Category: Training & Education

Psychiatrists are key players and need to stay informed.

Psychedelic-Assisted Therapy Essentials | Part 2

Psychiatrists do not need to support psychedelics. Still, it may be wise to pay attention. The zeitgeist is changing and, soon, if not already, patients will begin asking about them or even stopping their SSRIs in search of a miracle cure. The well-being of patients may depend, in part, on their psychiatrist’s understanding of these historically controversial substances.

To be clear, psychedelics are not the miracle cure the media sometimes announces. However, they have re-entered serious clinical and scientific conversation. Professional psychiatric bodies in the United States1, the United Kingdom, Australia and New Zealand are all taking the field seriously. The American Psychiatric Association supports continued research while withholding endorsement for routine clinical use outside approved investigational settings. The Royal Australian and New Zealand College of Psychiatrists has issued guidance specifically to inform psychiatrists about the potential therapeutic utility of these substances2. The UK Royal College of Psychiatrists has gone further and stated that psychiatrists should be involved in their future therapeutic use and in the clinical leadership of multidisciplinary teams3.

Why should psychiatrists care?

First, patients are increasingly hearing about psychedelics and their potential healing value. As their psychiatrist, you may be the one professional your patients trust most. It is only natural that they may turn to you to make sense of this landscape. What would you say when a patient asks whether psychedelics could help with treatment-resistant depression, or when they ask for your opinion about the Costa Rica retreat they just booked? This is your opportunity to discuss risks, expectations, medication interactions, and contraindications. When the stakes are high, knowing how to respond or who to refer to becomes a form of care.

Second, the research is no longer peripheral. Major psychiatry journals and organizations are engaging the topic seriously. The British Journal of Psychiatry has published guidance and reflections to support psychiatrists as this area evolves. Likewise, in the United States, the APA has issued a Position Statement on the Use of Psychedelic and Empathogenic Agents4. Although the matter is far from settled, the subject has matured enough that informed clinicians can no longer dismiss it as fringe, especially when suffering patients are paying attention.

Third, people interested in using psychedelics need the involvement of their psychiatrists. This area of mental health care should not develop without psychiatric input. Guides, therapists, sitters, and ceremonial practitioners may all benefit from psychiatric expertise. Psychiatrists are especially well-positioned to contribute diagnostic clarity, assessment of comorbidity, medication expertise, adverse-effect monitoring, contraindication screening, harm reduction, and continuity of care.

This matters because psychedelic-assisted therapy is no longer confined to underground or countercultural spaces, and more people are willing to try it to address issues such as depression, anxiety, PTSD, OCD, and fear of death. However, as suggested earlier in this series, what can heal can also harm. That is why psychiatry should join the conversation. Not simply to approve or disapprove, but to bring clinical judgment, patient protection, and a broader view of care to an area that needs all three. The opportunity here is not only for psychiatrists to stay current. It is also for them to better support patients who are curious, hopeful, cautious, or already walking into this territory.

Over the years, I’ve worked with many caring psychiatrists who, while aware of the risks, also recognized the potential benefits of psychedelics and helped make ceremonies safer and more healing. Sadly, I’ve also been called to support people in the aftermath of experiences they pursued on their own, sometimes because they felt they had no place to discuss the issue openly. Of course, patients are responsible for their own decisions, but having informed professionals in their corner can make a huge difference.

Psychiatrists do not need to slay, dismiss, or fear the dragon. But they cannot ignore it either. What is needed is engagement and a better understanding of the territory, if only because more patients are already looking in that direction. Your patients are counting on you.

Next: Fire and the Dragon. On the numinous quality of psychedelic work, and why awe and humility belong together.

If you are a psychiatrist, clinic, or training program curious about this topic, follow this series or reach out for a grounded talk, consultation, or educational offering on the subject.

  1. https://www.psychiatry.org/News-room/News-Releases/Special-Issue-APA-Journal-Psychedelic-Medication ↩︎
  2. https://www.ranzcp.org/getmedia/4cfd1fea-171c-43fc-8dab-7b476b3f706c/cm-therapeutic-use-of-psychedelics.pdf ↩︎
  3. https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/position-statements/position-statement—ps02_25-pars-for-medical-use.pdf ↩︎
  4. https://www.psychiatry.org/getattachment/d5c13619-ca1f-491f-a7a8-b7141c800904/Position-Use-of-Psychedelic-Empathogenic-Agents.pdf ↩︎

Why psychedelic work calls for humility, preparation, and respect.

