From Underground to Mainstream: Preparing for the Surge in Demand for Skilled Therapists

From Underground to Mainstream: Preparing for the Surge in Demand for Skilled Therapists

By Arthur Lee

Arthur Lee is a friend of the Numinus team. He wanted to share his perspective on the Psychedelic movement and the community, at large. Although the content below is his opinion, we are honored to share voices from the experience of those who helped us reach this point in access. Numinus Training is for licensed and unlicensed individuals on traditional and alternative paths. Thank you, Arthur, for your contribution! 

Psychedelic-assisted therapy is poised to transform mental healthcare. Anyone who's been paying a modicum of attention to the mainstreaming and medicalization of the field knows this, and the science is clear. For most people, psychedelic medicines are safe, suitable, and vastly more effective for a myriad of diagnosable disorders than standard therapeutic approaches. With MDMA widely expected to clear the final FDA hurdle in the United States in August 2024, we are approaching a watershed moment. A once-outlawed psychedelic drug will become legally available in a medical setting. Rather than be compelled to navigate the "underground," unlicensed market or travel to another continent in order to access legal, well-supported psychedelic care. I may soon be able to receive psychedelic-assisted therapy with licensed providers within clinics across North America. Call me optimistic, but I firmly believe this is true: The psychedelic genie is out of the bottle, and there's no turning back. 

 

Reshaping Mental Health: Recalculating The Math Of Supporting Wellbeing

As psychedelic therapy becomes legally available, one of the most pressing questions becomes: How do we meet the imminent demand for psychedelic-assisted care with skilled and trained therapists? There are currently a few thousand therapists in North America alone who are accredited by training programs provided by MAPS, Numinus, and others, but how do we serve all those who may potentially qualify for psychedelic treatment? In the United States, it's estimated that approximately 12 million American adults experience PTSD in a given year. In Canada, about 5% of the population of 40 million have been diagnosed with PTSD. Do the math. We are not yet prepared to care for all those who may benefit from these treatments. Not even close. 

And that's considering MDMA-assisted therapy for PTSD alone. What about psilocybin for depression, end-of-life anxiety, and other indications? What about ketamine therapy training for Physicians instead of just for pain centers? What about 5-MeO-DMT for addiction? What about other psychedelic medicines that have not yet been created that we will discover and their potential therapeutic use? Take all those into account, and we have a massive shortfall of trained psychedelic therapists. Long story short: It's all hands on deck to get people the help they need as the legalization of psychedelic therapy takes place. 

"While many people may have safe and even sacred experiences in the company and care of friends or informal "trip sitters,"-- overlooking the necessity for trained psychedelic therapists threatens to put many users and clients at risk of harm."

A fair question that some are asking as we wonder how to meet the projected demand is if one necessarily needs formal training or certification to support others through altered states. Survey the average person who's ingested a psychedelic substance at least once in their life, and it is far more likely they did so in the company of friends than in the presence of a clinically-trained therapist or shamanically-trained facilitator. My first time ingesting psilocybin mushrooms was with my best friend, Cody, in an RV parked in the driveway of his grandparents' northern Ontario home. In the absence of a guide, we were still thoughtful and intentional about set, setting, and dose. That unsupervised psychedelic experience was one of the most meaningful moments of my young adult life. No therapist or guide was present—honestly, that didn’t even cross our minds. In my opinion, there will always be a place for the responsible, safe, and even recreational use of psychedelics. It is a fundamental human right to possess freedom of thought and choose how to modulate our consciousness in whatever informed setting we ultimately select. This is coming from someone who has both provided nearly a hundred psychedelic experiences for others through a clinically informed lens and consumed psychedelic medicines in open-air jungle huts in South America. 

 

The "When, Why, and How" of The Increased Demand

With all that in mind, the increasingly global, clinical application of these powerful substances requires a more rigorous and specialized approach. While many people may have safe and even sacred experiences in the company and care of friends or informal "trip sitters,"-- overlooking the necessity for trained psychedelic therapists threatens to put many users and clients at risk of harm. To suggest that all one needs to receive proper care and support through a psychedelic experience is someone they trust and who knows the terrain through personal experience is irresponsible and untrue. Both of those are absolute prerequisites for psychedelic facilitators, but they're not enough. Necessary but not sufficient. 

 

Thank you, Psychedelic Alpha, for permission to use your research; full interactive link here: https://psychedelicalpha.com/data/psychedelic-laws 

While a trusted, knowledgeable companion can play an invaluable role in a person's psychedelic journey, the clinical application of these powerful medicines requires a level of training and expertise that goes far beyond informal peer support. Psychedelic-assisted therapy demands a comprehensive understanding of the pharmacology, neurobiological mechanisms, contraindications, and clinical evidence base for these substances. Practitioners must also be highly skilled in creating a safe, supportive, and therapeutically optimal setting, as well as guiding clients through the complex and emotionally charged experience. 

