Excerpt from Chapter 10 of The Psychedelic Renaissance - 3rd Edition
(An early draft. The final MS may have some edits. And the final book will include many great pictures!)
Chapter 10
The Growth of Psychedelic Therapist Training Programmes – And What’s Going on Down Under?
Having already described earlier, the host of new psychedelic start-up biotech and pharma companies that have emerged in the last ten years, and the wealth of research pouring into the scientific world, one might ask: Where is all this research coming from?
In this chapter we will look at some of the major academic centres of psychedelic research around the world. Then we will explore the subject of becoming a psychedelic therapist. And finally, we will examine the ground-breaking developments that are now occurring in Australia, which has led that country, which was previously relatively unfamiliar in the field of psychedelic research, into pole position on the world stage.
Where is today’s psychedelic research coming from?
At the beginning of the Psychedelic Renaissance, in the early 1990s, there were but a small handful of universities with individual professors dotted around the world, courageously proposing small, personal pilot studies with psychedelics – with Rick Strassman’s DMT project being one of the first. And we had Grob at UCLA, Griffiths at Johns Hopkins, Vollenweider in Switzerland, and Amanda Feilding, David Nutt and Carhart-Harris in Bristol and London, with a few others. We also had the beginnings of MAPS and Mithoefer’s work, with its primary mission aimed at MDMA for PTSD, and Hefetter’s impressive board of psychedelic expertise.
But globally there were not many people involved. I attended my first major psychedelic conference – the one for Albert Hofmann’s 100th birthday celebration in Basel, Switzerland, in 2006. And within a couple of years, I had met most of the main players in the field. It was a small and vibrant community. The folk involved were mainly isolated individuals running their psychedelic research, discretely attached to university departments, and often having to deal with considerable resistance from apprehensive non-psychedelic colleagues and local regulatory organisations.
What we certainly did not have back then was whole university departments devoted solely to psychedelic research. It would be potluck whether a certain brave psychedelic scientist in a given location might be able to obtain the funding and the ethical approval required to get a psychedelic project up and running or not. Psychedelic researchers would often meet institutional and professional opposition from their colleagues if they managed to do so. Psychedelic scientists and clinicians worked away, hidden from the public and with very few platforms for dissemination of their ideas, such was the level of stigmatisation about the subject.
The situation today is very different indeed. Within the last five years we have seen entire dedicated psychedelic research centres spouting up in many prestigious universities around the world. There are whole departments, with multidisciplinary staff, from neuroscience, imaging, psychopharmacology, chemistry, medicine, pre-clinical, animal studies, social scientists, psychologists and ethical and legal branches, all working under one roof; often in gleaming new state-of-the art buildings sponsored by big money from the private sector. Who could ever have dreamed of this twenty years ago?
What we have in some ways today is a return to how psychedelic studies was beginning to look towards the mid-1960s. Back then, psychedelic centres of excellence were beginning to emerge all over the world, such as Powick Hospital, Spring Grove at the Maryland Psychiatric Research Center, the Harvard Psilocybin project, Weyburn Mental Hospital in Saskatchewan, Canada, the Psychedelic Research Institute in Prague, Czechoslovakia etc.1
One can only wonder where we might be today in our understanding of the brain and consciousness, and what additional clinical capacities we might now have, had psychedelic research not been so unjustly terminated by the end of the 1960s. Still. We are where we are. Perhaps it was supposed to happen this way?
A global glimpse at today’s centres of psychedelic academic research
What follows is an (inexhaustive) list of prominent centres of academic learning that now have dedicated departments focusing primarily on psychedelic research. Beyond this list, there are also a great many smaller projects and teams at countless universities around the world running psychedelic projects. Bristol, where I work, for instance, has a handful of psychedelic academic projects going on in a smattering of different departments, but we do not have a gleaming psychedelic research centre.
What follows below are the gleaming new institutions and collaboration groups. Many of these new centres have come about through affiliation, and financial support, from private psychedelic companies.
European centres of psychedelic academia
Maastricht University2
While Maastricht University may not have a dedicated psychedelic research group, various researchers at the university are investigating the effects of psychedelics. Early research exploring psychedelics at Maastricht focused on the dangers of MDMA. Now focusing on microdosing, cannabis and NCEs, the department is headed up by Dr Kim Kuypers. Some projects are in collaboration with private companies Silo Pharma and the Beckley Foundation.
University of Basel – Liechti Lab3
The University of Basel Department of Biomedicine hosts the Liechti Lab research group, headed by Matthias Liechti, whose contribution to psychedelic neuroscience has been tremendous in the last ten years. Dr Peter Gasser is also involved in this team. And since 2020 they have been in collaboration MindMed, for their Project Lucy.
The Nordic Network for Psychedelic Science (NNPS)4
The NNPS was formed in 2021 by researchers from the University of Copenhagen, The Karolinska Institute in Sweden, and the University of Oslo in Norway. The aim of the network is to connect researchers from the Nordic countries, and with international researchers in the field. It was a great pleasure for me to visit the region in 2021 and 2022 to take part in their conferences.5
The Czech Republic Psychedelic Research Centre6
Headed by Tomáš Páleníček, the Czech research centre studies psychedelics, NCEs and cannabinoids, in collaboration with the Laboratory of Forensic Analysis of Biologically Active Substances at the University of Chemical Technology, and the University of Maastricht, and University of Lisbon, in Portugal, with support from the psychedelic research foundation PSYRES.
