Practical Guidelines for Supportive Touch in Psychedelic-Assisted and MDMA-Assisted Therapy: A Model for Practitioners and Researchers
Jason B. Luoma, Jenna Lejeune, Brian Pilecki, Kyong Yi, Kati M. Lear
PsyArXiv January 10, 2026 preprint DOI: 10.31234/osf.io/yfbp5_v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper |
|---|---|
| Topics | MDMA Psychedelic-assisted therapy |
| Key points | Proposes a conservative, structured model for ethically implementing supportive touch in psychedelic-assisted therapy, centered on a two-stage consent-assent process, categorized touch options with boundaries, ongoing assessment, and alternatives when touch is contraindicated. Argues that such guidelines can balance therapeutic potential with ethical constraints while prioritizing client autonomy, cultural sensitivity, and safety. |
Abstract
The use of supportive touch in psychedelic-assisted therapy (PAT) and MDMA-assisted therapy (MDMA-AT) presents unique ethical challenges and opportunities. While touch can be a valuable component of treatment, its implementation requires careful consideration due to the altered states of consciousness induced by psychedelics and the potential for boundary violations. This paper addresses a critical gap in existing protocols by proposing a comprehensive, conservative model for the ethical implementation of supportive touch within PAT. Our framework features: (1) a structured two-stage consent-assent process distinguishing between permission obtained in ordinary consciousness and psychedelic sessions, (2) a range of touch options with clear categories and boundaries, (3) protocols for ongoing assessment of touch experiences, and (4) practical alternatives when touch is contraindicated. Drawing from clinical experience and ethical principles, we provide specific guidelines for discussing touch during preparation, administration, and integration sessions. The model emphasizes cultural sensitivity, power dynamics, and individual differences while prioritizing client autonomy and safety. We discuss limitations of our approach and suggest directions for future research and the development of specialized training programs. By offering pragmatic guidelines that balance therapeutic potential with ethical constraints, this paper contributes to the development of evidence-based practices in psychedelic-assisted therapy.
Comparable studies
Other theoretical and historical papers on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Differences Between the Mechanism of Action of MDMA, MBDB, and the Classic Hallucinogens. Identification of a New Therapeutic Class: Entactogens | 1986 | Theoretical or philosophical paper | |
| The Background and Chemistry of MDMA | 1986 | Historical analysis | |
| The origin of MDMA (ecstasy) revisited: the true story reconstructed from the original documents* Original documents in Merck's historical archive in Darmstadt, Germany, years 1900–1960 | 2006 | Historical analysis | |
| Distinct neural mechanisms for the prosocial and rewarding properties of MDMA | 2019 | Theoretical or philosophical paper | |
| How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale | 2009 | Theoretical or philosophical paper |