Psychedelic-Assisted Therapy Essentials | Part 1

Psychedelic-assisted therapy is often discussed in terms of promise. And rightly so. For many people, it has opened doors that had long seemed sealed shut. It has helped illuminate buried pain, soften rigid patterns, and reconnect people with meaning, wonder, and life itself.

And yet, this promise can be misleading if it is not held alongside another truth: this work is not easy terrain.

As beneficial as it can be, psychedelic-assisted therapy, or PAT, can also be arduous, perilous, and thorny. The same processes that may support healing can also become destabilizing when approached without adequate preparation, support, or discernment. This is one of the reasons I find the old phrase hic sunt dracones so fitting here: here be dragons.

The point of such a warning is not to frighten people away. It is to invite seriousness. It is to remind us that there are forms of terrain we do not cross casually. Just as one would prepare carefully before entering difficult and unfamiliar terrain, deep preparation, respect for the journey ahead, and trustworthy guides are strongly recommended here as well.

Psychedelics can be profound teachers, but they are not a shortcut. They are not a silver bullet. They do not do our growing for us. At their best, they may help reveal what is true, loosen what has hardened, and open a path. But what happens next depends on many things: the participant’s readiness, the quality of preparation, the guide’s skill and maturity, the relational container, and the care taken to integrate what emerges.

This is why I often compare psychedelics to fire, or perhaps to a dragon. They are fascinating, powerful, and never fully tamed. One does not truly master fire. One learns how to work with it, how to respect it, and how not to be careless in its presence. The same is true here.

If this field is to mature, it will not do so through enthusiasm or good intentions alone. It will require humility, ethical clarity, thoughtful training, cultural respect, and a willingness to move more slowly than the hype might prefer. It will require us to remember that healing is not manufactured by intensity alone, and that deep work deserves deep preparation.

There is much to be hopeful about. I hold that hope. I have seen the healing psychedelics can support. But hope, by itself, is not enough. In a field like this, reverence must be accompanied by responsibility.

Perhaps that is one simple way of saying what this series is about: to prepare, to learn how to approach the dragon wisely, and to remain mindful of its unpredictable nature.

Next: Psychiatry and Psychotherapy on why we need psychiatrists to be part of this quest to the dragon.

Psychedelic-Assisted Therapy Essentials Series

An introduction to the Psychedelic-Assisted Therapy Essentials series

Psychedelic-Assisted Therapy (PAT) carries real promise. It also asks a great deal of everyone involved.

This is not a walk in the park. As beneficial as it can be, and research continues to suggest that it can be, the path can also be arduous, perilous, and thorny. Old maps warned travelers with the phrase hic sunt dracones—here be dragons. That image feels fitting here. Psychedelics can open doors to healing, insight, and transformation, but without adequate preparation, guidance, and integration, the same processes that may help can also harm.

This series is meant as a grounded orientation to PAT: what it is, what it is not, what makes it helpful, and what makes it risky. We will explore some of its core elements: set and setting, the medicine, intention, preparation, the guide, the participant, and integration; as well as the wider questions that surround them: ethics, relationship, culture, spirituality, and the humility this work requires.

To borrow a phrase from Rudolf Otto, psychedelics are a mysterium tremendum et fascinans; both fascinating and daunting. In that sense, they are a bit like fire, or perhaps a dragon: powerful, compelling, and never fully tamed. We do not master them so much as learn, with care and respect, how to work with them wisely. You can choose to befriend or confront a dragon; it will certainly impact your journey.

I write these reflections not as a detached observer, but as someone who has spent many years studying, teaching, and participating in this evolving landscape. My hope is simple: to serve as your guide, someone who knows the terrain, who can help you explore it more safely, point out what matters, and warn of the perils, so the path may feel clearer and steadier.

If you are new to this work, welcome. If you have been walking this path for some time, welcome as well. Either way, I hope these writings offer something useful for the journey.

Begin with: Here Be Dragons — why psychedelic-assisted therapy requires humility, preparation, and respect.

Register to stay informed of new articles, lectures, and updates.

…and when to reach out for human support.

So far, I’ve written warnings about the dangers of replacing humans with artificial relationships. The Center for Humane Technology and the AI Psychological Harms Research Coalition have been warning about “attachment hacking” (more on that in a future article). The American Psychological Association has also published recent health advice on AI chatbots.

