Psychedelic integration therapy

Domain VII · Transpersonal, psychedelic & altered states · Gorman, Nielson, Molinar · 2021

What it is

Psychedelic integration therapy is not one manualised therapy. It is a family of frameworks for psychotherapy that helps a person make sense of a psychedelic or other non-ordinary experience and carry its lessons into daily life. Bathje et al. (2022) reviewed 24 definitions and ten published models…

Format

• Status of the evidence on structure. No source gives a fixed session count for integration therapy. PHRI is stated to work in brief or ongoing formats. Bathje et al. stress that integration is long-term, should not be rushed, and that action in the world comes after internalising the experience.…
• Bourzat & Hunter (2019), Holistic Model for a Balanced Life: (1) returning from the experience by capturing its narrative; (2) understanding it by identifying themes and decoding content; (3) implementing practices across body, mind, spirit, community and natural environment; then sharing…

Who practises it, and how they are trained or regulated

• Legal and regulatory frame (as of the sources' dates, 2021 to 2024; check current law before practising)
• General: psilocybin, LSD, DMT and MDMA remain controlled in most countries, with exceptions for research, certain religious uses or licensed settings. Ketamine is a current legal exception in clinical practice.
• Oregon: Measure 109 (2020) created a regulated Psilocybin Services Program overseen by the Oregon Health Authority, with trained, licensed facilitators. Use outside that programme remains illegal.

Evidence status, as the guide reports it

• Status of the evidence on structure. No source gives a fixed session count for integration therapy. PHRI is stated to work in brief or ongoing formats. Bathje et al. stress that integration is long-term, should not be rushed, and that action in the world comes after internalising the experience.…

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?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• 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

• conflict escalation. Working: relationships adjust without rupture.
• big impulsive plans (see 4.21). Working: small actions are done and repeated.
• evangelism or alarmism in yourself. Working: you can describe risks and benefits evenly.
• pressure to recommend a specific guide or retreat. Working: the client uses resources independently.
• a life with very few supports (go slower). Working: a concrete list of practices and spaces is ready.

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.