 

Effective psychedelic therapy also necessitates advanced therapeutic skills that go beyond just "being there" compassionately and without judgment for someone. Therapists must be adept at preparing clients, working with non-ordinary states of consciousness, navigating challenging emotional or psychological material that arises, having knowledge and skill working with transference and countertransference, and then skillfully assisting with integrating lessons and insights gleaned. This requires in-depth training in modalities like trauma-informed care, emotion-focused therapy, Internal Family Systems, Gestalt techniques, or other evidence-based approaches. 

Beyond the clinical expertise, psychedelic therapists must have also cultivated a high degree of self-awareness, emotional maturity, and comfort with the unknown. The psychedelic experience can open an intensely personal and profound process, and therapists must be willing to confront their own biases, wounds, and shadow elements in order to be fully present and effective. They must also be able to hold a steady, grounded, and compassionate space as journeyers explore the furthest reaches of their consciousness. Your buddy who’s tripped a dozen times may fulfill some but not all of these requirements. Even if nine times out of ten, sitting with an untrained guide doesn't result in a bad outcome for the client, it's that tenth vulnerable person that we must go to great lengths to protect. 

The Challenges Of Mainstreaming The Psychedelic Industry In 2024

If I sound a bit uptight about all this, it’s only because I have a profound respect and love for what these medicines can offer when approached responsibly. I’ve heard of too many accounts of people coming to great harm at the hands of unqualified “trip sitters” who were in over their heads and offering support outside of their scope of practice. People who were re-traumatized. People whose symptoms worsened. And yes, even people who took their own lives because of the inadequate support they received throughout the psychedelic process contributed to their destabilization. The mainstream adoption of psychedelic therapy has too much potential and promise for us to take any chances. We’re talking about providing the utmost level of care for people in extremely vulnerable states. The difference between a trained guide and another who isn’t could determine whether a person’s experience is healing or profoundly harmful, whether they find relief from their symptoms or are plunged even deeper into illness.  

"While the recreational and spiritual use of psychedelics will always have an important place and should be protected, the clinical application of these substances requires a level of skill, knowledge, and personal development that goes beyond informal peer support."

As psychedelic medicines become mainstream, it will be crucial to establish rigorous training and certification standards to protect the integrity of this emerging field of clinical psychedelic therapy. Regulatory bodies, professional associations, and pioneering psychedelic therapy organizations will all play a key role in developing these frameworks and ensuring that only the most qualified practitioners are entrusted with guiding people through these profound and potentially life-changing experiences in a clinical setting. While the recreational and spiritual use of psychedelics will always have an important place and should be protected, the clinical application of these substances requires a level of skill, knowledge, and personal development that goes beyond informal peer support. As we move into this new era of psychedelic-assisted therapy, we must uphold the highest standards of safety, ethics, and therapeutic excellence for those accessing these treatments through licensed medical providers.  

Numinus is leading the way in training competent providers to offer psychedelic-assisted therapy safely and effectively. They offer certification in ketamine, MDMA, and psilocybin, which are taught by highly experienced and actively practicing therapists who can give real-world guidance and support. Their pathways (subject to pending FDA approval) will also include valuable experiential learning opportunities and practicum placements to get first-hand experience with the medicines and to see real clients before certification. Their clear path to practice and highly credible curriculum will help ensure future providers offer safe and evidence-based care to clients in need worldwide. 

To get started, check out their Fundamentals of Psychedelic-Assisted Therapy program here: Fundamentals of Psychedelic-Assisted Therapy - Numinus.  

 The Fundamentals coursework is interactive, with opportunities to learn from professionals actively working in Psychedelic-Assisted Therapeutic (PAT) practices. There are live remote learning sessions with breakout rooms for peer-led learning and small group time with the mentors leading the courses. The training offers a balance of understanding the applications of PAT and personalized care for individual cases. It is perfect for those licensed and attempting to navigate their client’s needs after an altered state and those who work outside licensures and want to deepen their abilities to work with a wider variety of clients and treatments.  

 

Group Ketamine-Assisted Therapy: A Therapist's Musings

Group Ketamine-Assisted Therapy From The Perspective Of A Therapist

 

When I first started bringing up the idea of group ketamine therapy to my patients as a potential option, I did so somewhat timidly, often prefacing the conversation with “ok, now hear me out” or “I know it sounds strange…group therapy but with ketamine”. This was in part because the idea and execution of it was new to me, my hopes for positive outcomes were still a hypothesis and in part, because the patients I spoke with about it were immediately incredulous and skeptical, not only of group therapy work, but also of throwing a consciousness-altering medicine into the mix. After seeing firsthand the positive outcomes of group sessions that my co-facilitator and I have led, and working closely with facilitators of other groups with similarly outstanding results, I approach the group ketamine conversation differently: with confidence and earnest convictions of the benefits for those who bravely enter this space.

