Building standards of psychedelic care: Qualitative examination of expert perspectives on safety, inclusion, and accountability.
Christina Chwyl, Adrianne R Wilson-Poe, Kim A Hoffman, Alissa Bazinet, Kellie Pertl, Jason B Luoma, Don Des Jarlais, Sarann Bielavitz, P Todd Korthuis
The International journal on drug policy January 1, 2026 Peer reviewed DOI: 10.1016/j.drugpo.2025.104938 via PubMed
Summary
Expert perspectives reveal significant gaps in best practices for facilitated psychedelic care and therapy. A qualitative study with 38 participants highlighted the need for stronger accountability, culturally responsive practices, ongoing community support, robust safety protocols, and clearer guidelines to navigate legal complexities. Key themes included enhancing safety through credibility, advancing inclusivity, and ensuring informed guidance to optimize outcomes in diverse contexts.
Study at a glance
| Design | qualitative study |
|---|---|
| Sample size | 38 |
| Population | experts in psychedelic care including providers and harm reduction specialists |
| Key finding | The study identified five key themes emphasizing the need for enhanced provider accountability and culturally inclusive practices in psychedelic care. |
Abstract
There remain significant gaps in knowledge about best practices for facilitated psychedelic care and psychedelic-assisted therapy. To inform the development of service models that support safe and beneficial experiences, this qualitative study explored expert perspectives on current and ideal standards of care, including key practices (e.g., screening, adapting care to diverse contexts) and regulatory and research challenges that influence service delivery. Online focus groups (n = 8) were conducted with a purposive U.S. sample of people with psychedelic content knowledge expertise, including providers (psychiatrists, clinical psychologists, addiction medicine experts, and licensed/unlicensed practitioners) and harm reduction specialists. Transcripts were analyzed through Thematic Analysis team-based coding using a combined inductive-deductive approach within a semantic framework. Participants (N = 38, mean age 47 (SD = 10) years, 53 % women, 84 % white) had an average of 10 years of psychedelic service experience (SD = 11) across diverse settings, including festivals/events, service centers, and clinical, research, ceremonial, community and 'underground' contexts. Five key themes emerged: (1) 'Strengthening Safety through Credibility and Accountability'; (2) 'Advancing Culturally Responsive and Inclusive Psychedelic Care'; (3) 'Healing in Community: The Crucial Role of Ongoing Support and Integration'; (4) 'Ensuring Safe Psychedelic Use: Preparation, Screening, Vulnerability, and Medication Management'; and (5) 'Providing Informed Guidance and Navigating Legal and Informational Gray Areas.' Overall, results underscore the need for stronger provider accountability structures, culturally inclusive practices, accessible and integrated community support, robust safety and screening protocols, and clearer guidelines to help providers navigate legal complexities, ensure safety, and optimize outcomes across diverse populations.