What Do Licensing Boards Think of Psychedelic Integration Therapy?

Psychedelics are growing more popular for treating mental health problems and public demand for integration services is growing in sync with this demand. Many therapists have begun offering psychedelic integration therapy for clients who are already using or experimenting with psychedelics, but also have questions about legal and ethical risks involved in doing this kind of work. Psychedelic integration work is a relatively new practice and guidelines are still developing. Practicing in any new areas entail risk, so it’s important to think about how to manage it. A common question is, “What will my licensing board think?”

These two activities are particularly risky when it comes to licensing boards: 

1. Helping clients access psychedelics, for example by referring them to an underground guide 
2. Doing therapy with clients while they are under the influence of psychedelic substances that they obtained themselves.  

Both of these are likely to lead to licensing board sanctions if your licensing board finds out. They could even put you at criminal risk as an accessory to a crime or due to drug house laws that forbid hosting a place for people to use illicit drugs. 

It would be ideal if we could just ask our licensing boards what they thought, but licensing boards typically do not make generalized statements about ambiguous situations, especially in cases where there may be a legal or ethical gray zone.  

So, we are left thinking this through on our own. First off, we might consider What is the role of a licensing board? Licensing boards have a primary duty to protect the public and take disciplinary action against providers in situations such as: 

Becoming familiar with common types of licensing board violations can provide a better sense of how to practice within ethical boundaries. In evaluating your own practice, take some time to imagine how a licensing board might perceive what you are doing. To help mitigate risk around psychedelic integration therapy, here are some things to think through. Taking each of these steps is likely to reduce your risk of licensing board sanctions should a complaint be filed against you. 

• Ethical violations 
• Sexual misconduct 
• Illegal activities 
• Provider impairment 
• Billing or insurance fraud 
• Practicing outside areas of expertise 
• Malpractice 

Stay within the law: With some exception, most psychedelics remain illegal. Therefore, do not help clients obtain access to drugs, or even access to other people who can supply drugs such as underground guides. Do not allow clients to attend therapy sessions while under the influence of drugs. 

Obtain education and training: The more training and education in the area of psychedelics that you have, the more you can argue that you are practicing within an area of competency. Be able to demonstrate that this is an area of expertise. 

Consult with others: If you choose to incorporate client usage of psychedelics into your therapy practice, consult with other therapists who are doing the same thing. This is especially important when you are confronted with situations or dilemmas that you aren’t sure how to respond to. 

Be clear with clients: Aiming for clarity in communicating with clients is key in reducing the risk that a client may misunderstand what you are offering. Make sure that clients understand what it is you can offer, and what it is you can’t offer.  

In the end, there is no guarantee of protection against disciplinary action by a licensing board. However, taking steps to lessen risk can allow you to provide psychedelic integration therapy to clients who have an increasing need for this service.  

Written by Brian Pilecki Ph.D. & Jason Luoma, Ph.D.