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Psychedelic Therapy Guide: How to Choose the Right Therapist for You

Disclaimer: Psychedelics are potentially illegal substances, and we do not condone their use where it’s against the law. We created Third Wave’s directory as source to find legal plant medicines and substances from vetted centers in the US and abroad.

Psychedelic therapy offers breakthrough options for freeing people from old patterns and optimizing their mental health. But the field is still in its infancy, which can make it challenging to know where to begin.

Finding a psychedelic therapist means sorting through a lot of information: understanding what to expect from the experience, identifying the psychedelic drug best suited for you, and finding a therapist who specializes in psychedelic medicine.

While most psychedelic drugs remain illegal on a federal level, Third Wave believes in the healing power of plant medicine and in the countless success stories from psychedelic therapy patients across the country. We want to make it easy for you to have a safe and positive experience with psychedelic therapy, so we’ve compiled a guide to help you get started, along with a few therapists that we’ve personally verified.

Let’s get started.

What is Psychedelic-Assisted Therapy?

Psychedelic-assisted therapy generally makes use of psychedelic substances along with traditional talk therapy to facilitate mental and emotional transformation. Because psychedelics shift your perceptions of reality, the experience works by opening your mind to new ways of thinking, allowing you to break free from destructive behaviors, thought patterns, and traumas.

Psychedelics can also literally change your brain, by creating new neural connections that help you reframe habitual thought patterns. When you combine the insights you glean from intense psychedelic journeys with a therapist to help integrate the lessons, you can create lasting change.

Psychedelic-assisted therapy is a brand new modality, often operating in a legal gray area. That means your choice of psychedelic therapist is even more important because the professional who guides you also creates your treatment plan.

How Does Psychedelic Therapy Work?

When it comes to ketamine-assisted psychotherapy, your journey generally starts with an intake session, where you’ll meet with your therapist to discuss your expectations and goals. You’ll also share concerns, and talk through any questions you have about the process or the experience of working with hallucinogens.

After the intake session, you’ll meet for your first psychedelic session, where your therapist will administer a low to moderate dose and remain with you for the duration of the experience or “trip”. During this time, you’ll experience the mental and physical effects of the drug, which can include visual and auditory hallucinations, as well as a sense of expanding consciousness, a more profound sense of self, and greater feelings of connection to the world around you. With ketamine, you may need to return for multiple sessions.

But your journey isn’t over after the trip ends—the most important part has only just started. Generally, after each session, you’ll have time to explore your findings with your therapist. Then, when you’re done with treatment, your therapist will likely schedule follow-up integration sessions to help you work through your emotions and create a plan to make changes in your daily life. During these sessions, your therapist may help identify growth areas and opportunities that enable you to feel more fulfilled.

Every therapist and clinic operates differently, but most of the time you can do intake and integration sessions remotely. In some cases, if you’re working with an unregulated substance (like MDMA), you’ll also have to administer the psychedelic drug remotely. But if you’re working with ketamine, a legal psychedelic, you’ll most likely go to a clinic for the experience.

In-clinic therapy sessions ensure that you’re in a safe location and monitored by healthcare professionals who can hold space for you to fully let go without fear. Psychedelic clinics are designed to create the perfect setting for a “good trip”, often adorned with plush furniture, soft colors, and a soothing atmosphere.

What can Psychedelic Therapy Help with?

Psychedelics bring new treatment avenues to the field of psychopharmacology (the scientific study of the effects of drugs on the mind and behavior), helping you overcome a range of issues, from a lack of connection to severe PTSD, addiction, or depression. Psychedelic therapy is profoundly effective because it can help address the root causes of mental illnesses, expand consciousness, and even create new pathways to process information in the brain.

Mental Health Conditions Include:

  • Treatment-Resistant Depression
  • Alcoholism and Drug Addiction
  • Post-Traumatic Stress Disorder (PTSD)
  • Unresolved Trauma
  • Obsessive-Compulsive Disorder (OCD)
  • End of Life Anxiety
  • Chronic Pain

Thanks to a growing body of psychedelic research, we also know that the use of psychedelics can have long-lasting positive effects. A 2018 research study tested the effects of psilocybin on personality traits in people with treatment-resistant depression. Three months later, the study found that all patients continued testing higher for openness and extraversion and lower for neuroticism. This lasting effect may be because of psychedelics’ ability to increase connections between brain neurons. This ability to rewire broken neural connections can help change your relationship to the world and the people, places, or things that used to cause significant stress.

Different Types of Psychedelic Therapy

Ketamine-Assisted Psychotherapy for Depression

Ketamine is the only federally legal psychedelic medicine in the United States. First approved in the 1970s as an anesthetic, ketamine has since proven to have powerful antidepressant properties, relieving depressive symptoms and suicidal ideations in mere hours in some cases.

In 2019, the Food and Drug Administration (FDA) approved a esketamine nasal spray to treat depression, but your psychedelic therapist may administer off-label ketamine infusions to increase  bioavailability.

