Experiential Training in Psychedelic-Assisted Therapy: A Risk-Benefit Analysis.

Experiential training—where aspiring therapists undergo psychedelic-assisted therapy themselves—should not be mandatory, according to an ethical analysis applying Sandell et al.'s framework of training therapy functions. The analysis identifies five potential benefits (therapeutic, modeling, empathic, persuasive, and theoretical functions) but weighs them against six domains of risk: physical and psychological harms, negative effects on therapeutic skill, justice and equity concerns, dual relationships, privacy breaches, and undue pressure. Because many programs already include experiential components, the authors argue that the analysis can inform risk-mitigation strategies rather than justify a requirement.

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Abstract

Well-trained, competent therapists are crucial for safe and effective psychedelic-assisted therapy (PAT). The question whether PAT training programs should require aspiring therapists to undergo their own PAT-commonly referred to as "experiential training"-has received much attention within the field. In this article, we analyze the potential benefits of experiential training in PAT by applying the framework developed by Rolf Sandell et al. concerning the functions of any training therapy (the therapeutic, modeling, empathic, persuasive, and theoretical functions). We then explore six key domains in which risks could arise through mandatory experiential training: physical and psychological risks; negative impact on therapeutic skill; justice, equity, diversity, and inclusion; dual relationships; privacy and confidentiality; and undue pressure. Ultimately, we argue that experiential training in PAT should not be mandatory. Because many PAT training programs already incorporate experiential training methods, our exploration of potential harms and benefits may be used to generate comprehensive risk-mitigation strategies.