Experiential training—where aspiring therapists undergo psychedelic-assisted therapy themselves—should not be mandatory, according to an ethical analysis applying Sandell et al.'s framework of training therapy functions. The analysis identifies five potential benefits (therapeutic, modeling, empathic, persuasive, and theoretical functions) but weighs them against six domains of risk: physical and psychological harms, negative effects on therapeutic skill, justice and equity concerns, dual relationships, privacy breaches, and undue pressure. Because many programs already include experiential components, the authors argue that the analysis can inform risk-mitigation strategies rather than justify a requirement.
A cross-sectional survey of 791 adults who use psychedelics found that 80% used them for therapeutic purposes, but only 30% of those therapeutic users had discussed this use with their physician. Barriers included stigma, perceived lack of physician knowledge about psychedelics, and legal concerns. Patients with mood disorders or posttraumatic stress disorder, and those who used ketamine, were more likely to have such discussions. The findings indicate most therapeutic psychedelic users are hesitant to talk with their doctors about it, highlighting factors that may facilitate or hinder patient-physician communication on this topic.