Ketamine’s exact mechanism of action is unknown, however scientists believe it works by improving or inhibiting neural activity in the brain. Unlike most antidepressants, which act on serotonin pathways, ketamine acts on the brain’s glutamate pathway. Glutamate is one of the most common neurotransmitters, which regulates large swaths of the nervous system. Overactive glutamate receptors have been linked to long-term depression. Ketamine blocks these receptors, which indicates why it may be so effective.

MDMA for Post-Traumatic Stress Disorder (PTSD)

3,4-Methyl​enedioxy​methamphetamine, also called MDMA, is a synthetic drug that produces intense feelings of euphoria, empathy, and emotional well-being. As early as the 1970s, MDMA was used to treat trauma and depression in inner-city kids but fell out of favor as it became popular recreationally. Today, MDMA shows promise in treating PTSD, among other mental health conditions.

In one study conducted by the Multidisciplinary Association for Psychedelic Studies (MAPS), 68% of participants no longer suffered from PTSD one year after MDMA treatment. A 2021 study of 91 people found that, after 18 weeks of treatment, 67% of participants no longer met diagnostic criteria for PTSD and 33% were in remission.

How does it work? MDMA can help increase your self-compassion and reduce shame and anger. This creates a “window of tolerance” where you can revisit and process traumatic experiences without feeling intensely triggered.

Today, MDMA is in Phase III clinical trials for PTSD treatment and has been granted “breakthrough therapy” status by the FDA. That means we could see full approval and prescriptions by 2022 or 2023.

Psilocybin for Depression and Anxiety

Psilocybin mushrooms are some of the most well-known classic psychedelics, producing powerful hallucinations and even mystical experiences. You can find this chemical compound in over 180 species of magic mushrooms. Today, researchers are turning to psilocybin to treat anxiety and depression as well as cluster headaches, addiction, and obsessive-compulsive disorders.

A 2016 study at Johns Hopkins University showed that 92% of critically ill patients who received a high dose of psilocybin showed a clinically significant reduction in depressive symptoms after five weeks. Six months later, an astounding 83% continued to see a reduction in symptoms.

There is also early evidence showing that psilocybin may have a therapeutic effect on people with bipolar disorder. While some scientists feared high doses could activate psychosis in people at risk, a 2021 review found evidence that this may not be an issue for people who are supervised during the experience.

Today, psilocybin is still a Schedule 1 drug, which means you won’t easily find a psychedelic therapist who legally uses this medicine in the US. But laws are changing. For example, Oregon legalized psychedelics for therapeutic use in 2020, which means you may start seeing psilocybin clinics as early as 2022. In the meantime, you can also look for psilocybin research and clinical trials at places like New York’s Mount Sinai Health System and Johns Hopkins Center for Psychedelic and Conscious Research in Baltimore, Maryland.

LSD-Assisted Psychotherapy for Mental Health

Lysergic acid diethylamide, or LSD, was first created in a lab in 1938. In fact, up until the mid-20th century, researchers studied this compound for its effect on anxiety, depression, addiction, as well as ailments like migraines, hypertension, and ulcers. Scientists believe that LSD works by binding with 5-HT2A receptors in the brain and interacting with serotonin receptors on the surface of the brain cells.

Clinical research on LSD halted for decades after the US government added the substance to the Schedule 1 Controlled Substances list in 1970. In 2014, however, MAPS revitalized LSD’s public image by conducting the first double-blind placebo-controlled study with human trials since the ban. In the year-long study, 77% of participants reported a reduction in anxiety and 66% reported increased overall quality of life.

Since then, scientists have continued studying LSD for mental health conditions, including major depressive order.

Psychedelic-Assisted Addiction Therapy

Could psychedelic drugs be the key to battling addiction to opioids, alcohol, and tobacco? Ibogaine, a naturally occurring psychoactive compound harvested from Iboga root bark in Africa, is particularly effective in this area. Ibogaine is not a cure for addiction, but it can lessen the withdrawal, detoxification symptoms, and future cravings.

Clinical trials on ibogaine are limited, but initial findings show promise. Two studies conducted by MAPS found 20% to 50% of patients experienced a long-term reduction of withdrawal symptoms. Further clinical research showed between 60% and 80% of patients experienced a long-term reduction in symptoms through the use of ibogaine.

Ibogaine is the most well-known psychedelic for addiction therapy, but it’s certainly not the only one. For example, research shows that other psychedelics, including psilocybin, LSD, ayahuasca, and mescaline, are all effective in quelling harmful compulsions as well.

Other Psychedelic Therapies:

  • Ayahuasca: Ayahuasca is an entheogenic brew made from an Amazonian plant. A 2013 Canadian study found ayahuasca provided “statistically significant improvements in several factors” for 12 people with substance use disorder. Six months later, all participants reported positive, lasting changes. The authors of the study noted ayahuasca did not decrease cannabis use.
  • 5-MEO-DMT: 5-MEO-DMT is a chemical psychedelic that can be extracted from certain plants and toad species or produced in a lab. A 2019 study of self-reported DMT experiences found 80% of participants with depression and 79% of participants with anxiety reported improvements in their condition after use.

