How to Start A Psychedelic Therapy Practice
It’s a cold, rainy Tuesday. Your rain jacket drips a slow stream from the coat rack to the floor. Steam rises from your mug of tea. By all accounts, this should be a gloomy day, but warmth and joy is radiating from the center of your office: a client, who you have seen for three years, no longer feels suicidal. They talk to you about their week and how their new antidepressants are interacting well with the ketamine. You listen attentively and take notes, but under the surface, you are jumping for joy: yes, yes, yes!
How I Decided To Start A Psychedelic Clinic
When people ask me how I decided to become a therapist, the answer was simple: because I had therapists. I had safe spaces to heal, to talk, to process the tough parts of life, and share the victories. I knew I wanted to provide other people with that same space.
Sometimes, when people hear that I am a therapist that uses psychedelics they are surprised at my credentials being so mainstream. They don’t realize that to be a good psychedelic therapist, you have to be a good therapist first. My bachelor's in psychology at Muhlenberg College led to my MA in Psychology and my Ed.M in Counseling at Columbia University.
Along the way, I specialized in existential psychology. That, paired with my personal experiences with understanding the healing power of entheogens in the space of therapy, organically led to my incorporation of ketamine as a tool to use with clients.
A side note- if you balk at the idea that I do psychedelic medicine, this might not be the field for you. You need to know what the medicine does before you go on recommending it to others. I know from personal experience how effective psychedelic medicine can be for healing; I have seen it in friends, family, and myself. If used appropriately, and in a way that is intentional, conscious, and ethical, psychedelics can produce an incredible amount of psychological healing.
I quickly learned that to be a skilled psychedelic therapist, you must be a skilled therapist first. Ketamine therapy through my clinic is not a magic pill (no pun intended) or an all-powerful tool- it is a supplement that enhances the work that I am already doing with my clients with depression. If you are a skilled therapist that knows the needs of your clients, that has experience treating depression, and that wants to enhance the good work you are already doing, ketamine might be a tool worth integrating.
Ketamine is going mainstream, and for good reason. The molecular structure of ketamine allows the neurological changes to the Default Mode Network that will help depression off the bat- but that won’t last forever. Ketamine isn’t a new lifetime antidepressant- your job is to work within that period to help your client expand that experience with good integration. Some clients will still need to use ketamine in concert with other antidepressants. Your clients will likely still stay on antidepressants and need therapy, but this will give you incredible gains- but only if you have the right training.
Finding the Best Training for Psychedelic Therapy
While ketamine has been around since the 1960’s, the regulations surrounding the clinical use of ketamine for treatment-resistant depression have been slow to catch up. Currently, there is no governing body or accrediting institution- just beginning programs. Because of this variance in the types of programs out there, you must be selective in your vetting process. Don’t despair, though! The right groups are out there. As a therapist, your intuition and networking skills will do most of the work for you- that is what happened for me.
I attended a psychedelic professionals organization meeting in Fort Collins and connected through a client with Dr. Scott Shannon, the head of the Wholeness Center. Getting to know other professionals through that meeting led me to get my training with PRATI , connected me to a psychiatrist that I work with for Reflective Healing’s Ketamine Assisted Therapy program, and helped me find a supervision mentorship. While the idea of a ketamine-centered training might conjure up some images of a Woodstock festival, I hate to burst your bubble. It was all professionals there- no lab coats in sight, but you knew they possibly had them hanging in a closet somewhere, or their luggage (there were people from all over the country in the PRATI training, so don’t let commutes scare you).
The “Red Flags” of Psychedelic Training
Here’s the truth: right now, it’s the wild, wild, west of psychedelic therapy. We are all trying to figure out how to do best practice, and there is no “best way” of doing it- there are different ways. With that being said, there are some red flags, and things to look for.
Be wary of the “pump and dump” model.
In my experience, ceremony and integration are crucial for the process of what this medicine does. The hard part isn’t getting a client the ketamine- the hard part (which is also the best part) is doing the work of integration after they take the medicine.
Your job as a psychedelic therapist is to help your client integrate this medicine in a lasting, meaningful way, so you would think that all training would focus on this part. Unfortunately, there is a rash of new training centers that use a “pump-and-dump” method: give the client ketamine, leave them in a room alone until it wears off, and then send them a bill.
If you encounter one of these centers: consult with your inner skeptic!
Avoid training that doesn't emphasize mentorship.