Although this is still a new phenomenon, I am beginning to see its negative impact. People seem to be forgetting how to relate, empathize, and navigate disagreement. These are skills that AI cannot teach. We need other humans to relate to and, from time to time, bump heads with.

Just as we were not able to accurately measure the impact of social media and its algorithms on society in real time, right now, it is hard to measure the harms of AI “attachment hacking,” especially for children and adolescents. So let me say it again without ambiguity. AI can support mental health, but it should not replace human connection.

Having made that clear, I also believe that when used judiciously, AI can be a valuable tool. So the question is not “Is AI good or bad?” A better question is: When might AI support psychological growth, and when does it quietly pull people away from the very thing they need?

Where AI can be genuinely helpful

In my experience, AI can help when the task is primarily about information, clarity, language, and structure. Psychoeducation, journaling prompts, basic skills coaching (similar to a self-help book), preparing for therapy, and integration after therapy.

This matters. It can reduce confusion and help people arrive at therapy with more clarity. Sometimes it can even deepen therapy by freeing time for the relational work that cannot be rushed. Quite often, my clients bring to sessions insights gained from using AI. Tangentially, that is precisely why I developed “The Potential Space”.

To put it briefly, AI can support reflection when a deep human connection is not essential.

Where AI becomes risky

AI becomes risky when it is used as a stand-in for relationships and for anything involving relatedness, discussion, opinions, humor, disagreement, care, and ethical and moral guidance. Basically, anywhere human support or interaction is needed.

The human brain is predisposed to attribute intention and agency to non-human entities. That is why we talk to our computer or car even when we know they are machines. With a car, since it does not reply, we do not get pulled in. AI does reply, and it uses first-person language. This is often called computational self-reference or as-if agency.  Of course, this may simply be a syntactic tool to reduce cognitive friction (make communication easier). The problem is that the human brain, evolutionarily designed to predict the mental states and future behaviors of “others,” has a hard time separating the machine from the illusion of consciousness, and ends up relating to it as if it were a someone.

This becomes most dangerous when judgment is impaired due to age or circumstances, such as when someone is in crisis or severely overwhelmed, losing touch with reality, triggered by past trauma, afraid, etc. It also becomes risky when the stakes are high and we do not understand a topic well enough, so we are tempted to outsource decisions to someone (or in this case something) that seems better-informed than we are.

In these cases, the problem is not only that the information may be wrong. It is that AI does not carry responsibility. It does not hold duty of care. It does not know you in a lived, embodied way, and it cannot reliably make sense of what is happening in your nervous system or in the relational field between two human beings. It can be very convincing. That is part of what makes it powerful, and part of what makes it risky.

A simple “traffic light” way to think about it          

To be clear, I am not here to judge your use of AI. It is fascinating, compelling, and even seductive, particularly when someone feels lonely, overwhelmed, or afraid. Still, it carries risks. My goal is not moral judgment. It is practical discernment.

  • Green zone:
    • learning and reflection (psychoeducation, journaling prompts, values clarification, basic skills practice, preparing for therapy).
  • Yellow zone:
    • heavy emotional use late at night, repetitive reassurance-seeking, avoiding difficult conversations, using AI when highly activated, using it as main support for long periods of time.
  • Red zone:
    • crisis states, self-harm urges, severe hopelessness, relapse risk, paranoia, loss of reality-testing, domestic violence contexts, urgent medical decisions, or anything requiring immediate human care.

Likewise, it is not a good idea to use AI to meet social interaction needs, such as love, companionship, validation, care, or humor. This can feel harmless, but chatbots are designed to be agreeable and rarely challenge you. Real relationships do. That friction is part of how we learn and grow.   Relationships include attunement, pacing, co-regulation, rupture and repair, boundaries, and accountability. These are not “taught” in the way information is. They are learned through lived experience in a relationship.

How to create a virtuous cycle with therapy

If you are in therapy, use AI to support preparation, and let the human relationship support transformation. Use it to name what is happening, summarize themes from the week, generate questions to explore, or practice a conversation before having it with a real person. Pay attention if your use of AI is increasing isolation, avoidance, or dependence. Often, what we need is not more information, but contact.  Reach out.

If you have concerns about your own use of AI, or that of someone you know, or if you’d like to explore how AI can be used in helpful rather than harmful ways, please don’t hesitate to reach out. I’d be glad to help.

