Who could be included in your Accountability / Consult Group:

5-8 therapists ideally with similar and different therapeutic interests and modalities.

Interdisciplinary works well too for a wider therapeutic viewpoint and wider expertise.

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What this group is NOT: This is NOT clinical supervision. Clinical supervision is direct observation of your practice by a colleague / mentor / elder  with more experience in psychedelic assisted therapy.

1. Regular Meetings:
   • Regular Monthly 1-2 hours.
   • Establish “Intentions and Agreements” in the first meeting (which can include the below and more):
     • Agree to follow a Code of Ethics https://www.psychedelicassociation.net/code-of-ethics
     • Listen to hear
     • Non-Violent Communication
     • Assume goodness in people
     • Lean in to challenging conversations
     • Participate! Even if challenging
     • Bring ideas and suggestions
     • Leave the meeting with positive ‘to do’ actions
     • Send out recently published articles to review and discuss
     • Ensure space for all to participate
     • Specific conversations stay IN the group. General themes & learnings may be taken out of the group.
     • Stay in integrity.
   • Discuss challenging cases - maintaining full confidentiality of patient/client.
   • Present 5 minute pearls (i.e. something recently read, a synopsis of a recent course, a new learning).
   • Foster organic open discussion.
   • Encourage ongoing development of core competency of the ethical therapist
     • Empathetic Abiding Presence
     • Trust Enhancement
     • Spiritual Intelligence
     • Therapist Self-Awareness and Ethical Integrity
     • Knowledge of the Physical and Psychological Effects of Psychedelics
     • Proficiency in Complementary Techniques
   • Maintain a group you can trust to be honest with you and you with them using non-violent communication.
   • This is your safety net for honest timely feedback, ideas, and counsel.
   • Review regularly boundary crossings - of therapists and of patients/clients. Real world examples are good to discuss with solutions on better ways of being.
2. Emergency meetings:  Called at any time at any point by any member needing counsel.
   1. Person calling the meeting sets time, date & sends doxy/zoom link
   2. Any member that can attend does
   3. Confidential deidentified details & seeking feedback & counsel
3. Transgressions:  If you have crossed a line - immediately seek professional counsel. Legal counsel  will provide guidance on proper reparation.  Your regulatory board or college can also provide guidance for repair.
4. Remember any boundary crossing can be a liability for the rest of your career.
   At almost any point a complaint can be made. What seems “friendly & innocent” now will not look so from outsiders assuming and deciding what happened without the actual details. You will always be deemed to have been in a position of power. Take that obligation VERY seriously.
5. When in doubt - ask your  insurer / regulatory college what you should do.
   For example, if a patient sends you a suggestive email - ask for assistance immediately. Document asking for help. Discuss these cases with your accountability group so they too can learn from these red flags.
6. If you are feeling attracted to a patient/client - get counsel asap.
   There are steps that need to be taken if you want to have the FUTURE option of a non-professional relationship.  (i.e. you need to end the therapeutic relationship, there needs to be a certain amount of time of no contact, and many more steps - find out from your regulation organization).

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The more we discuss these openly and honestly the more we can prevent our good intentions from moving us out of integrity and in a direction that we regret.

The most vulnerable therapists can be the ones that care a lot (too much)! The data shows that the majority of practitioners that transgress were in a time of stress, conflict, and emotionally challenging situations. Most did not intend to transgress. Most are transgressions with a single client/patient.

And there are also predators in our professions. People who continually transgress and cause harm. People who deny harm, ignore repair, refuse reconciliation and restorative justice. These people must be reported to their regulatory boards and law enforcement if a law has been broken. 

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Resources

Sexual Boundary Violations - Andrea Celenza

Developing Guidelines and Competencies for the Training of Psychedelic Therapists: Janis Phelps 2017

The Ethics of Caring: Finding Right Relationship with Clients - Kylea Taylor

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Thank you to the volunteers at the  Psychedelic Association of Canada Ethics Working Group who spearheaded this document as a gift for the community:

Dr. Pamela Kryskow, MD

Lauri Comoli, BSW