A Qualitative Exploration of Relational Ethical Challenges and Practices in Psychedelic Healing
Journal of Humanistic Psychology – September 16, 2021
Source: OpenAlex
Summary
As psychedelic therapies near approval, underground psychotherapists navigate complex ethical challenges using MDMA and psilocybin. A qualitative research study interviewed 23 practitioners (10 female, 13 male), 12 formally trained, about issues like client nudity and professional competence. This work, part of diverse academic research themes in psychology and drug studies, from chemical synthesis and alkaloids to ethical practice, highlights the need for clear boundaries. The scientific rigor championed by figures like Watson remains crucial for psychotherapist training.
Abstract
As both 3,4-methylenedioxymethamphetamine (MDMA)- and psilocybin-assisted psychedelic psychotherapy near U.S. Food and Drug Administration (FDA) approval and gain acceptance as efficacious clinical approaches, concerns have been raised about the likelihood of sexual violation of a client and other relational boundary transgressions. In the current study, 23 practitioners who have administered MDMA and psilocybin to clients in underground (i.e., extralegal) healing contexts were interviewed about their experiences navigating multiple relationships, nonsexual touch, and sexual boundary-setting in their work. Of these practitioners, 12 had undergone formal, graduate-level training in psychotherapy, 10 identified as female, and 13 identified as male. A phenomenological research design was used to assess what unique relational challenges they have faced in this work and what practices they have found helpful in doing so. Two sets of themes addressing these two questions were developed from the data. Descriptive themes represent the unique challenges that psychedelic practitioners have encountered in their work, and prescriptive themes are made up of the practices they have found most useful in confronting these challenges. Some themes are unique to psychedelic work (e.g., client nudity, the use of touch, the belief that therapists must continue to have their own psychedelic experiences), while others represent a psychedelic-specific take on standard ethical considerations (e.g., transference, supervision, staying within one’s scope of competence). Discussion of these results includes implications for the training of psychedelic psychotherapists and other regulatory decisions facing the field. Editor’s Note The manuscript “A Qualitative Exploration of Relational Ethical Challenges and Practices in Psychedelic Healing” by Brennan et al. presents a descriptive psychological study of ethical challenges faced by “underground” practitioners of psychedelic healing approaches. The manuscript is a descriptive study of the healers’ subjective experiences and related ethical challenges; its purpose is not to validate or normalize these underground practices. Importantly, some practices of underground practitioners are explicitly disallowed by ethical guidelines in the mental health professions. Licensed psychologists and other mental health professionals should abide by the ethical codes and guidelines for research and practice in their relevant professions, including but not limited to the Ethical Principles of Psychologists and Code of Conduct ( https://www.apa.org/ethics/code ), the American Counseling Association Code of Ethics ( https://www.counseling.org/docs/default-source/defaultdocument-library/ethics/2014-aca-code-of-ethics.pdf ), and the American Medical Association Code of Medical Ethics ( https://code-medical-ethics.ama-assn.org/principles ). Please see the addendum to this article for more information.