Kings College London Psychedelic Research Centre7
The centre was opened in 2023, part of a long-term strategic partnership between biotechnology company Compass Pathways, South London and Maudsley NHS Foundation Trust, and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London. It is led by Professor Allan Young, head of academic psychiatry at IoPPN, and Dr James Rucker, consultant psychiatrist and lead of the Psychoactive Trials Group at King’s College London. The centre’s research focuses on researching psychedelics for treatment-resistant depression, post-traumatic stress disorder and anorexia nervosa.
Imperial College London Centre for Psychedelic Research8
Formed in 2010 when David Nutt left Bristol University to take up the position of Edmond J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences. It also incorporates the CNWL–Imperial Psychopharmacology & Psychedelic Research group, launched in 2021 and led by Dr David Eritzoe, which aims to unlock new therapies for mental health and neuroscience. Many of the psychedelic researchers mentioned throughout this book have worked here, including Robin Carhart-Harris.
United States centres of psychedelic academia
Johns Hopkins Psychedelic Research Center9
The late Roland Griffiths and his team, including addiction psychedelics expert Matthew Johnson, and Katherine Maclean, have been providing the world with ground-breaking research since the early 2000s. Then in 2019, a group of private donors gave them $17 million to start the Center for Psychedelic and Consciousness Research at Johns Hopkins Medicine. Matt has since moved, but many other leading psychedelic figures still work in the department, where a broad range of psychedelic research is carried out.
New York University Langone Health Center for Psychedelic Medicine10
Led by director Michael Bogenschutz and associate director Stephen Ross, the team in New York have been producing cutting-edge psychedelic research for decades. Ongoing research includes psilocybin projects for smoking cessation, depression, anxiety, AUD and OUD.
Massachusetts Center for Neuroscience of Psychedelics11
Established in 2021, with Jerrold Rosenbaum as the director. The foundational research studies aim to understand how psychedelics facilitate changes in brain structure and function, with an initial focus on psilocybin for patients with treatment-resistant depression. They are working in collaboration with Atai.
Washington University Program in Psychedelic Research (PiPeR)12
The Program in Psychedelic Research (PiPeR) at Washington University is a partnership between The Healthy Mind Lab, the Washington University (WU) Neuroimaging Labs and Usona Institute.
UCLA Psychedelic Studies Initiative13
Overseen by Charles Grob and Thomas Strouse. Dr Grob plans to begin a multisite clinical trial of psilocybin, to extend his 2011 work looking at the impact of guided psilocybin experiences on the psychological well-being of patients with life-threatening medical illness.
University of California in San Francisco and Berkeley
In 2021, Robin Carhart-Harris relocated to the United States when he was appointed Ralph Metzner Distinguished Professor and director of the Neuroscape14 Psychedelics Division in the Department of Neurology at the University of California, San Francisco. Robin is part of the Neuroscape Psychedelic Division and is now exploring aspects of the REBUS (or Relaxed Beliefs Under Psychedelics) theory, which he proposed with Karl Friston.
The team aim to investigate the positive influence of psychedelics on neural network dynamics and long-term neuroplasticity in healthy human research participants using neuroimaging. The centre is also a site investigating MDMA-assisted therapy for PTSD. Another project is the Translational Psychedelic Research (TrPR) Program,15 seeking to enhance understanding of how psychedelics impact the brain and other organ systems. And the team are carrying out a pilot study exploring the effects of psilocybin on anxiety and depression in people with Parkinson’s disease. The team at the TrPR are conducting a trial in collaboration with the Usona Institute investigating a single dose of psilocybin in people with major depressive disorder.
University of Texas at Austin16
Co-directed by Greg Fonzo and Charles B. Nemeroff, the UTA recently launched the Center for Psychedelic Research and Therapy within the Dell Medical School. They will look at severe depression, anxiety, PTSD and substance use disorders through psychedelic-assisted psychotherapy and research focused heavily on military veterans and adults affected by early childhood trauma.
Oregon Health & Science University17
Researchers at the Social Neuroscience and Psychotherapy (SNAP) Lab at OHSU are investigating the therapeutic potential of psychedelics. Assistant professor of psychiatry Dr Chris Stauffer is the current director of the lab. Mission Statement
SNAP Lab aims to maximise the benefits of therapeutic alliances and psychotherapy through the adjunct use of social psychopharmacology, such as oxytocin, MDMA and psilocybin.
Emory University
The Center for Psychedelics and Spirituality at Emory University18 combines expertise in psychiatry with spiritual health to better understand the therapeutic promise of psychedelics as medicine. Launched at the end of 2022, the group will work towards making psychedelic-assisted therapies more effective within a wide cultural and spiritual context.
Canadian centres of psychedelic academia
University of Toronto19
The Psychedelic Studies Research Program (PSRP) was established at the University of Toronto Mississauga in 2020. They are currently the first Canadian research facility to conduct a double-blinded, randomised control trial to test the benefits and drawbacks of microdosing psilocybin. The PSRP has been in conversation with potential industry partners for collaboration.
Queen’s University20
Queen’s University’s main campus is in the city of Kingston, Ontario. Since 2021, they have taken a multi-pronged approach to supporting research and knowledge translation in the area of psychedelic-assisted therapy, with the launch of a Psychedelics Research Collaborative, an interdisciplinary space for research, innovation and knowledge translation in the field of psychedelics, and as a platform to connect experts across campus and stakeholders and partners in the broader community.