Qualities of a Good Psychedelic Therapist

In 2017, Janis Phelps Ph.D, co-founder of the California Institute of Integral Studies Center for Psychedelic Therapies and Research, was the first to identify and outline six core qualities of a good psychedelic therapist. According to Dr. Phelps, these qualities include:

1. Empathetic, abiding presence

Psychedelic therapists must have empathy above and beyond other mental health professionals because creating a safe environment is critical to effective psychedelic therapy. It takes a skilled professional to navigate the altered states of consciousness induced by hallucinogens. Therapists must remain balanced and composed, practice mindfulness, and respond to you in a calming way.

2. Trust enhancement

To get the most out of your psychedelic therapy experience, you must trust not only your therapist but in your own capacity for healing. Psychedelic therapists should be able to inspire this level of trust by navigating unexpected, paradoxical moments and breakthroughs without making you feel ashamed or embarrassed.

3. Spiritual intelligence

Unlike in some other health professions, spiritual intelligence is critical for a good psychedelic therapist. Psychedelics can yield ego death and transcendental moments that are more “mystical” than “logical”. A good psychedelic therapist should be familiar with concepts like transcendence of self, equanimity, impermanence, and unconditional love.

4. Knowledge of the effects of psychedelic drugs

A good psychedelic therapist understands the psychological and physiological effects of these substances, in both theory and practice. As a result, they can pre-screen you for potential drug interactions, take stock of your mental health needs, and create the ideal setting that prioritizes harm reduction. All in-person psychedelic therapists should adhere to a harm reduction model, meaning they supervise you before and after the psychedelic experience to minimize the risk of a challenging trip and maximize the benefits of medical use.

5. Therapist self-awareness and ethical integrity

When you’re experiencing a psychedelic journey, you’re in a heightened state of vulnerability and in need of a therapist who can make you feel comfortable. The best psychedelic therapists will employ empathy, knowledge, and professionalism to make that happen. Good psychedelic therapists understand their motives for work, can hold boundaries, have a strong network of therapeutic alliances, and hold a capacity for self-care to avoid burnout.

6. Proficiency in complementary techniques

Complementary techniques are critical to helping you integrate your psychedelic therapy sessions into real-life change. That’s why you should seek a therapist who can administer complementary modalities, such as holotropic breathwork, meditation, therapeutic touch, shadow work, guided affective imagery, and more.

Questions to Ask While Looking for a Psychedelic Therapist

To get you started, consider these questions:

1. What are your goals/intentions?

What are you hoping to get out of psychedelic therapy? Do you want to treat a chronic condition like depression, PTSD, anxiety, or substance use disorders?

Having a set objective before you start allows you to screen therapists who might have particular expertise in that area. It also allows you to focus your unconscious mind, while increasing your chances of a transformative experience.

2. What are the therapist’s licenses and training?

Don’t be afraid to ask your therapist about their professional licenses and their training with psychedelics.

In addition to a typical therapist’s education, certification, and training, your psychedelic therapist should have training or certification from psychedelic organizations, such as the Multidisciplinary Association for Psychedelic Studies (MAPS), Johns Hopkins University, the Integrative Psychiatry Institute, or the California Institute of Integral Studies.

3. Do you feel safe?

Feeling safe while taking psychedelics is foundational for a good experience. The intake meeting is a time to assess your therapist, ask questions, and make sure you’re in a good place to be vulnerable with that person. Don’t ignore red flags or enter a situation where you may feel uneasy or unsafe, as these can quickly lead to a bad trip.

4. What is the cost?

The cost for psychedelic therapy sessions in the US can vary, ranging from $125 – $600+ per session. Plus, insurance companies will not cover the treatment because it’s unregulated, so be prepared to pay out of pocket. Discuss the cost of treatment, payment plan options, and the number of sessions necessary before starting.

Psychedelic Therapists in the US

To help guide you through finding a therapist, Third Wave has compiled our own therapist directory.

Our team has carefully verified all of these professionals, so you can reach out with confidence to start your journey. We will continually add more high-quality therapists as the list of available practitioners grows, so be sure to bookmark this directory for yourself and to give referrals to friends.

The Bottom Line

The therapeutic potential of psychedelics can be a powerful tool for healing destructive thought patterns and increasing your day-to-day quality of life. If you’re ready to take the first step on an incredible healing journey, psychedelic therapists can facilitate breakthroughs and help you identify negative patterns in your life that are blocking your way forward.

Psychedelic therapy is a blend of art and science, and working with the right therapist can help you make intentional changes for your mental and physical health. That’s why it’s crucial to find a psychedelic therapist that aligns with your goals and expectations.

A journey of healing awaits you—all that you need to do is take the first step.

Elena Schmidt · October 11th, 2021