I will say here what I say to my patients who I think are a good fit but who are skeptical of this model: healing happens in groups. Yes, individual work is important, and for some people that individual work needs to happen first before entering a group space, but for generations across time, across cultures, and across the world, healing has happened in communities, when we witness and are witnessed in this process and we begin to embody the sense that we are all connected in more ways than we ever dreamed.  

During the medicine sessions, this is not group talk therapy, although we are together in the same room each person is having their own experience with the medicine. Typically, everyone is wearing eyeshades and music is playing while at least two facilitators carefully watch over the group, providing support when needed, but mostly leaving participants to explore their own innate ability to heal themselves, with support from others. All are welcome in this room, laughing, crying, and complete silence, it is all ok and requires no explanation.  

When we have shared experiences of transcendence, of entering the depths of sorrow, of embodying joy and playfulness, of connecting deeply with those around us, we find that we are better able to do those things in our everyday lives: with our families, our friends, and our community. We are able to bring these learnings back to those we love, facilitating a deeper connection with others, and ourselves.  And for those who feel they lack those relationships in their lives currently, practicing this kind of vulnerability opens the door of possibility that community is not only possible but accessible. Connection often doesn’t just happen in the culture we currently live in, it's not a given - it must be sought out and practiced. Coming together in a group with a shared purpose gives each of us the opportunity to practice vulnerability and connection with others in ways we are not often afforded in our everyday lives.  

I know I keep referring to “we” and “us”.  I have done this because we come into this group together. The group is not a service we as therapists and medical providers are giving to you. We are in this place together, learning and growing along with you, and for that we thank you for taking this leap.  

 

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If you're interested in learning more about our Group Ketamine-Assisted Therapy sessions, visit our webpage. 

If you're in the Utah area, we are leading Group Ketamine-Assisted Therapy sessions focused on chronic and serious illness at our Murray Clinic starting October 9th. One-on-one intake visits are currently open until October 4th. To learn more or to book your spot email INFO-UTAH@NUMINUS.COM or call 1 (801) 369-8989.

 

 

Pride Month: Fostering Mental Health & Advocacy

Numinus Stands with the LGBTQ2+ Community

June 6th, 2023, the Human Rights Campaign (HRC), a leading LGBTQ+ advocacy group, declared a state of emergency for LGBTQ+ individuals in the United States due to a surge in anti-LGBTQ+ legislation, primarily targeting transgender Americans. In 2023 alone, legislators from 41 US states introduced more than 525 anti-LGBTQ+ bills, with 220 of them specifically aimed at transgender people. These bills encompass a wide range of measures, such as denying transgender students the right to participate in sports, restricting access to gender-affirming healthcare, and prohibiting transgender individuals from using certain bathrooms.

Statistics derived from the Trevor Project's 2023 National Survey on the Mental Health of LGBTQ Young People reveal alarming figures. Within the past year, nearly 50% of transmen, transwomen, and nonbinary/genderqueer youth aged 13-25 seriously contemplated suicide, while over 20% of transgender young individuals attempted suicide. The survey also uncovered that rates of suicidal ideation, suicide attempts, depression, and anxiety among LGBTQ+ youth are two-to-three times higher compared to cisgender, heterosexual peers. The adverse effects of anti-LGBTQ+ legislation directly impact the mental health of queer youth.

We are currently facing an unprecedented mental health crisis within the LGBTQ2+ community. Without decisive and meaningful action, the social and political climate in the United States will continue to jeopardize the health and well-being of queer individuals. As a queer healthcare provider myself, I am devastated and appalled by the ongoing threats to the basic rights of queer people in our country. This Pride Season, it is my hope that mental health providers and organizations will reflect on how we can further advocate for and support the LGBTQ2+ community. Mere symbolic gestures, such as flying flags or posting on social media, will not suffice. We require fundamental and structural changes that permeate every aspect of mental healthcare, including the creation of affirming patient-care spaces and the elevation of queer voices in decision-making processes within institutions. The choices we make today will have a direct impact on the mental health outcomes of LGBTQ2+ individuals for generations to come.

At Numinus, we are committed to fostering a safe and inclusive environment for the LGBTQ2+ community. We prioritize creating a space where individuals of all gender identities and sexual orientations feel respected, affirmed, and free from discrimination. We strive to ensure that our services are accessible, sensitive, and tailored to meet the diverse needs of the LGBTQ2+ community. To our LGBTQ2+ clients and fellow providers, please know that you are seen, valid, and indispensable. Each of you brings unique contributions to this world that no one else can replicate, and together, we collectively enhance the beauty of this world.

 

LGBTQ+ Mental Health Resources

If you require emergency support or assistance, please reach out to the available support networks:

 

Written by Dr. Deven Jennings DNP, PMHNP-BC, APRN