South American centres of psychedelic academia
University of São Paulo, Brazil
The University of São Paulo is somewhat of a hub for psychedelic research, specifically with ayahuasca. Ayahuasca is legal in Brazil given its traditional use by religions such as Santo Daime, União do Vegetal and Barquinha. The Centro Brasileiro de Informações sobre Drogas Psicotrópicas (CEBRID), the Brazilian Center for Information on Psychotropic Drugs, is directed by Dr Elisaldo Luiz de Araujo Carlini.21
Australian centres of psychedelic academia
Monash University, Melbourne22
The Clinical Psychedelic Research Lab at Monash University is Australia’s first research group dedicated to the study of psychedelics. The lab is run by top geezer Paul Liknaitzky. Current projects include psilocybin for anxiety, MDMA for PTSD in veterans, and 5-MeO-DMT in depression.
University of Sydney23
Two research teams have been awarded $3 million AUD by the Australian Government. One group will be led by Kirsten Morley to examine MDMA therapy to treat combined alcohol use disorder and post-traumatic stress disorder. The second team will conduct a trial exploring psilocybin therapy for anorexia nervosa. I had the great pleasure of meeting Kirsten Morley and the team in May 2023, when I visited her research facility, and we discussed how her study with AUD relates to our Bristol BIMA study.
Middle East centres of psychedelic academia
Tel Aviv University, Israel
In 2023 Tel Aviv University established the Institute for Integrative Psychedelic Research (IPR-TLV).24 The IPR-TLV aims to promote interdisciplinary research on psychedelics, focusing on the study of brain–mind–body associations with the goal of revolutionising mental health.
So, you want to train to be a psychedelic therapist?
One of the most common things I get asked by colleagues and psychedelic enthusiasts at conferences (apart from “Hey, Ben! Can you get me some clinical grade MDMA?”) is “Hey! How do I train to become a psychedelic therapist?”
This used to be a tricky question to answer. Until recently, training to deliver psychedelic therapy (in the overground, that is – the underground world has its own (absence of formal) rules) is really something one did only because one had a research trial to deliver.
If you were a therapist on a MAPS trial delivering their protocol for MDMA-assisted therapy for PTSD, then MAPS would train you specifically to deliver MDMA therapy for them. If you were working on a Compass psilocybin therapy trial, then Compass would train you to work with psilocybin. Or if you were going to be working at a ketamine-assisted psychotherapy clinic, the local team or company running the clinics would provide their own in-house training for their staff.
This is how I received my own triple training in delivering MDMA therapy (with MAPS), psilocybin therapy (with Compass) and ketamine therapy (with Awakn), because I had ongoing studies or clinical work ready to go with those organisations.
This meant that until a few years ago, worldwide, there were only a several dozen trained psychedelic therapists – all of whom had been lucky enough to be clinicians on a small smattering of research studies. And all (generally) only trained on the particular drug that they were using for their specific study.
But this has now changed. Today we are seeing reams of people training to be ‘generic psychedelic therapists’. And this is exactly what is needed. As we see MDMA become licensed and rolled out in the next 12 months, and psilocybin hot on its heels in the next few years, we are going to need tens of thousands of trained, licensed and approved psychedelic therapists around the world – and quickly!25
Why become a psychedelic therapist? And what qualities does one need?
People often ask me: what are the qualifications for becoming an MDMA therapist, what competencies does a psychedelic therapist need, and how can they become one? While there are some well-formed opinions and structured approaches to answering this question – especially from the crew at MAPS who, rightly, have been spearheading the training for international MDMA therapists – the truth is that no one knows exactly.
MDMA therapy, in the mainstream, is relatively new. And crucially, there is no agreed international gold standard – or globally recognised certification – to be a psychedelic therapist. And there are no formal guidelines or prescribed training techniques – just a bunch of general principles that most good training schemes try to adhere to.
Competencies of a psychedelic therapist
One very competent and inspiring professional who has done a lot on recent years to formulate the training criteria for psychedelic therapists is Janis Phelps. She has written extensively on the subject, and also leads the California Institute of Integral Studies (CIIS) psychedelic therapist training course in the USA. The CIIS course (about which we will learn more in this chapter) is arguably the biggest and the best of all the global training courses available today.
Janis has highlighted six key areas of knowledge, skills and attitudes that a psychedelic therapist requires to be a successful, safe and effective clinician. They are:
Knowledge, skills and attitudes (from Phelps, 2022)26
1) Empathic abiding presence
2) Trust enhancement
3) Knowledge of the physical and psychological effects of psychedelics
4) Ethical integrity and self-reflection
5) Transpersonal awareness
6) Awareness of complementary techniques
The therapeutic goals that one is aiming for when conducting psychedelic therapy with a patient include the following:
· Working in such a way that will help the patient with breakage of patterns and circularity
· Perception of the depressive door opening to new experience
· Remodelling of their sense of self
· Encouraging enhanced flexibility
· Helping them to trust in the stability of the mind
· Guiding them towards putting trauma in the past
· Moving towards peace
· Helping them to achieve a relaxation of habitual vigilance and distrust of self
· Showing them they can accept impermanence
· Providing an experience of reduction of negativity
· Teaching them an enhanced capacity for meditative mindfulness
· Creating new mental formations with enhanced creativity
· Providing a diminution in the fear of going crazy
· Showing them the value of awe
· Opening their mind to wonderment and the reduction of negative narcissism and self-obsession
· Increasing their trust in self and others
· Expanding their sense of spaciousness and capaciousness of mind
· Developing their trust in the intuitive self and spontaneity, and
· Showing them the value of relaxation and openness to experience and to others.
Quite a list there!
