What is Psychedelic Harm Reduction and Integration?

Psychedelic Harm Reduction and Integration, also known as PHRI or Psychedelic Integration Therapy (PIT) is a client-centered approach to working with people in a clinical setting who are considering having a psychedelic experience in any context, including therapeutic, spiritual, peer-led, or alone. 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.

General Principles

Psychedelic Harm Reduction and Integration:

  • is 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.   

Certificate Program Graduate Expectations:

The following are expectations of our Postgraduate Certificate in Psychedelic Harm Reduction and Integration graduates. Please see the Program Overview page for full details.

Knowledge, Competencies, Experience:

1. Knowledge:

The graduate will:

  • Know how to evaluate and conceptualize a patient’s relationship to psychedelics and the relationship between the patient’s experience with psychedelics and their presenting problem or concerns;
  • Know how to embed preparation for psychedelic experiences and integration of psychedelic experiences into the existing course of psychotherapy or treatment plan;
  • Be highly informed regarding psychedelics, their effects, their risks, and the extremely varied ways that they are used for meaning, healing, growth and treatment;
  • Know (in their own therapeutic orientation) how to understand (make meaning of) and work with experiences that may be neutral, positive, challenging, traumatic, and ranging from under- to overwhelming intensity that can occur with psychedelic medicines;
  • Identify and respect a range of motivations patients bring to their psychedelic experiences such as personal growth, spiritual growth, psychiatric/medical healing, and recreational pursuits, and apply this knowledge to the treatment they offer;
  • Recognize common signs clinical danger that may be related to psychedelic use, and be prepared to consult with other professionals and provide crisis intervention;
  • Have knowledge of transference reactions, both those commonly seen in non-psychedelic-focused treatment, and also those unique to psychedelic work;
  • Know how to recognize countertransference reactions, how to use them creatively when possible, and seek consultation when difficulties arise;
  • Have basic knowledge of the legal aspects of psychedelic use in the US.  
2. Competencies:

The graduate will:

  • Be competent to establish and maintain a therapeutic alliance as well as skillfully manage termination and referral process as it relates to PHRI;
  • Have competency at recognizing both verbal and non-verbal communication as it relates to PHRI;
  • Be competent to maintain boundaries and confidentiality, as required by their licensing board as these relate to PHRI;
  • Be competent in understanding and integrating a broad range of treatment modalities  as these relate the patient’s care;
  • Be competent in identifying and understanding the range of psychological reactions to psychedelic experiences as these relate to the patient’s care;
  • Be competent to provide psychoeducation in basic information regarding psychedelic medicines;
  • Demonstrate respect for wisdom traditions (indigenous and alternative treatments) that may be part of the patient’s experience.
  • Possess an ability to access higher meanings, values, and abiding purposes, and to integrate these in living richer and more creative lives, with respect to themselves and their patients.
  • Have competence in maintaining self-care and identifying need for expanded work in self-care domains, with respect to themselves and their patients.
  • Be competent in self-monitoring clinical work at all times.
  • Accurately represent themselves and their professional services, including PHRI, to the public in ways that are aligned with all applicable laws and regulations.
  • Provide professional services, including PHRI, to the public in ways that are aligned with all applicable laws and regulations.
3. Experience:

The graduate will:

  • Have close clinical consultation with Fluence trainers regarding the PHRI they have conducted with volunteers or patients who have undergone non-ordinary states of consciousness (NOSC) experiences;
  • Have thorough consultation with Fluence trainers regarding their own NOSC work in any form, setting, and origin.