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PHRI is transtheoretical and transdiagnostic and can include working with patients both before and after a psychedelic experience, independently of that experience, and regardless of whether the provider is at all involved in that experience. The Fluence model for Psychedelic Harm Reduction and Integration includes building on the practitioner’s existing psychotherapy skills and orientation, incorporates harm reduction and psychedelic-assisted therapy principles, as well as elements of mindfulness-based interventions and psychodynamic approaches.

Psychedelic Harm Reduction and Integration is differentiated from psychedelic harm reduction or integration that occurs in non-clinical settings. It is distinct from psychedelic-assisted therapy in that it focuses on preparation for and integration of psychedelic work, not the administration of psychedelics or conducting psychedelic sessions. Although psychedelic-assisted therapy includes integration, it is our position that integration can be conducted independently of the psychedelic session.

Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

Fluence Co-Founders Ingmar Gorman and Elizabeth Nielson co-authored a foundational paper in 2021 exploring PHRI as a modality.

General Principles of Psychedelic Harm Reduction and Integration

  • grounded in the therapist’s existing clinical training, experience, and practice; 
  • assumes all the clinical, ethical, legal covenants that are attendant to the therapist’s scope of practice;  
  • sees the patient in a comprehensive clinical way, including the medical, psychiatric, psychological, and social conditions in which the psychedelic integration work is situated;  
  • is patient-centered, respecting the patient’s autonomy, rights, and personal liberty with regards to their decisions regarding psychedelic use;   
  • is respectful of wisdom traditions and other care modalities that may lie outside the therapist’s experience or practice;
  • is collaborative with medical and mental health providers, somatic health practitioners, alternative healing practitioners, and spiritually oriented healers;
  • is offered in alignment with the provider’s professional ethics and in a spirit of inclusion, non-violence, affordability, non-discrimination, and transparency;
  • is fully compliant with the MAPS Code of Ethics for MDMA-Assisted Therapy, published in Spring, 2019.