There are also many other related activities that could prepare one for becoming a psychedelic therapist. An understanding of transpersonal therapies, including Breathwork, provides an important underpinning for any psychedelic therapist; training for these methods is readily available. Many practitioners have also had experience working in psychedelic emergency care, e.g. festival support services such as the Zendo Project,27 and PsyCare28 and the Loop29 in the UK.
Does one have to be a doctor, nurse or therapist to be a psychedelic therapist?
Of course, many of the people interested in becoming psychedelic therapists are already involved in psychological services. Having a clinical training is essential for at least one half of the MDMA therapy co-therapist pair and, of course, when it comes to prescribing a medicine there must also be a doctor present to administer the drug – there is no way around that once we see these substances licensed.
Psychedelic therapy is a specialist form of psychotherapy. Just as one cannot participate in a course of specialist brain surgery techniques without first being a general brain surgeon, one cannot come from a non-clinical background, undertake a psychedelic therapist training programme – however lengthy – and call oneself a clinician.
So, most professionals in the field agree that before becoming a specialist psychedelic therapist, one must already be an experienced clinician.30 This can include medicine, nursing, clinical psychology, counselling / psychotherapy, social work etc. Only after one has demonstrated extensive training and many years of experience of those clinical roles can one then have the skills to train in the specialist subject of psychedelic therapy.
There are other professions, however, that might make one competent to become a psychedelic therapist, such as those with experience in pastoral care, meditation or spiritual directions. The key to progress is an understanding of non-ordinary states of consciousness and a willingness to be with and alongside people undergoing traumatic memory recall. There are many allied professions and complementary therapy models that are good at that kind of work.
We will now look at some of the psychedelic therapist training opportunities that exist today around the world. There are so many options available now, and I would signpost interested readers to look online for up-to-date lists of courses available in your region.31,32,33
Courses vary tremendously in terms of length, breadth, experiential opportunities, face-to-face or remote access, degree of supervision provided, formal academic credentials attained or not and – of course – cost. And none of them – whether a simple 1-hour online e-Module, or an extensive 12-month diploma or postgraduate certificate course – provide a gold standard ‘certificate’ that is internationally recognised that you are now ‘a psychedelic therapist’.
So, when I am asked by people about which course to do, I tend to say: Do as much as your time and budget allow. The more experience and the greater teaching you get, the better psychedelic therapist you will be. But at the end of the day, until we have an internationally recognised system for training, that 1-hour eLearning certificate is just as ‘valid’ (or not) as having attended an expensive university course.
The major courses available
The list below – as with all the lists in this book! – is not exhaustive. And, given the pace and dynamics of this field, it is highly likely to have changed by the time you are reading it. I will list just a few of the major courses available.
1. The California Institute of Integral Studies (CIIS) Certificate in Psychedelic-Assisted Therapies & Research34
The CIIS training course is arguably the biggest, most extensive and most respected psychedelic therapist training that any individual can undertake. It is led by psychedelic educator number one, Dr Janis Phelps.
The CIIS course entails 150 hours of education – with the expectation that participants also carry out extensive home-based work outside of classes. The teaching incorporates both face-to-face and online teaching modules, for two cohorts based in either San Francisco or Boston, USA, who meet online and in person throughout the 10-month course. The curriculum emphasises coursework on the use of MDMA and psilocybin in psychedelic-assisted psychotherapy. There are also weekend residential activities, which include partaking in Breathwork practices, to provide an opportunity for participants to experience this (non-drug induced) altered state of consciousness.
An incredible line-up of educators teaches the lectures and workshops, and I have had the great pleasure of being in the CIIS teaching faculty in past years. Given the volume of teaching that is received, it costs up to £10,000 with all the additional extras involved. Which, in my opinion, is an absolute bargain.
2. Mind Medicine Australia (MMA) Certificate in Psychedelic-Assisted Therapy (C-PAT) Course35
This another excellent, broad, detailed and experiential course. It includes 13 weeks of online learning and a six-day full-time, face-to-face residential workshop. The programme is both for prescribing psychiatrists as well as other mental health professionals delivering psychedelic treatments as part of a multidisciplinary team.
Given Australia’s unique – and enviable – position whereby MDMA, psilocybin and ketamine are now all available as approved medicines, the MMA C-PAT course covers them all and is well set up for participants to go straight into delivering treatments. The training is delivered by a world-class faculty made up of global leaders in the field, and I was privileged to be on that faculty for three years in the past. The residential workshop events are especially fun to be part of and include opportunities to experience altered states of consciousness using Breathwork sessions.
We will hear much more about MMA and Australia’s situation later in this chapter.
3. The MAPS MDMA Therapist Training Course
The MAPS training system – aimed specifically at delivering MDMA therapy for PTSD – is good for that purpose. When I did my MAPS training in 2015 and 2016, it involved reading the MAPS Manual, attending a week-long video observation group, and then having experiential sessions with MDMA therapists as part of what was then called the MT-1 programme. At that time, only a small handful of people around the world had completed such training, namely those doing MAPS studies. It was relatively easy to organise large-scale video training groups, and I attended one given by Michael and Annie Mithoefer at Tyringham Hall in the UK. But there was certainly a bottle-neck when it comes to getting the experiential training with MDMA. However, like any therapy, the real expertise comes with years of clinical expertise; or in the terminology of MDMA therapy, Flight Hours.
In recent years MAPS have extended and formalised their teaching programmes significantly – with the knowledge that they will need many thousands of trained therapists to deliver their treatments in the next few years. The MAPS teaching now includes a Fundamentals Course – a series of modules for begniners36 – and a very comprehensive four-part course for those wishing to become an MDMA therapist.37 The MAPS course includes:
Part A: Online Course. This 14-hour course outlines the chemistry and history of MDMA, common reactions, possible mechanisms of action and study design.