While preparing a series of talks on Shamanism, I gathered a few reflections that gradually shaped themselves into something beautiful. I share them humbly and with no claim of ownership, trusting they may resonate with you:

Sink your roots with reverence into the Earth. To wound nature is to wound yourself (Haudenosaunee)

Attend to Grandfather Fire; he teaches those who wish to learn (Wixárika Huichol)

Let the great sea set you in motion; be carried trembling with joy (Netsilik Inuit)

***

Learn patiently from the plants; wisdom grows through discipline (Payé)

Hear the medicine speak; it reveals what is hidden (Mazatec)

Everything has its own song; listen until rocks and colors sing (Lakota)

***

Seek solitude; deep wisdom grows far from the noise of men (Caribou Inuit)

Find your inner light; let it guide you through the dark (Iglulik Inuit)

Understand your own madness; then the spirit world will not carry you away (Chontal)

***

Release your personal history; let go of the past that blocks your growth (Mochica)

Enter the places of fright and terror; truth often waits there (Mazatec)

Take responsibility for your health; neglect prevents healing (Aztec)

***

Look into the body like clear water; seek the truth beneath the sickness (Jívaro)

Know that heart heals heart; the strongest medicine is the desire to serve (Lakota)

Attend to the silence; songs are born there like bubbles rising to the air (Little Diomede)

***

Recognize that healing restores the balance of the community (Dagara)

Stay close in danger; do not separate on the paths of the wind (Wixárika Huichol)

Understand that I am you and you are me; everything in life is connected (Maya)

***

Thank the ancestors and the medicine; gratitude keeps the world in balance (Wixárika Huichol)

Know your place in the sacred hoop; every being is your relative (Oglala Lakota)

***

Guard your words; harmful words are shadows that lead you astray (Lakota)

Make your life a worthy offering; ask nothing in return for healing (Lakota)

Realize that each of us already carries the Great Medicine (Aztec)

***

Move in balance and harmony along the sacred Red Road (Lakota)

Walk in wonder; the world is alive and listening (Wixárika Huichol)

***

Trust what is greater than you; the sacred is never exhausted (Caribou Inuit)

Stand humbly like a child before the endless mystery (Wixárika Huichol)

Collected by Sergio Rodriguez-Castillo from traditional indigenous teachings worldwide

These teachings are shared with respect. Because many of the original voices are anonymous, I’ve listed only the cultural traditions from which these lines were collected, rather than attributing them to specific individuals. This post is offered as an invitation to reflection, not as a substitute for cultural context, lived relationship, or community-held knowledge.

…or why AI should not replace human connection

In my earlier article Should ChatGPT Be Your Therapist?, I briefly argued against it. This article further explains my answer.

Many people turn to AI because they are lonely, overwhelmed, or afraid. That is understandable. But if AI becomes a substitute for relationships, something important is lost. Our brains are wired for connection.

Before starting, let me insist that I am not anti-AI. Quite the opposite. I am excited about the possibilities of using it as a companion to therapy (more on this below). Used wisely, it can be genuinely helpful.

Although this is not often emphasized, psychotherapy is not only about providing information. It is a relationship. Good psychotherapy may feel like a simple conversation. Still, there is a lot going on under the hood at psychological and biological levels. Our nervous systems are shaped by contact with other human beings. Our attachment style (basically, the way we relate to others) is formed by how we experienced connection in early life. Who we are is, in large part, the result of our relationships. As it is often said, our wounding happens in relationships and can only be healed in relationship. We do not change only through insight. We change through connection.1

We need to feel safe before we can change

Evolutionarily, our nervous systems are programmed to scan for safety. This is an automatic process that occurs mostly below conscious awareness.2 Tone of voice, pacing, the steadiness of a presence, and the sense that someone understands us and will stay with us without collapsing or attacking. These signals shape how we experience the world and live our lives.

When we feel anxious, shut down, ashamed, or guarded, our whole system contracts. Thinking becomes rigid. Options feel limited. Emotions feel overwhelming. Sometimes we cannot even accept help when it is available. On the other hand, when we feel safe, supported, and accepted, something changes. We relax. We open up. Feelings become tolerable. Reflection becomes possible. We see more clearly and are able to choose. The body must feel safe before the mind can be free.

What the relationship does

It offers co-regulation. Meeting a grounded therapist is not just “nice.” Their steadiness helps settle our system. Over time, we become able to reproduce that steadiness, and it becomes available inside. This is one of the quiet phenomena of good therapy. We borrow regulation until we learn to provide it for ourselves.

