Questions to Discuss with a Prospective Psychedelic Facilitator

By Joshua White (Fireside Project) and Juliana Mulligan (Center for Optimal Living)

This blog post is intended as a harm reduction resource only. Despite the enthusiasm associated with the psychedelic renaissance, psychedelics remain illegal in many countries and lesser jurisdictions, as is serving as an underground facilitator. Our organizations do not encourage or condone the illegal use of psychedelic drugs. These principles are intended for the use of people who have already made the decision to have a guided psychedelic experience or psychedelic-assisted therapy and are seeking out psychedelic facilitation services.

Neither the use of this guide nor its accompanying questions guarantee a safe or positive psychedelic experience or psychedelic therapy session. You should use extreme caution, care, and diligence before entrusting someone with the privilege of supporting you during non-ordinary states. Even if no warning signs are present, a facilitator may still engage in unethical, inappropriate, fraudulent, or abusive behavior. Engaging an underground facilitator is illegal, and will always carry risks.

To accompany our “Ten Warning Signs When Selecting a Psychedelic Facilitator,” we've put together this list of questions for discussion with a prospective facilitator or psychedelic therapist, should you be seeking a professional experience. These questions may literally be read aloud, question by question, as you evaluate your prospective facilitator.

Take notes during the conversation and discuss the responses with a trusted and knowledgeable friend. It is a major cause for concern if your facilitator refuses to discuss these questions with you, or if their responses are vague, evasive, or questionable. Any ethical facilitator or psychedelic practitioner would actively welcome these questions. After discussing these questions with your facilitator, conduct follow-up research. As you go through this process, trust your intuition. If something feels off, it probably is.

Touching Clients During Psychedelic Experiences:

• What are your views about touching a client during a psychedelic experience? Do you believe that it is ever appropriate to touch a client on or around their genitals or breasts during a psychedelic experience? Have you ever done so? In your view, is it ever acceptable to have sexual contact with a client during a psychedelic experience, even if they initiate the contact?
  
  A facilitator should never touch you without your consent. It is never appropriate for a facilitator to touch your genitals or breasts or otherwise have sexual contact with you during a psychedelic experience, even if you initiate the contact.
  
  

• Do you provide your clients with a document before facilitating a psychedelic experience that sets strict rules about physical touching and boundaries during the experience? If not, why not? If yes, please provide me with a draft document.
  
  The best practice is for psychedelic facilitators to create a mutual consent document that they discuss with you during your intake process. This document should discuss each person's boundaries and roles, as well as expectations about each person's behaviors.

Sexual Experiences with Clients:

• Have you ever begun, or tried to begin, a sexual relationship with a client after you facilitated a psychedelic experience for them? Have you ever had sexual contact with a client? (By “ever,” I mean ever — whether days, months, or years later.)
  
  It is never appropriate for a facilitator to have a sexual relationship with a client, no matter how long after the experience, even if initiated by the client before, during or after psychedelic facilitation.

Training and Being Trauma-Informed:

• How long have you been a facilitator? How many psychedelic experiences have you facilitated? Have you undergone a facilitator training program? Can you tell me about your training and coursework to become a psychedelic facilitator? Where and with whom have you studied? Have you had formal training about facilitating in a trauma-informed way? What does being trauma-informed mean to you? Are you currently supervised or being mentored? By whom? Are you involved in any community mental health organizations or groups for psychedelics users?
  
  As in other professions, more experience can — but does not always — mean more skill and more wisdom. It is certainly worth having an understanding of the person's background and training process. Some state bodies such as the Oregon Health Authority are beginning to license psychedelic services providers. Other organizations such as the Multidisciplinary Association for Psychedelic Studies (MAPS), now known as Lykos Therapeutics, have offered certifications in MDMA-assisted psychotherapy. Also, psychedelics often cause unresolved trauma to come to the surface of your consciousness. It is therefore imperative that your facilitator be trauma-informed. Even if they aren't clinicians, they should have done some type of trauma-informed training.
  
  

• [If you, as the voyager, identify as a person of color and/or LGBTQIA+, consider asking the following questions.] What if any training have you received to understand the types of traumas that people with identities similar to mine have experienced, be they people of color, LGBTQIA+, or any other background? How much experience do you have supporting people with identities like mine? What kind of feedback did you receive from those clients?
  
  If you are a person of color and/or you identify as LGBTQIA+, your facilitator should have substantial training and experience within the psychedelic ecosystem supporting people with similar identities and working with the types of traumas that people with those identities often experience. Regardless, you may feel more comfortable working with a facilitator who shares aspects of your identity.

Plans for adverse events:

[Note: An adverse event is any adverse reaction during or after a psychedelic experience requiring psychiatric, medical, or psychological care. Examples include suicidal ideation, suicidality, panic attacks, Hallucinogen Persisting Perception Disorder (HPPD), toxicity, psychotic episodes, overdose, cardiovascular disease, hypertension, and others.]

• How many adverse events have occurred for someone for whom you've been facilitating, including adverse events that occurred during the psychedelic integration process? For each of them, tell me: when did they happen, why do you believe they happened, what if anything did you learn as a result, what if any changes did you make to your procedures afterwards, and do you believe those changes have been effective?
  
  That an adverse event may have happened does not, by itself, mean that your prospective facilitator is inept or unethical. But a refusal or reluctance to talk about them or to explain plans to reduce their likelihood should cause concern. An experienced facilitator who claims that no adverse events have ever occurred on their watch should be regarded with suspicion
  
  

• What is your plan if I need emergency medical attention during or after my journey? How did you formulate this plan? Has this plan been vetted by any medical professional? If not, why not?
  