Part B: Residential Training (7 days). This part is focused on therapy video review and live dialogue with experienced MDMA-assisted psychotherapists, and covers topics outlined in the Treatment Manual. Trainees are taught how to conduct sessions, provide inner-directed therapy and adhere to treatment protocol, in a culturally informed manner.
Part C: Experiential Learning (15 hours). Each trainee is invited to participate in FDA-approved clinical trial offering MDMA-assisted psychotherapy to professionals training to become providers in the modality.
Part D: Role Play (1 day / 6 hours). Therapy pairs gather to conduct role play didactic training. Role play scenarios are provided, each trainee getting a chance to play the role of provider, participant and observer.
Part E: Supervision and Evaluation. Trainees receive in-depth video review and clinical supervision during the treatment of their first patient receiving MDMA-assisted psychotherapy. Therapy video recordings are rated for adherence to the treatment method. Supervision is provided by experienced MDMA-assisted psychotherapists.
4. Exeter University PGCert in Psychedelics: Mind, Medicine, and Culture38
This online course is not aimed at delivering specific hands-on skills to become a psychedelic therapist – and is open to anyone with a 2:1 grade degree or above. Rather, it is an introduction to the practical and theoretical sides of contemporary psychedelic research. It is a 12-month course, and provides a formal educational achievement, a postgraduate certificate. Participants learn about psychedelic therapy, neuroscience, anthropology, ethics and research methods. The course is directed by Professor Celia Morgan and Dr Peter Sjostedt-Hughes. Peter provides a strong emphasis on psychedelic philosophy and metaphysics.
5. Compass Pathways Therapist Training Course39
Compass provides in-house training for their therapists taking part in Compass clinical studies of investigational Comp360 psilocybin treatment. Participants must be mental health professionals with active licences, in good professional standing who already have experience providing psychotherapy and counselling. The training consists of 10 hours of online theoretical study modules, 3 days of face-to-face practical training on how to deliver psilocybin therapy, further clinical training through reviewing video cases, and ongoing continuous professional development and mentoring. I did this course in Bristol under the auspices of Sara Tai and found it excellent. While all aspects of psychedelic experiences are taught, the emphasis is on psilocybin therapy only, as it is only for those carrying out Compass trials.
6. Fluence – Psychedelic-Assisted Psychotherapy and Integration40
Co-founded by Ingmar Gorman and Elizabeth Nielson, Fluence offers an exciting programme of online courses and webinars, delivered (online) by world-leading experts in the field. They also provide formal programmes, which they state provide ‘industry-leading certification’, including an introduction course, and specialised modules in delivering ketamine, MDMA and psilocybin-assisted therapies. They also provide harm reduction and integration modules. Participants are expected to be independently licensed and able to practise psychotherapy within their scope of practice.
7. Integrative Psychiatry Institute – IPI Online Psychedelic-Assisted Therapy Training41
The IPI provide 256 hours of mostly online training designed for therapists, physicians, nurses and other allied mental healthcare professionals, so they can, ‘get involved with ketamine-assisted therapy right away’, and become ‘prepared for the anticipated approvals of MDMA and Psilocybin in the near future’. The mostly online course also involves being part of in-person ketamine and psilocybin training components. The course is delivered in collaboration with the American Society of Ketamine Physicians, Psychotherapists, and Practitioners, the Oregon Health Authority and the Usona Institute.
8. Psychedelic Support42
Co-founded in 2018 by Alison Fedducia, an experienced neuropharmacologist, psychedelic researcher and educator. In her earlier days, Alison worked on some of the first MAPS MDMA studies. Psychedelic Support has produced an impressive catalogue of teaching modules covering all aspects of psychedelic training. The platform offers a bunch of free courses online and also provides information about how to find a licensed therapist for psychedelic therapy, how to join a psychedelic drug trial and general advice and support around connectiveness with local psychedelic communities, including information about attending
experiential residential retreats.
9. Institute of Psychedelic Therapy43
This organisation, based in the UK and run by the inimitable and experienced Tim Read and Maria Papaspyrou, provides a two-year course, incorporating 20 months of academic modules, experiential retreats, personal psychotherapy and continued support and networking. The Institute of Psychedelic Therapy staff team are some of the brightest and best of the UK’s psychedelic research, academic and therapeutic community.
10. The MIND Foundation44
This German-based organisation is overseen by, among other excellent professionals, Andrea and Henrik Jungaberle, who also run the Ovid ketamine clinic in Berlin. The MIND Foundation training course offers their Augmented Psychotherapy Training (APT), a 15-month programme providing knowledge and skills needed to practise psychedelic-augmented psychotherapy and integration-focused psychotherapy in a legal, safe and evidence-based framework.
11. Clerkenwell Health45
This UK-based organisation, which also works to provide a research platform for clinical trials, offers an online course, consisting of 30 hours of self-directed, asynchronous lectures and interviews, along with comprehension and reflection questions, and a final exam.
12. Psychedelics Today46
Describing itself as ‘The Planetary Hub for Psychedelic Learning’, Psychedelics Today offers dozens of online courses covering many aspects of psychedelic therapies.