It offers a different experience, not just advice. Even when people come to therapy for information, they often stay for something else. The client is constantly sensing the relationship. How does the therapist relate? Are they kind, clear, steady, curious? Can they hold boundaries with care? Can they tolerate strong emotion without collapsing or attacking? Over time, this becomes a living template for how to be with oneself and with others.

It creates a space to explore without shame, guilt, or rejection. After a while, as the client continues to feel accepted by the therapist, they may begin to wonder: “If my therapist accepts me as I am, maybe I can accept myself too.” Again, this relaxes the nervous system and makes room for change. In such an environment, you can explore how you protect yourself, how you handle closeness, how shame organizes your attention, and what you believe you are allowed (or not allowed) to feel. These patterns are often automatic and live below awareness. Over time, a stable relationship helps reorganize these implicit layers and experiment with alternative ways of being. Therapy changes people through lived experience, not simply through insight.3 4

It offers rupture and healthy repair. Therapists are not perfect. Sometimes your therapist does not get it. You may feel misunderstood or even rejected. Often this triggers old experiences of not being seen or accepted, and the conclusion that something is wrong with you. What to do next? Shut down? Capitulate? End the relationship? If the therapist is skillful and navigates this with care and accountability, the nervous system learns something powerful. Conflict does not have to mean abandonment. Misunderstanding does not have to mean danger. This repair, while remaining in connection, is part of how trust is built, and it is difficult to replicate without a real person who can make mistakes, take responsibility, and show up again.

At the risk of oversimplifying, the therapeutic relationship is difficult to replace because healing is not purely cognitive. It is an embodied, relational process that unfolds through attunement, emotional resonance, and real-time interaction.

What AI cannot replace (at least yet)

AI can generate language that sounds empathic. It can reflect feelings. It can offer prompts. It can help you map patterns. You may even feel understood.

But AI is not alive. It does not have a body or a brain. It does not co-regulate in the full human sense. It does not track your breathing, posture, tears, long pauses, or the subtle shifts that guide pacing in real time. Even with voice or video, something central is missing. A real nervous system is not on the other side. AI cannot truly see you, even if it sometimes sounds like it does. And your nervous system knows when something is missing.

AI also lacks accountability in the way a human therapist does. Human therapists are trained to listen not only to words, but to context, tone, and what does not fit. A good therapist does not simply agree. Even a very empathetic therapist may challenge you if something does not make sense, needs clarification or if it make it tingle their -very human- spidey sense. As one of my teachers used to say, therapy is not a polite endeavor. A caring therapist will slow down, double-check, explore hunches, and name what is being said and even name what is not being said. AI cannot feel or care in this very human way. Technically, AI does not understand words the way humans do, and it cannot sense what is implied but unspoken. This always matters, but it matters especially at the edges, when someone is destabilized, overwhelmed, in crisis, paranoid, or losing touch with reality.

There is also the problem of overconfidence and hallucinations. AI can sound certain when it is wrong. That can be harmless in low-stakes settings, harmful in emotionally vulnerable moments, and dangerous in crises. Add privacy concerns, cultural mismatch, and the risk of overdependence, and the picture becomes clearer. AI can be a tool, but it is a risky candidate for replacement.

Where AI can genuinely help

None of this means AI is useless. It means we should understand what it is good for.

AI can support reflection when deep human attunement is not essential. It can help with journaling, psychoeducation, basic skills prompts, and preparing for therapy sessions. It can help you find language for what you are experiencing. It can help you organize a question you want to bring to your therapist. It can offer structure between sessions. I will develop this in more detail in future articles.

Used wisely, AI can even deepen therapy. When it helps with basic learning or clarification, more therapy time can be devoted to what requires human presence. That is meaningful synergy.

A gentle rule of thumb

If what you need is information, conceptual clarity, journaling prompts, or help exploring something already discussed in therapy, AI may help.

If what you need involves attachment wounds, trauma healing, deep grief, relational repair, severe anxiety, existential distress, or you are facing a crisis, a human therapist is usually safer and more effective. Certain kinds of healing require contact with a real person, in real time, over time. And again, since our wounding happened in relationships, it can only be healed in a human relationship.

If you are curious, you can try “The Potential Space” an AI companion designed to support users between sessions with preparation, psychoeducation, and integration.

