A weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next.
An EMDR Therapist's guide to ethical psychedelic integration
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Hey there, As psychedelic-assisted therapy moves toward mainstream acceptance (with FDA breakthrough therapy designations for both MDMA and psilocybin and more states adopting legislature for legal psychedelic therapy), many EMDR therapists are asking the same question: “How can I ethically incorporate psychedelic integration into my practice?” Luckily for you, I've probably spent more time researching this exact question than many people in the EMDR community. So much so that I gave a presentation on it last summer at the EMDRIA Virtual Conference! So today, I want to break it down for you. The answer involves understanding what's called Psychedelic Harm Reduction and Integration Therapy (PHRI) – an approach that allows you to support clients before (sometimes) and after (definitely) their psychedelic experiences without ever handling controlled substances. By the end of this email, you’ll have a clear path to ethically enter this space and understand how you can more confidently support clients who plan to independently pursue psychedelic therapies outside of their work with you (but in the context of their treatment goals). Disclaimer: The information contained in this document is for informational purposes only. This is not legal advice and I make no guarantees about the outcomes or results from information shared in this document. Proceed at your own risk and discretion. Understanding the Legal and Ethical Side of Integration Work Let me be clear from the start: Ethical psychedelic integration work does NOT involve controlled substances in your practice setting. The approach I'm describing focuses on two specific phases of the 3-phase psychedelic- assisted therapy (PAT) model: Phase 1 (Preparation): Working with clients before they pursue legal psychedelic experiences. Phase 3 (Integration): Supporting clients after they've completed their experiences. What this means is that you're not facilitating access to psychedelics, providing space where substances would be used, or coordinating with underground guides. That would happen in Phase 2 of the PAT model which doesn’t apply to your PHRI approach and is only legally viable in certain states/jurisdictions or in an FDA-approved research context. You're also not applying judgement of the client by encouraging or discouraging substance use. Instead, you're providing education about research-informed risks and benefits, preparation work using evidence-based practices (just as you might help prepare a client for EMDR), and integration support focused on therapeutic goals. This approach falls squarely within existing scope of practice and ethical guidelines when done correctly. My Ethical Due Diligence Framework If you're like most EMDR therapists I talk to, you're probably wondering: "This sounds interesting, Chris, but how do I know I'm not crossing any ethical lines? What if my licensing board comes knocking?" That's exactly the question I had, which led me to analyze my state law, professional codes, and clinical standards. After reviewing Washington state law, NASW ethics codes, and national clinical standards, here's what I’ve found to support this work:
Disclosure: Some of this may vary depending on your state and guidelines for your discipline, so I always recommend diving into research for your own legal and ethical standards if you live in a different state or have a different discipline (i.e. counselors, MFTs, psychologists). An important piece is informed consent. Clients must understand exactly what you can (and cannot) provide, plus the legal, ethical, and clinical considerations involved in pursuing psychedelic experiences independently with a third party access or retreat center. This foundation gives you the confidence to move forward ethically, while also serving clients who are increasingly interested in these alternative healing approaches (many of whom with clinical presentations that often overlap with a typical EMDR client). How EMDR Compliments Psychedelic Preparation (Phase 1) What's fascinating is how naturally your existing EMDR skills translate to preparation work. If you think about it, you're already doing most of what's needed (just in a different context)! Here’s what I mean: Stabilization and Resource Building: Traditional EMDR preparation becomes even more critical when clients are considering psychedelic experiences. The same skills that help clients tolerate trauma processing can help them navigate challenging psychedelic content like:
Target Assessment: Rather than targeting specific traumatic memories, preparation work involves helping clients identify:
Psychoeducation: EMDR therapists already excel at explaining how trauma affects the nervous system. In this context, that same EMDR expertise translates directly to helping clients understand:
The preparation work you already excel at becomes the foundation for safer, more intentional psychedelic experiences that they might pursue independently. Integration Work Using EMDR Principles (Phase 3) Many clients return from psychedelic experiences with vivid memories, insights, or even challenging material that needs processing. This is where EMDR truly shines in the integration space. Here's how the standard EMDR protocol adapts beautifully to integration work: Memory Processing: Psychedelic experiences often bring up core memories or create new significant experiences. Some examples for using the standard EMDR protocol:
Somatic Integration: Psychedelic experiences are often deeply embodied. EMDR's attention to body sensations helps clients:
Cognitive Restructuring: The positive cognition phase of EMDR becomes particularly powerful for integration:
(Note: What many therapists find is that integration work often feels more profound than traditional EMDR sessions. That’s because clients are processing material that emerged during heightened states of consciousness.) Practical Considerations for Your Practice Now before diving into this type of work, there are several important elements to consider for implementation. Let me break them down for you. Training Requirements: Before offering PHRI services, it’s important to invest in proper education (this isn't something you want to learn as you go):
It’s also helpful to keep up with ongoing supervision throughout your early cases, not just during initial training. Documentation and Marketing: To protect both yourself and your clients, make sure you explicitly state in all marketing materials what you do (and don’t) offer. You don’t provide access to controlled substances – only assistance with the preparation and/or integration phases. Client Screening: It’s important to recognize that not every client is appropriate for PHRI services. That's why it's always important to screen for a stable mental health baseline, realistic expectations about psychedelic experiences, and adequate support systems for integration work. Know what the contraindications are and look for them early if a client is suggesting they have plans to pursue a therapeutic psychedelic experience outside of their work with you. The key is building competency gradually while maintaining the highest ethical standards throughout the process. The Future of EMDR and Psychedelic Integration As psychedelic therapy moves toward mainstream acceptance, EMDR therapists are uniquely positioned to contribute to this field. The same client population that tends to benefit most from psychedelic therapies are the ones who can benefit most from EMDR too. Our skills in trauma processing, bilateral stimulation, and nervous system regulation translate directly to both preparation and integration work. The ethical frameworks already exist within our professional guidelines, and the training pathways are becoming more accessible. I don’t think the question is whether psychedelic therapy will become mainstream (that’s just a matter of time). The real question depends on whether EMDR therapists (like you) will be ready to serve clients ethically and effectively when it does. Are you considering adding psychedelic integration to your EMDR practice? What questions do you have about the ethical considerations involved? This would be a great topic for conversation in Helicon’s (free) private Signal group for EMDR providers. Use this application to apply and join the group and connect with other EMDR pros sharing the same interests! (try using Google Chrome if you have any issues with the form) Until next week, Chris |
EMDR Therapist Weekly
A weekly dose of insights, tools, and opportunities for EMDR therapists; designed to support your growth, sharpen your practice, and connect you with what's next.
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