13. The Alef Trust47
Run by David Luke, professor of psychology at Greenwich University, the 12-month online Alef Trust course entitled ‘Psychedelics, Altered States and Transpersonal Psychology’ provides an academic grounding in psychedelics. There is a particular emphasis on, ‘mystical and shamanic experiences, as well as inter-species communication, entity encounters, psi experiences, out-of-body and near-death experiences, insight and creativity, love, compassion, connectivity and empathy, and other experiences and concomitants of the psychedelic encounter’. Far out, man. And Dave are Pascal are great teachers, so it is highly recommended for those who dig this sort of stuff.
14. Naropa Center for Psychedelic Studies48
Based at Naropa University, in Boulder, Colorado, USA, courses provide an 8-month, 150-hour postgraduate non-degree certificate training, which includes both online and intensive retreat-based learning. They also offer a 6-month, virtual learning Psilocybin Facilitator Training certificate programme that provides a combination of hybrid instruction and asynchronous content that students can engage at their own pace in accordance with the programme timeline.
15. Drug Science49
And finally in this section, Drug Science are now also offering a series psychedelic training modules, where participants can learn about many aspects of how to become a psychedelic therapist. The course is delivered by several members of the Mind Medicine Australia faculty, including Eli Kotler, David Nutt, Lauren MacDonald and Peter Hunt. This leads us nicely into the next section.
What is happening in Australia right now?
The simple answer to this question is: something truly special, surprising and potentially world-changing. That’s what.
There are those of us in the field who are not prepared to work underground, but rather we strive through research and lobbying governments to see if we can get psilocybin, MDMA, LSD and other psychedelics approved as legal, overground medicines for our patients. But this has been a long and arduous journey, and we are still not there.
While there are rapid changes worldwide in the legal or semi-legal / grey area availability of psilocybin (such as in the Netherlands and Jamaica), the truth is that nowhere are these compounds accepted as formal medicines (with a capital M) yet. That will only come when a national medicines approval agency (such as the FDA in the USA or the EMA in Europe) add them to their list of approved medicines. Then doctors will be allowed to prescribe them to patients.
And while ketamine is a useful psychedelic drug, and especially when combined with psychotherapy (KAP), for treating a wide range of treatment-resistant disorders, it is arguable that the reason there have been so many ketamine clinics spring up in recent years is simply because ketamine is all we have. That was certainly the sentiment among our staff at the UK’s first psychedelic medical clinic we ran from 2020 to 2023. We used to think of our clinic as ‘Ketamine Now. MDMA and Psilocybin coming soon!’
Ketamine is good. But it’s no psilocybin. And it’s no MDMA. And all these years we have been hanging on every word from MAPS, with the promise of MDMA approval always ‘just around the corner’ but never quite there. Amid this painful waiting game of the last 20 years, psychedelic therapy has been at times a frustrating place to be in. Why even bother training to become an MDMA or psilocybin therapist, many people ask, when you can’t even work (legally, overground) with the chemicals anyway, as they are not available anywhere?! It is a very good point.
Then, in the context of this frustrating situation, in 2023 something miraculous happened in Australia. The Therapeutic Good Administration (TGA), the Australian equivalent of America’s FDA, ruled in favour of rescheduling MDMA and psilocybin from Schedule 9 (prohibited substances) to Schedule 8 (controlled medicines) of their Poisons Standard policy.
This is different from being completely approved as medicines (which as for the FDA and EMA requires a lengthy process of completed phase 3 trials and subsequent scrutiny of results by the regulatory body). But what this new rescheduling means is that now psychiatrists in Australia are able to utilise psilocybin for treatment-resistant depression and MDMA for PTSD.
The process that got Australia to this point was not actually miraculous. It was in fact the result of an impressive body of work, hard graft and inspirational activities of a few key figures, with much credit going to Peter Hunt and Tania de Jong at Mind Medicine Australia (MMA) for working so tirelessly and giving their own time and money to get the rescheduling over the line.50
It was a most convoluted process, which started way back in July 2020 when MMA initially lodged applications with the TGA, requesting the rescheduling of MDMA and psilocybin from Australia’s Poisons Standards of Schedule 9 to Schedule 8. After a public submissions period, the TGA replied with a negative interim decision in February 2021. MMA subsequently lodged a submission in response to the TGA’s decision.
Then in April 2021 the TGA initially deferred the issue. David Nutt and I got involved. We took part in a Zoom panel meeting with the TGA, alongside MMA, in June 2021. We presented safety and efficacy data from recent MDMA and psilocybin trials – urging the TGA to accept the submissions from MMA. And we provided a detailed reply to the TGA’s interim refusal decision, in which every single objection issue was examined and answered.
But sadly, in December 2021, the TGA gave their final negative decision – rejecting the submission. The TGA’s negative outcome was partly influenced by objections from the Royal Australian and New Zealand College of Psychiatrists (RANZCP), and the Australian Medical Association (AMA) who took, we felt, an overly risk-averse approach.
MDMA and psilocybin were to remain in Schedule 9. At this point it looked like it was all over, and the TGA were never going to yield. But Peter and Tania were undeterred and refusing to give up. They submitted a second round of applications in March 2022, only to receive another negative interim decision from the TGA in October 2022.
But MMA kept going. They submitted a response to the negative decision in November 2002, producing an extensive and lengthy detailed document answering every single point of the RANZCP and AMA objections, with multiple references and citations to demonstrate that MDMA and psilocybin are far advanced in their research, that they are safe and they are efficacious, and that – although they are not yet licensed medicines anywhere in the world – there is nevertheless enough safety and efficacy data out there in international trials to shift them from Schedule 9 to 8 in Australia.
