Accreditation Guidelines for Psychedelic Practitioners (AMAPP)

AMAPP Date of Creation: 25/03/2023 Last Edited: 7/06/2023

Psychedelic- Assisted Therapy (PAT) has shown potential to be a very effective treatment, particularly for ‘treatment resistant’ mental health conditions such as Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD). The use of psychedelic medicines as a treatment option requires much more than a stand-alone dosing session. The preparation and integration phases are considered crucial components of delivering safe and effective psychedelic-assisted psychotherapy that optimises treatment outcomes. As a paradigm shift to traditional modes of psychotherapy, working with non-ordinary states of consciousness requires additional training, experience and supervision to develop the necessary skillset. This includes appropriate background training in complementary therapeutic modalities that have been recognised for their effectiveness in treating trauma. The following guidelines for safe and effective PAT have been informed by research and recommendations from international protocols and guidelines (Mithoefer 2017; Phelps 2017), consultation with international trainers and have been adapted to accommodate Australian community-based settings. The AMAPP credentialing subcommittee is comprised of a multidisciplinary team of psychiatrists, psychologists, social workers and psychotherapists with clinical trial, research and therapy expertise, as well as PAT-specific training.

Definitions

1. Accreditation: The process of recognising a practitioner as being qualified to practice PAT either as a Psychedelic-Assisted Therapist (PAT) OR Psychedelic Facilitator (PF)

2. Provisional accreditation: Practitioner is receiving training and supervision to become fully qualified to practice PAT as either a Psychedelic-Assisted Therapist OR Psychedelic Facilitator

3. Full accreditation: Practitioner has completed the requisite training and supervision necessary to practice PAT as a Psychedelic Assisted Therapist OR Psychedelic Facilitator

4. Dosing session: A full psychedelic medicine session from client arrival to departure from the dosing venue

Pathways to Accreditation

Three types of psychedelic practitioners will be accredited:

  1. Psychedelic Prescriber (PP)

  2. Psychedelic- Assisted Therapist (PAT)

  3. Psychedelic Facilitator (PF)

FULL or PROVISIONAL accreditation will be determined by level of training, experiential training and experience. PROVISIONAL therapists will have the option to work towards FULL accreditation by completing the necessary training and requirements, such as obtaining further experiential training by engaging in supervised practice with an AMAPP-accredited supervisor.

Role Definitions

Psychedelic Prescriber:

A Psychedelic Prescriber is a psychiatrist with PAT-specific training who assesses the patient, prescribes the medicine and may, if qualified, participate in the preparatory process and administer the medicine.The Psychedelic Prescriber must have received Authorised Prescriber status following their application to a Human Research Ethics Committee to prescribe psilocybin and MDMA, and relevant background training in PAT.

When prescribing ketamine for the treatment of depression, it is crucial that ketamine is only prescribed by a psychiatrist or a medical practitioner with adequate expertise in ketamine treatment.

Psychedelic-Assisted Therapist:

A Psychedelic-Assisted Therapist engages with the patient through all three stages of treatment - preparation, dosing session, integration and ongoing therapy. The Psychedelic-Assisted Therapist has PAT-specific training, background training in psychology, psychotherapy or counselling skills, and additional training in complementary treatment modalities.

Psychedelic Facilitator:

A Psychedelic Facilitator is a co-therapist in the therapy dyad during preparation and dosing sessions, initial integration session and may also have a role in subsequent integration sessions. Facilitators have PAT-specific training and training in a mental-health-related field.

Therapy Dyads

Therapy dyads for the dosing session must consist of at least one Psychedelic-Assisted Therapist, followed by another Psychedelic-Assisted Therapist OR Psychedelic Facilitator. There cannot be two Psychedelic Facilitators in a therapy dyad. The Psychedelic-Assisted Therapist is involved in all phases of PAT. The Psychedelic Facilitator or co-Psychedelic-Assisted Therapist will need to be involved in preparation sessions for therapeutic relationship building, as well as the dosing session and initial integration session. However, ongoing integration and therapy will be provided by the Psychedelic-Assisted Therapist. Where appropriate, the client may be referred back to their treating clinician in the community for ongoing therapy.

At least one member of the dyad must hold a current registration with the Australian Health Practitioner Regulation Agency (AHPRA). This can either be the Psychedelic-Assisted Therapist or the Psychedelic Facilitator.

Examples of dyads:


1. Core Training

  • Both Psychedelic-Assisted Therapists and Psychedelic Facilitators must have completed core training in Psychedelic-Assisted Psychotherapy with a minimum of 100 hours of theory/didactic learning where the following learning outcomes can be demonstrated:

  • Foundational knowledge: History of early psychedelic research and of psychedelic use in the West, the ‘Drug War’ and the resurgence of research with the ‘psychedelic Renaissance’
    Indigenous wisdom: Understanding of the historical use of plant medicines across Indigenous traditions worldwide, and the Indigenous wisdom underpinning the use of these medicines

  • Pharmacology: Basic understanding of the pharmacology of psychedelics, neuroscience and their mechanisms of action

  • Medical Screening: Engaging in appropriate medical screening for suitability assessment, potential contraindications and complexity; trauma-informed care and practice

  • Research: Current status of research both in Australia and overseas, research protocols and outcomes; scientific developments

  • Ethics: Awareness of ethical issues relevant to psychedelic facilitation, understanding of related laws and guidelines from relevant governing bodies; ethics of safety and risk mitigation

  • Preparation and Integration: Medical assessment and screening, clinical intake and assessment, elements of preparation, consideration of set and setting, intention setting and management of expectation, transpersonal awareness and the mystical experience, phases of integration, somatic and trauma-focused approaches to integration; harm reduction; spiritual emergence and existential themes

  • Space Holding: Characteristics of a facilitator, skills of non-directiveness and attunement, supporting and responding to difficult experiences, trauma-informed use of therapeutic touch, music and playlist curation

  • Therapeutic Relationship: Managing boundaries, transference, countertransference, therapist self-care

2. Experiential Training

  • Therapists must have at least two years clinical therapy experience and have completed at least 40 hours of experiential learning in the form of breathwork, role play and dosing sessions.

