
• Cultural and spiritual mismatch

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.