And at this point, Peter and Tania arranged for David Nutt to visit Australia and carry out an exhausting coast-to-coast lecture tour, sponsored by herbal tincture and organic chocolate brands. Throughout November 2022, Nutt flew around the country and spoke at public meetings and met Australian officials from all sides of the debate. And there were also black-tie events with philanthropists and stakeholders at the Australian Clubs in Sydney and Melbourne.
But perhaps the most important part of Nutt’s approach was to introduce to these Australian stakeholders the human story of psychedelic therapy, through the widow of a patient with treatment-resistant depression who died by suicide. The message from Nutt was that psychedelic therapy is not to be overlooked as a potential treatment for the future of psychiatry. David was worn out at the end of his visit, and when we spoke in December 2022, despite his efforts, we – and all parties – felt despondent that what had seemed like a great idea for Australia and the world was never going to happen
Subsequently, the next bit really did feel miraculous! In February 2023 the TGA announced that they were in favour of the rescheduling. I spoke to a jubilant Peter and Tania at this point, and they invited me to come to Australia to be part of a major teaching programme, as it was clear that Australia had a momentous opportunity to commence the roll-out of psychedelic clinics able to offer legal MDMA and psilocybin as medicines – the first in the world! – and that MMA would be an important organisation in this programme.
I was thrilled to be invited, but at the time was working full-time in the Awakn clinic in Bristol and would have to work out some kind of sabbatical in order to get away to Australia for long periods of time. But then I decided that the Australia opportunity was too good to miss. Australia was where it’s at in the world today in the field of psychedelics. I just had to be part of this. So, I resigned from Awakn clinic in April 2023, and took up MMA’s offer to be part of their first residential teaching programmes. The TGA rescheduling came into effect in July 2023, and a new era of international psychedelic therapy had begun.
Unique developments spark mixed reactions
This exceptional event incited a mixture of both positive and negative news across Australia and throughout the world. Academic contributions praised the TGA and MMA’s part in the tremendous step forward for global psychedelic therapy.51 But not everyone supported the idea, with some commentators stating that the decision was made too fast by the TGA, without enough evidence of safety and efficacy, and concerns about what safeguards would be put in place when rolling-out the initiative.52 It is understandable that clinicians would be cautious of such a bold and relatively rapid step forward.53
But personally, I disagree with those voices who opposed the idea completely. There are decades of documented safe and efficacious evidence in respect to MDMA, and thousands of years such data in respect of mushrooms. MMA found themselves being criticised by how they went about the negotiations with the TGA, with some commentators accusing them of ‘bullying and lobbying’ inappropriately. And even some Australian clinicians who appeared to be supportive of psychedelics in the past were now stating that the decision had been made too hastily. There was a lot of both good and bad media attention for MMA at the time, and Peter and Tania suffered some ghastly and inappropriate personal attacks.54,55
The issue has sadly been rather divisive in Australia. It is sometimes difficult to disentangle truth from reality. All I can say personally, from my many contacts with them, is that Peter and Tania are charming, smart and savvy individuals who by being the people behind getting the TGA decision over the line – by whatever methods – have done more for Australian psychedelic therapeutics than anyone else.
Perhaps there is as much envy and sour grapes as there is genuine concern over MMA’s achievement? I couldn’t possibly comment. The proof will be in the pudding, in terms of how Australia does going forward. It is in an enviable and strong position worldwide if it can deliver successful psychedelic therapies to large numbers of Australians who can benefit from these treatments with MDMA and psilocybin for PTSD and treatment-resistant depression.
Interpreting the TGA decision and teaching in Australia for MMA
The TGA released initial documents outlining what the new decision means for doctors and therapists.56 They were clear about what the decision meant and how it was to be implemented. Perhaps in response to the critics from Australia who were fearful of the decision, a number of guidelines were issued.
Firstly, the TGA decision does not to allow a free-for-all with MDMA and psilocybin. Australian clinicians can only use MDMA for PTSD, and psilocybin for treatment-resistant depression (TRD), no other conditions. And the TGA stated the importance of robust training required for Australian doctors, nurses, therapists, clinical psychologists and pharmacists. Doctors who wanted to prescribe the newly scheduled medicines had to become ‘Approved Prescribers’, which meant satisfying thought-through eligibility criteria in terms of training and ongoing supervision.
And there was also the suggestion that patients undergoing treatments at the newly forming clinics should have appropriate outcome data pooled, so that the safety and efficacy of MDMA and psilocybin therapies could contribute to a national register of real-world data, which as discussed previously is becoming an important tool in demonstrating to approval agencies why psychedelic medicine is beneficial.57
In Australia, Professor Paul Fitzgerald at the Australian National University (ANU) in Canberra is leading this project.58 Australia is sitting on a goldmine of potential data. As the development of Australian clinics increases in coming years, they will have on record thousands – if not eventually tens of thousands – of cases of patients under treatment. This anonymised data pool can carry great weight in encouraging other countries around the world to make similar rescheduling decisions, thus opening up psychedelic therapies for everyone – ahead of formal approval by bodies such as the FDA and the EMA.
Training Australians to deliver psychedelic therapies
Of course, MMA’s C-PAT training course, as described earlier in this chapter, is not the only psychedelic training course available in the country, and other groups also offer good training. One such group is the Psychedelic Institute Australia (PIA), staffed by a lot of experienced professionals with a history of conducting psychedelic research in Australia. The PIA offer in-person and online educational materials, and a 5-day in-person workshop.59 The folk at PIA also offer consultation services for teams in Australia wishing to take advantage of the unique TGA decision, and needing support to turn their traditional clinical work into psychedelic clinical services. This is an excellent and well-needed service in Australia.