  A variety of emergencies may arise during and after a psychedelic journey. Your facilitator should understand this, have a detailed plan in place for how they’d respond, and be willing to share that plan with you in detail. As you listen to it or read it, think through the plan’s thoroughness and likely effectiveness.

Disciplinary and legal history:

• Do you have any licenses, certifications or additional training for psychedelic facilitation or any other relevant disciplines? Which ones? From which licensing authorities or certificate program? Have those licenses or certifications ever been revoked or suspended? Have you ever been disciplined by those licensing authorities? If so, please provide written documentation of every instance of revocation or suspension. Have you ever applied for a licensure or certification but been rejected? If so, which licensure(s)/certifications, when were you rejected, and why? Please provide all documentation from the licensing authorit(ies) about all rejections.
  
  Some facilitators may be professionals, possibly even licensed therapists, doctors, nurses, or massage therapists with a clinical practice, social workers, etc. Many of these professionals must maintain active licenses, and their licensing authorities keep databases — some of which are available online — about sustained allegations of misconduct. Before deciding on a facilitator, learn their disciplinary history. They may also be making a conscious decision to put their license or private practice at risk by facilitating your experience or conducting psychedelic-assisted psychotherapy in their jurisdiction.
  
  

• Have you ever been sued? When, by whom, and in which jurisdiction? Who were all the parties? What was the result? What was the nature of the allegations? How did the lawsuit resolve?
  
  Lawsuits may contain allegations that someone has acted in an unethical, illegal, and/or fraudulent way. This can be important information in helping you evaluate a prospective facilitator. Many court systems contain searchable databases for current and past lawsuits. If your facilitator has been involved in any, see what you can learn about their legal history. If your facilitator has been sued and describes the allegations to you, cross check what they tell you against what court documents say.
  
  

• Have you ever been the subject of a police report or complaint? Where and when? If so, do you have any documentation? What did the report or complaint allege?
  
  Understanding a person's criminal history can, depending on the nature of that history, give you insight into whether they may be a suitable facilitator for you. For instance, if the person has been accused of sexual assault or other types of assault during facilitation or psychedelic-assisted therapy. This can be highly relevant information as you evaluate a facilitator.
  
  

• Have you ever been mentioned in an article, book, podcast, or online forum about inappropriate behavior related to a psychedelic experience? If so, please tell me all of them.
  
  Even if a person has not been arrested or sued, there may be publicly available information about them that may shed light on their fitness to be your prospective facilitator and whether or not they are operating and ethical practice.
  
  

• Apart from police reports or lawsuits, have you ever had a client accuse you of inappropriately touching them? For example, has a client ever sent you a private email, voicemail, or letter accusing you of inappropriately touching them? What specifically was the accusation? How did you respond? How did it resolve? Do you have any documentation regarding that resolution?

Power dynamics and accountability:

• Are you a shaman? If so, what does that term mean to you, and who authorized you to use that term?
  
  It should be concerning if a person holds themselves out as a shaman and is neither Indigenous nor has trained with an indigenous person who has authorized them to use the term shaman. Such a person is not only engaging in cultural appropriation, but may also have an inflated sense of themselves and their role in the healing process. This is unfortunately common within the psychedelic community.
  
  

• Are you a guide? If so, can you explain what that term means to you and why you chose it? Can you talk to me about what you believe your role is in the healing process?
  
  No one heals you but you. A facilitator may support you in your healing exploration, and some may share insights with you and offer reflections or even advice on directions you may take on that journey. But ultimately you and only you have the power to heal. A facilitator should acknowledge this humbly and wholeheartedly.
  
  

• Are you part of a network of facilitators? Are there systems of accountability within that network? Who holds you accountable?
  
  Some system of accountability is imperative for discouraging inappropriate conduct.
  
  

• Can you share your thoughts on power dynamics within the facilitator-voyager relationship? What steps do you take to ensure that this is a professional experience, and that dynamic does not lead to abuse or exploitation?
  
  The power imbalance between a facilitator and a voyager is significant, and a facilitator should have devoted considerable thought to this issue and how to ensure that it does not lead to unethical outcomes.

Contraindications and testing:

• Are you familiar with the contraindications for the substances I’m about to take? How are you familiar with them? Do you regularly review the scientific literature for updated research about those contraindications? Please describe your process for learning about developments in contraindications.
  
  Different psychedelics have different contraindications, including medical conditions and medications. Your facilitator should be familiar with these, and also familiar with the limits of scientific research. New research is coming out all the time, and your facilitator should be up to date on the latest science. A failure or refusal to discuss these with you or a lack of familiarity about potential risks should be a major source of concern.
  
  

• Do you test your substances before you provide them to me? Are you willing to test the substance in front of me before you provide it to me?
  
  There are more dangerous adulterants than ever in psychedelic substances. You should never consume a psychedelic substance unless it has been tested by you or someone you trust.

Catch-all questions:

• Is there anything that we haven’t discussed that you think is relevant to me evaluating whether you are a good fit for me as a facilitator? If you were me, what else would you want to know that we haven’t touched on yet? What is your reaction to me discussing these questions with you?

Facilitators can employ a variety of techniques and healing modalities. An examination of the growing psychedelic community shows an incredible diversity of facilitation options, ranging from preparation and integration to psychedelic-assisted therapy. Make sure you understand what is involved in the scope of practice you are seeking and choose accordingly.

Interested in learning more? We've collected some recommended reading from our authors and partners on topics like the therapeutic potential of MDMA-assisted therapy, the legal and ethical questions around ketamine-assisted therapy, or the cutting-edge research from institutions like Johns Hopkins and Imperial College London. Explore Fireside's resources page for more information on the growing psychedelic ecosystem, as well as some other tools to support your journey.