Psychedelic Harm Reduction and Integration
Psychedelic Integration, or Psychedelic Harm Reduction and Integration—also known as PHRI—is a client-centered approach to working with people in a clinical setting who have had or are considering having a psychedelic experience in any context—including therapeutic, spiritual, peer-led, or alone. It does not involve the administration of a psychedelic substance or working with a client during an acute psychedelic experience.
Psychedelic-Assisted Psychotherapy is a clinical practice that combines the administration of a psychedelic substance with psychotherapeutic support. Until recently this modality has mostly been explored in the context of research and clinical trials due to the regulatory status of these substances. Examples of psychedelic-assisted psychotherapy include MDMA-assisted therapy, ketamine-assisted psychotherapy, and psilocybin-assisted therapy. Many of these approaches are designed to treat a specific indication using a certain substance and therapeutic approach. See below for more about the history of this research and specific types of psychedelic-assisted therapy.
A very brief history of psychedelic-assisted therapy
Psychedelic-assisted therapy has existed in the clinical sense since at least the 1950s, following the discovery of LSD and early research around its therapeutic potential, including for the treatment of alcohol use disorder. Despite promising early results, the scheduling of LSD in 1968 led to shutdown of most research in this era that persisted until the late 1990s. Throughout this period therapists and researchers were also exploring the therapeutic potential of other new substances like MDMA—which was ‘rediscovered’ in 1976—as well as non-drug techniques for inducing non-ordinary states of consciousness. MDMA showed similar therapeutic potential before it, too, was scheduled in 1984, leading to the formation of MAPS. It wasn’t until some early research with DMT received the green light in the mid-90s that research began to slowly open back up, with Phase 1 safety approval for MDMA research also granted around this time. Through the early 2000s psilocybin became the most common psychedelic to be researched, culminating in a 2006 study at Johns Hopkins that some might argue marks the beginning of the current psychedelic ‘renaissance.’ Ketamine too, began to garner more interest starting in the early 2000s for its efficacy in alleviating depression and acute suicidality, following its early history in the 1970s as an anesthetic.
In the last fifteen years research into psychedelic-assisted therapy has exploded, and today there are countless studies exploring the therapeutic potential of dozens of substances, for numerous indications. Many of these indications do not currently have other adequate treatments available. Some of the most promising and notable include: MDMA-assisted therapy for PTSD, ketamine-assisted psychotherapy for depression, psilocybin-assisted therapy for depression, psilocybin-assisted therapy for alcohol use disorder and other addictions, psilocybin-assisted therapy for anxiety and end of the life care. Recent years have also seen increasing research around ‘newer’ compounds like 5-MeO-DMT, which also shows promise for treating depression and addiction.
Many of the trainers at Fluence have been at the forefront of some of this research, including our co-founders. To learn more about our team’s involvement in research, see Our Team page and bios, and as well as our Publications section. You’re also encouraged to see our Partners and News sections to learn about how we’re supporting the latest phases of research by training therapists in clinical trials.
Want to learn more about the history of psychedelics and clinical research? Our introductory workshop Premise & Promise explores this history in much more detail, and is a great place to start.
Interested in a particular substance or modality? Learn more about Fluence’s approach to psilocybin-assisted therapy and ketamine-assisted psychotherapy. And make sure and sign-up to our newsletter to hear about when we roll out additional trainings.