Another Australian organisation providing training in psychedelic medicine is RANZCP, who offer training. Their course of 200 hours of teaching over 12 months provides pathways to accreditation to become a legally practising accredited psychedelic therapist, Approved Prescriber or psychedelic facilitator, and is open to registered psychiatrists, psychotherapists, occupational therapists, counsellors, social workers, naturopaths, paramedics, indigenous practitioners, nurses, physiotherapists, mental health workers and allied health professionals.60
It is good to see that even those detractors who initially opposed the TGA decision developments, and were so critical of MMA’s role in making it happen, are now getting on board and working alongside MMA and others to see Australia become a leading nation in the field of psychedelics. Collaboration and affiliation are always more effective than competition.
I made two long visits to Australia in 2023 as part of the roll-out of the new TGA plans. The first, in May, was to Perth in Western Australia, to deliver teaching at the PAX Centre and for Emyria. They are two of the many established traditional clinical services in Australia that are wishing to take the opportunity to move into psychedelics. I was hosted by Mike Winlo, a medical doctor and CEO of Emyria, a man with his finger on the pulse of Australia’s exciting psychedelic future, and his colleagues at the PAX Centre.
Dozens of other clinics in Australia will be opening soon, including the Clarion Clinic in Melbourne61 and the planned clinic from Ted Cassidy, co-founder of Monarch Mental Health Group (MMHG).62 Ted made history when he wrote the world’s first-ever prescription for MDMA outside of a research trial, after the TGA decision was made. He posted a picture of the script online.
In October 2023, I returned to Australia again for another 10-week trip. I was providing facilitation at two week-long residential workshops in Sydney and Melbourne, and also travelling around giving lectures and meeting some of the stakeholders hoping to work with psychedelics. It was a pleasure meeting such a broad range of professionals from Australia, everyone wide-eyed and enthusiastic – but not naïve –about the challenges that lie ahead of them.
Like David Nutt the year before, MMA had me on a punishing but enjoyable schedule of coast-to-coast meetings. None of it would have been possible without Peter and Tania’s great generosity and hospitality, and without the work of the MMA staff member, Scott Edwards, who kept me to schedule perfectly as we crossed back and forth between Sydney, Canberra and Melbourne.
Unfortunately, I was unable to join MMA for further teaching residential retreats in 2024, but my colleagues Lauren MacDonald and Imperial’s David Eritzoe continue the good work. The MMA programme continues to be one of the best in the world. I am sad to not be joining them. Maybe next year!
Continued challenges for Australia
Understandably, the TGA specifies strict rules for the supply of MDMA and psilocybin to feed the new developments. There are guidelines about the import, export, manufacture, storage and dispensing of the medicines.63 Peter Hunt at MMA is keen to increase accessibility to the new treatments by providing Australian doctors, Approved Prescribers, with an affordable source of the drugs. He has done this by arranging a contract with the company Optimi Health Corp. a leading Health Canada pharmaceutical manufacturer, specialising in controlled substances such as psilocybin and MDMA. MMA has secured an import permit with Optimi to export its GMP MDMA and psilocybin capsules to supply approved psychiatrists under Australia’s Authorised Prescriber Scheme.
Optimi and MMA have also developed a secure Prescriber Portal, to launch in June 2024 to a network of more than 2,800 Australian psychiatrists. This tool will provide comprehensive information on the import and export process, as well as detailed insights into Optimi’s MDMA and psilocybin capsules. Optimi CEO Bill Ciprick commented,
Affordability and accessibility is the backbone of our partnership, and we intend to deliver on that commitment by offering MDMA and psilocybin capsules at the most cost-effective price in the market.64
The general cost of treatments, which are likely to cost between $25,000 and $35,000 AUD, is also an issue that has raised a lot of concern in the Australian media.65 These costs could put such treatments out of reach for average Australians. However, one must look at these prices in relation to the current costs to individuals, society and public healthcare systems of not adequately treating PTSD and TRD.
An intensive, therapist-hours-heavy course of treatment is necessarily expensive. But it still makes economic sense. There have been several cost-benefit economic analyses for MDMA therapy (though, sadly, less are available for psilocybin treatments), which have consistently demonstrated that the costly treatments adequately pay for themselves, with superior results compared to traditional treatments, which leave patients stuck in expensive mental healthcare systems for years.66,67,68
Again, MMA is seeking to address these issues by having recently been in discussions with the MSAC, the Australian government Medical Services Advisory Committee, to begin the conversation about making psychedelic therapies in Australia available to all through government-sanctioned benefit schemes.69 Further conversations also need to be had with Australian health insurers, to make psychedelic therapies more accessible and affordable to all.
In summary – Things are progressing slowly, but surely in Australia
At the time of writing this, in September 2024, there are currently 11 fully licensed Authorised Prescribers in Australia, a small drop in the ocean, but a start. Over 50 psychiatrists have graduated from MMA’s training programme, with far more expected to complete the course by the end of 2024. And there are at least three clinics now providing MDMA and psilocybin therapy under the new TGA ruling, with others coming online all the time.70
It is true that progress is slow, and the rush of enthusiasm that I experienced during my two visits to beautiful Australia in 2023 has transmogrified, understandably, into a more realistic position of hard graft.
In the meantime, it will remain to be seen how Australia fares with this wonderful opportunity they have been given. And in the context of the continued difficulties that MAPS appears to be having with the FDA, I still have great confidence in Australia making the most of their privileged position and leap-frogging other countries to become the premier site on Earth to develop nationwide, publicly funded psychedelic therapies.