  • For full accreditation, therapists/facilitators must have facilitated at least two dosing sessions as part of their experiential training, such as participation in a clinical trial or working within a community-based setting such as cannabis or ketamine-assisted therapy. Sessions must have been observed by an AMAPP-accredited supervisor either in person or video-recorded, with feedback provided, to gain full accreditation.

  • Provisionally accredited therapists/facilitators must complete a minimum of six hours supervised practice with a supervisor either in person or through the viewing of video- recorded sessions conducted by the Therapist/Facilitator. The supervision hours must be signed off by an AMAPP-accredited supervisor to obtain full accreditation.

3. Personal Development Work

Personal work is an important component of therapist development, particularly in non-ordinary state work. Therefore, Therapists and Facilitators must have significant experience of their own personal work and be committed to ongoing personal development work in the form of personal therapy, reflective practice and legal non-ordinary state work (i.e. breathwork, meditation).

4. Professional Registration

For full accreditation, Psychedelic Therapists must have eligibility for registration with a governing body such as:

  • Australian Health Practitioner Regulation Authority (AHPRA)

  • Australian Association of Social Workers (AASW)

  • Psychotherapy and Counselling Federation of Australia (PACFA)

  • Australian Counselling Association (ACA)

  • Indigenous Allied Health Australia (IAHA)

5. Complementary Therapeutic Modalities

To obtain full accreditation, Psychedelic Therapists must have a background training in psychology, psychotherapy or counselling and must be able to work with complementary therapeutic modalities to aid the ongoing therapy and integration process. Trauma-informed and somatic-orientated techniques have been recognised throughout current research and research protocols as complementary techniques for psychedelic-assisted psychotherapy (Mithoefer 2015, Phelps 2017). These modalities include:

Somatically focused therapies such as EMDR, Hakomi, Sensorimotor Psychotherapy, Somatic Experiencing

Trauma-informed therapies that recognise the multiplicity of the psyche such as EMDR, Internal Family Systems, Structural Dissociation, Ego State Therapy, Resource Therapy, Clinical Hypnosis, Gestalt Therapy, Jungian Depth Psychology, Psychodynamic Psychotherapy, Schema Therapy, Transpersonal Psychology, Voice Dialogue.

Mindfulness-based approaches such as Acceptance and Commitment Therapy, Dialectical Behaviour Therapy)

Therapists without a relevant background in complementary modalities or eligibility for registration with a governing body will be eligible for registration as a Psychedelic Facilitator.

6. Therapist Characteristics

Therapists/Facilitators applying for accreditation with AMAPP must be able to demonstrate that they are of good personal character and work with ethical integrity by demonstrating:

  • Eligibility for registration with a governing body for their profession

  • Respect for Australian law and legalities around the use of psychedelics

  • Ethical practice in the community without outstanding allegations of abuse or misconduct

  • Adherence to the AMAPP Code of Conduct

7. Aboriginal and Torres Strait Islander practitioners

AMAPP acknowledges the wisdom of plant medicines and therapies as place-based original knowledge systems passed down through the generations of Indigenous peoples over thousands of years, in safety with ceremonial and therapeutic purpose for individual and collective well-being and longevity of the communities and lands.

We acknowledge these lineages are still accessible today, however, have not been offered agency in the scope of modern use in trials and therapy. We acknowledge the right of Aboriginal and Torres Strait Islander peoples to engage in culturally safe healing practices that may not lead to registration with a governing body.

Therefore, AMAPP will support accreditation pathways for Aboriginal and Torres Strait Islander practitioners who work with culturally informed healing practices, including but not limited to:

  • Narrative Therapy

  • Grief and Loss Counselling

  • Indigenous Counselling skills training

  • Culturally-Informed Trauma Integrated Healing

  • Aboriginal Support workers

AMAPP aims to build relationships with original knowledge holders and create capacity for expansion in this field, and accreditation pathways, through engaging in a consultation process to include this knowledge through the engagement of relevant Indigenous mental health practitioners, Indigenous organisations, Elders and community leaders, to determine the most appropriate and safe approaches for treatment practices and practitioner registration. Without the inclusion of these original knowledge systems and practitioners, this field is deficient in overall outcome potentials for psychedelic-assisted therapy.

8. Continuing Professional Development

AMAPP-accredited Psychedelic Therapists and Psychedelic Facilitators must commit to the ongoing development of their skills in psychedelic-assisted psychotherapy. Members agree to engage in regular supervision and professional development activities to ensure their skill set remains current and they are up to date with evidence-based practice.


References

BrainFutures (2023, May 25). Professional practice guidelines for psychedelic-assisted psychotherapy. https://www.brainfutures.org/mental-health-treatment/professional-practice-guidelines

Mithoefer M (2017). A manual for MDMA-assisted psychotherapy in the treatment of posttraumatic stress disorder. Version 8. http://www.maps.org/research/mdma/mdma-research- timeline/4887-a-manual-for-mdma-assisted-psychotherapy-in-the-treatment-of-ptsd.

Phelps, J. (2017). “Developing guidelines and competencies for the training of psychedelic therapist.” Journal of Humanistic Psychology, 57(5), 450–487. https://doi.org/10.1177/0022167817711304



Last modified: Friday, 9 February 2024, 6:01 PM