  1. Lewis, T., Amini, F., & Lannon, R. A General Theory of Love. ↩︎
  2. Porges, S. W. The Polyvagal Theory. ↩︎
  3. Schore, A. N. The Science of the Art of Psychotherapy. ↩︎
  4. Cozolino, L. The Neuroscience of Psychotherapy. ↩︎

Why California LMFTs need psychedelic-informed care1

The relationship between psychedelics and psychotherapy has always been… complicated. In the late 50s and early 60s, LSD was distributed to mental health professionals to explore its therapeutic potential. Sandoz suspected there was something there, but couldn’t quite pin down where it fit. When Tim Leary later “discovered” psilocybin mushrooms, he framed them as psychologically significant. MAPS, from the beginning, assumed therapists would be at the bedside for MDMA experiences. With the 70s, prohibition made the relationship illegal, but it didn’t make it disappear. Many clinicians simply went underground.

Now, in the current psychedelic renaissance, while most psychedelics remain illegal, mental health professionals face a familiar dilemma: how do we support clients without stepping outside legal and ethical boundaries?

With support from CAMFT Sacramento Valley, I’m teaching a six-session series on Psychedelic-Informed Care (PIC)—how clinicians can respond when psychedelics enter the therapy room without fueling hype or reinforcing taboo. Should we lean in? Set boundaries (which ones)? Redirect? The series is designed to help you answer those questions with precision.

The topic will show up.

It arrives in many forms: questions about legality, reactions to a news story, curiosity about a ketamine clinic, plans for a retreat abroad. “Would you recommend it?” “What are the risks?” “Would microdosing help?” And, of course, the therapist’s favorite: “Is it true it’s five years of therapy in one night?” Clients are often confused, and they want orientation from someone they trust—you.

De-mystification

Right now there’s cultural noise, mixed messages, and outright misinformation. As clinicians, we don’t need to endorse or condemn. We need to help clients differentiate—between curiosity and compulsion, hope and inflation, meaningful experience and destabilizing aftermath. PIC begins with demystification: separating evidence from hype, and myth from clinical reality.

The legal landscape patchwork

Part of the surge is legal ambiguity. The picture is no longer a single, clear “no.” It’s a mixed bag: regulated access models in some places, research pathways, tightly controlled international frameworks, religious-use carve-outs, and—closer to home—local reforms and “decriminalization” language.

Even in California, where classic psychedelics remain illegal, several jurisdictions have deprioritized enforcement around entheogenic “plant medicine” (including places like San Francisco, Oakland, and Santa Cruz). But deprioritization is not legalization. It doesn’t change state or federal controlled-substance law—and it doesn’t change LMFT scope.

Why psychedelics? Why now?

The “why now” isn’t mysterious. Psychological suffering keeps rising, and so does the hunger for new solutions (especially when many mainstream antidepressants remain variations on monoamine modulation). Add promising research signals, a primed cultural zeitgeist, and media acceleration—and you get momentum.

But when a society is suffering and hungry for relief, it becomes vulnerable to shortcuts. Psychedelics, when framed as shortcuts, become especially seductive.

Potential benefits—and real risks

It’s hard to deny that psychedelic research is promising. Across trials at different stages, psychedelics have shown potential relevance for trauma-related suffering, depression and anxiety, existential distress and end-of-life fear, relational patterns, and spiritual meaning-making.

At the same time, potential benefits are not guaranteed, and they are not risk-free. Alongside positive outcomes are reports of harm: destabilization and disorientation after experiences, inflation, bypassing, aftercare gaps (no containment, no follow-up, no integration), and boundary/exploitation risks—especially in unregulated contexts.

This isn’t fear-mongering. It’s clinical realism. The psychedelic ecosystem is still maturing. Ethical failures occur. And when they do, the cleanup often lands back in traditional therapy.

So where do LMFTs stand?

Every clinician know to keep this distinction front and center: scope of practice is what California law authorizes; scope of competence is what you personally are trained to do safely.

California’s LMFT scope includes assessing and treating substance use and related mental/behavioral concerns, and explicitly includes client education, consultation, and clinical case management. But legal permission does not equal clinical readiness, and clinical readiness does not grant legal permission. In plain language: just because you can talk about psychedelics doesn’t mean you should, unless you have the training.

PAT vs. PIC (and the underground)

To stay grounded, it helps to separate three different situations:

  • Psychedelic-Assisted Therapy (PAT): administration plus a protocolized, regulated setting.
  • Psychedelic-Informed Care (PIC): what LMFTs can do ethically—discuss, educate, harm-reduce, integrate.
  • Underground work: unregulated and often illegal “guided” psychedelic work, with wide variability in competence and ethics.