As with any good trip, you’ll want to have a guide. I cannot stress enough how important it is to have supervision and mentorship from an ethical practitioner! It was crucial to my journey to get to where I am. I recommend getting supervision from a practitioner who is doing this work already and learning under them or by working at a clinical ketamine center.
Find a training where you take the medicine yourself.
How weird would it be if you went to a restaurant where the chef had never bothered to try a single item on the menu? To effectively administer the medicine, you have to have experienced it through the context of therapeutic administration and ceremony yourself. Don’t do a training where you don’t get the experience of doing the medicine!
The bottom line?
Be sure that the training that you choose aligns with your values, morals, and reasons for wanting to utilize this medicine. After you do that, the fun part begins: integrating ketamine therapy into your practice!
How to Start a Ketamine-Assisted Therapy Practice
For an article that is about starting a ketamine assisted therapy practice, you might be surprised that this is the shortest part. And that is a good thing!
Disclaimer: In the same way that you shouldn’t do this type of practice if you don’t want to try the medicine yourself, it likely is also not for you if you don’t already have robust experience serving clients with a variety of diagnoses.
If you have the two key skills needed- good training and experience as a therapist- then the medicine takes care of the rest. There are some supplies, sure (a nice memory foam pad for your clients to lay down on, an eye mask, and speakers with headphones) but the rest is all in the shift of what you can now offer to your existing clients.
After your training and taking the medicine, you will be better able to tell which clients you are serving that would benefit from ketamine. Do it with an existing client who you thought would be a good fit- hold off on advertising that you are doing this- and use the rapport you already have to do it. Have a price list (here’s mine). This is where your networking is also crucial: you’ll want to have a working relationship with the prescribing medical provider so you can consult on cases. Once you find your rhythm and start seeing victories, you can think about expanding your marketing (here is who I used).
Challenges and Victories from My Ketamine Assisted Therapy Program
As you might expect, there are some challenges when it comes to incorporating psychedelics like ketamine into your practice. The good news? A lot of these barriers are more internal than external, and if you weren’t good at tackling the internal, we wouldn’t be here!
Challenges:
Ketamine therapy and similar psychedelic therapies are time-consuming.
This isn’t a magic pill, but it is an expensive one.
You need to be able to let go of your inner perfectionist.
This is an expensive treatment. As a practitioner with a high standard of care that you want to provide, it might feel tricky charging your client for something that might not necessarily work. Being realistic with your clients and letting them know that this isn’t a magic pill and that you both need to manage your expectations is crucial.
You also need to manage your time. Clients will be coming to you for two or three-hour sessions- make sure that you can fit this in without compromising your work/life balance. And speaking of balance… you need to have patience with yourself as you learn this! There is no bluebook for this type of treatment; you are going to make mistakes and do things that might not work.
That said, as long as you can take criticism from clients and be open to change, the victories can feel huge.
Victories:
Seeing the massively expedited change in a client.
Having avenues open up in terms of talk therapy that you might have never thought possible.
Having clients who struggled with things like major depression or suicidal ideation see progress.
Here is where the good news comes in: the medicine does some of its own therapy! You will see something beautiful happen: the medicine does its work, you facilitate and integrate, and the client can tap into that wisdom that comes from within. In a way, the client gets to be their own therapist! The client may l still have to stay on their prescribed medications (cue the ‘managing expectations’ music) and they will still likely want to attend non-psychedelic therapy (which, from a business side, isn’t a bad thing) but they can be leaps and bounds from where they started. That rainy day picture that I painted at the start of this article? Yeah, that was a real story of a real client! And you can achieve that, too.
Final Advice for Aspiring Psychedelic Therapists
Find a community of practitioners- online or in-person- who are doing this work.
Have a one-on-one with someone at the meeting. Ask how they got there and what their practice looks like.
Find a training program and supervision group.
Make sure that you don’t overwork, and make time for your own spiritual healing.
Manage the expectations of your client. Make sure they understand that results are hoped for, but not guaranteed.
And some final words of wisdom?
Respect the medicine. Respect the process. Be aware of your ego. This isn’t about you- it’s about how the medicine and client are working together, and how much space you are holding for them. To hold space here is a whole new type of therapy. It’s less doing and more being. I am excited for you- you have got this!
I love to hear what others are thinking. We are pioneers, and there is a lot of space to explore. Just don’t do it in a vacuum! Feel free to reach out to me via my email, or check out Reflective Healing’s Ketamine Assisted Therapy program.
Be well,
Dori Lewis