Training psychedelic therapists

Colorado will open its first psilocybin-assisted therapy clinics next year, but how are those therapists trained?


On Sept. 30, 2024, Colorado’s Natural Medicine Advisory board will make its first recommendations (Weed Between the Lines, “Tip of the psychedelic spear,” Dec. 1, 2022). It’s expected that within weeks of that, Colorado’s first state-regulated psychedelic therapy clinics will open their doors and specially trained therapists will start using psilocybin — the active ingredient in magic mushrooms — to treat people for depression, PTSD and other psychic traumas.

It will be a huge step forward for psychedelic medicine, and a major blow to the stigmas that still cling to these substances even as states legalize them, even as their medicinal benefits are stacking up and their functional uses are becoming clearer. 

Those clinics and the therapists working in them will be on the front lines of a completely new field of modern medicine. But they won’t be the first ones there. In November of 2020, Oregon passed Ballot Measure 109 directing the Oregon Health Authority to start licensing and regulating the “manufacturing, transportation, delivery, sale, and purchase of psilocybin products and the provision of psilocybin services.”

Oregon has a head start on Colorado. Their psilocybin therapy clinics will open this year. And there aren’t nearly enough therapists trained and certified as psychedelic facilitators to meet the expected demand. According to Michael Pollan, lead of UC Berkeley’s Center for the Science for Psychedelics’ public education effort, and author of How to Change Your Mind, the industry is going to need around 100,000 trained therapists, nationwide.

Rick Doblin, founder of the Multidisciplinary Association for Psychedelic Studies (MAPS), agrees with those numbers. That’s why MAPS’ goal is to train 25,000 therapists in MDMA-assisted therapy for PTSD before 2030. And the few businesses that offer training programs for psychedelic-assisted therapy are going to have their hands full. 

“We’re passionate about doing this because it represents a paradigm shift in the way we think about mental health and the way we think about the potential of an experience engendered by a psychedelic to impact someone’s life,” says Elizabeth Nielson, co-founder of Fluence, a business offering continuing education and certificate programs in psychedelic integration and psychedelic-assisted therapy. 

Nielson is a psychologist with a background in addiction psychology, drug research and social determinants of drug use. In 2019, at a psychology workshop in New York, she met Ingmar Gorman, another psychologist with a similar background. Together, the two founded Fluence. 

“We’re really coming from a harm-reduction perspective and wanting to promote education,” Nielson says. 

She and Gorman developed a curriculum and were already training people in ketamine-assisted therapy prior to Oregon passing ballot measure 109. That positioned them perfectly to start working on a psilocybin-assisted therapy curriculum.  

In 2022, Fluence was selected by the State of Oregon to be one of the state-licensed facilitators of psychedelic-assisted therapy training. Its curriculum received approval from the Oregon Health Authority and has been licensed by the Oregon Higher Education Coordinating Commission. 

“We have a variety of programs,” Nielson explains. “We have continuing education programs for clinicians. We work with drug developers who are running trials on psychedelic therapy to write their treatment manuals and train their trial therapists. And then we have a variety of other clients like clinics where we provide specific education, tailored to their needs.”

Some of their courses include “Intoxication and Dissociation in Psychedelic-Assisted Therapy,” “Ketamine-Assisted Psychotherapy Theory and Methodology,” “Navigating the Regulatory Process for Psychedelic Medicine,” and “Psychedelic Integration: Premise and Promise.” Fluence also offers certificates in “Psychedelics and Psychoanalysis,” “Integrating Psychedelics with Evidence-Based Therapy,” “Analytic Explorations in Psychedelic Therapy,” and a lot more.

“Our materials are really all our own creation,” Nielson says. “We’re creating a lot of video material, a lot of our own processes for how to do role plays and feedback models, case vignettes and demonstration videos.”

Nielson acknowledges there’s been plenty of educational resources and work in their field to draw from. MAPS, for instance, has already done a lot of work training therapists in MDMA- and ketamine-assisted therapy. There were also educational resources from mainstream psychology they were able to use. 

But by and large, Nielson says, they’re writing the manual for this new form of therapy. Fluence has its own content studio where they’re taking photos, filming and building the curriculum for psychedelic-assisted therapists, she says. That custom content is then used across their courses and certification programs. 

“It’s definitely a creative process,” Nielson says. “But I think it needs to be done and it needs to be done well.”

That’s a true statement considering just how many therapists trained and certified in psychedelic-assisted therapy the U.S. is expected to need going forward. 

Some therapists in Colorado have already taken Fluence courses, Nielson says; even though Fluence isn’t a state-licensed training business here. And while Nielson doesn’t have immediate plans to become one of Colorado’s state-licensed facilitators of psychedelic-assisted therapy, she does hope that the work they’re doing in Oregon has a broader impact on the medicinal psychedelic industry. 

“We see this as part of a larger context of social justice work,” Nielson says. “[It’s] paradigm-shifting work with respect to drug policy and the drug war and our societal approach to thinking about drugs and people who choose to use them.”