Here’s the key takeaway: to remain within ethical and legal grounds, LMFTs must stay in the green zone—discussion, education, case management, referrals (for education, not sourcing) and integration—and avoid the red zone: using, offering, facilitating/administering, or coaching sourcing/dosing for illegal substances. Yes, there are yellow areas and nuance. But clarity protects clients and therapists alike.

Your stance matters

Beyond scope, not every therapist feels the same about psychedelics—and that’s okay. Within professional boundaries, there’s a spectrum of reasonable stances: cautious, curious-but-boundaried, harm-reduction oriented, or integration-focused. The goal isn’t ideological alignment. The goal is ethical, competent care.

The PIC toolkit

PIC is practical. It boils down to three skill areas:

  1. Psychoeducation (balanced, reality-based, myth-correcting)
  2. Preparation (scope-appropriate: intentions, supports, safety planning, consult triggers—without “how-to”)
  3. Integration (meaning-making, relational repair, values-to-action, stabilization)

A simple response flow helps: Discuss → Educate → Harm-reduce → Integrate. If you can remember that loop, you can respond with confidence even when the topic is charged.

And it should go without saying, but it doesn’t: documentation is your shield. When psychedelics come up, chart the discussion, state client goals, document boundaries, note risks reviewed, and record consults/referrals. That’s not bureaucracy—it’s ethical self-respect and license protection.

In closing: your license gives you a clear road to walk with clients, and a reliable compass to stay oriented—so you can support their journey without losing your way.

In future sessions, we’ll cover the state of the art (research/legal/ethics), cultural context and humility, what to do when the client brings it up, what to do when things go sideways, and—finally—a clear vision of the LMFT’s role in the psychedelic landscape.

Now you know. If you have questions or want to explore this topic further, feel free to contact me.

  1. Although many of these principles apply to all LMFTs, note that this article focuses in California law. ↩︎

Clients are bringing psychedelic questions and experiences to therapy. This six-part series gives LMFTs a clinically grounded, culturally informed approach to discussing psychedelics within scope—with tools for education, harm reduction, and integration. It is not a “how to do PAT” course. You’ll learn the current research/ethics/legal context (incl. religious-use carve-outs), cultural considerations, and concrete safeguards around risk and boundaries. Clinicians will leave with clear language for discussing benefits/risks and integration interventions.

Sessions (at a glance – click link for details):

*Please note that you have to register individually for each session

*Education and integration within LMFT scope; no sourcing or dosing guidance.

As I wrote in Should ChatGPT be your therapist? there is hardly a week when a client doesn’t tell me they consulted AI about something therapy-related. I think that’s fantastic. AI can help by providing psychoeducation, which in turn allows us to deepen our healing work.

AI is an excellent information resource, even in the field of therapy, however, I don’t believe artificial relationships should replace human connection. We also need to keep in mind that this technology is so new that it’s still impossible to know what the long-term impact of such a replacement could be.

Every day we hear about the many things AI can do—both the unprecedented promises and the potential perils. As someone who has been studying the evolution of consciousness for decades, I’ve been following both trends with great interest. Below you’ll find a non-exhaustive list of resources (prepared with ChatGPT’s help) that includes some cases where things have gone wrong. It may help keep things in perspective.

I’ve also been working on an AI companion for therapy. I figured that if my clients are going to keep using AI, they might as well have access to one I can trust. More on that soon.

One-stop incident trackers (good “master links”)

Suicide / self-harm–linked interactions

Harmful or unsafe advice

Manipulation / paranoia / “grandiose” dynamics

Youth safety & companion platforms (policy actions)

I’m fascinated by this topic and its evolution. Are we witnessing a new step in the evolution of consciousness, the birth of the transhuman, or, as James Barrat has suggested, are we on the verge of the end of the human era? What do you think?

Honoring indigenous wisdom and ethics in psychedelic therapy

This conversation explores how modern psychedelic practice risks losing its heart as it becomes mainstream. It reflects on how true healing lies in balancing Western psychotherapy with ancestral and spiritual wisdom. The discussion highlights the importance of ethical and well-trained guides, deep personal work, and honoring traditional relationships with plant medicine—emphasizing that integration, humility, and love are central to authentic psychedelic practice.

Monthly NEwsletter

Stay Up To Date .

Subscribe to stay informed of new articles.