Psychedelic therapy, also known as Psychedelic-Assisted Psychotherapy (PAP), is a mental health treatment that utilises intensive psychotherapy alongside the administration of a psychedelic compound. In Australia, there are only two legal compounds, if prescribed by an authorised psychiatrist.

Typically treatment involves three types of sessions: preparation, psychedelic journey or dosing, and integration. Preparatory sessions provide the foundation for the psychedelic dosing sessions, building a therapeutic alliance and establishing rapport between patient and therapists. 

The therapy team, often consisting of two practitioners, and the patient will spend time in the weeks and days prior to the psychedelic experience exploring the patient’s intention for coming, history, symptoms, what they are hoping to gain from the experience and any questions they might have.

The psychedelic journey or dosing sessions can span 6-8 hours in a treatment room specially prepared for psychedelic therapy. Important elements of the therapy setting include scent (which can act as a trigger for memories of the experience in future), warm, comforting lighting and a specially curated playlist of music that both anchors and spurs on the psychedelic journey. During the experience the patient is accompanied by the therapy team who hold a safe, neutral therapeutic space, listening or guiding the client to open to their experience with empathy and openness.

In subsequent integration sessions, the patient and therapist team explore the contents of their psychedelic experiences, work with challenging material that may have come up during dosing day, and help to bed down new perspectives gained during the psychedelic experience into daily life. Through identifying insights, new perspectives or sensations that arose during the psychedelic session, clients can begin to translate the experience into meaningful, long-term change.

The non-psychedelic psychotherapy sessions are essential elements of the therapeutic process both in terms of safety and effectiveness of the treatment. There is an emphasis on the potential for emotional and psychological growth throughout the psychotherapy and psychedelic-assisted portions of the treatment.

Research into this therapy so far shows results for individuals with certain mental health conditions that are promising enough to warrant further investigation.

Psychedelic, a word meaning mind manifesting, refers to substances that can alter perception, cognition, mood, and behaviours during the time they are active in the body. Like many other psychiatric medications, they are psychoactive, eliciting their action by interacting with the brain and nervous system processes.

Psychedelics commonly engender a mystical experience. From a biochemical perspective, psychedelics predominantly interact with serotonin receptors and other neurotransmitters (depending on the substance).Through these and other actions psychedelics have also been shown to increase or alter neural connectivity and activity both during and after the dosing session.

In a clinical and supervised setting, psychedelics have a good safety and tolerability profile. There is a negligible risk for toxicity and most psychedelics prescribed appropriately by a qualified psychiatrist aren’t likely to be associated with addictive behaviours. In fact, many are being investigated for their capacity to reduce or eliminate substance abuse.

Along with the perceptual effects observed during dosing sessions, individuals are observed to show transient increases in body temperature, heart rate and blood pressure which are monitored by the therapy team.

However, like all drug treatments, there are possible side effects. Clients are thoroughly screened to ensure the highest possible level of safety throughout any treatment. Individuals who are determined to be at risk of psychosis, who have cardiac issues or conditions related to the liver aren’t usually eligible for psychedelic therapy due to safety concerns. Additionally, some medications are contraindicated with psychedelics. Certain medications may exclude individuals from treatment or they will have to titrate off medications before treatment begins.

As of July 1st, 2023, two psychedelic substances are legal under strict circumstances. One is for the  treatment-resistant feelings of despair and hopelessness, and another for symptoms stemming from past trauma. However, not all patients are eligible and require assessment for eligibility. These substances also need to be prescribed by a specially authorised psychiatrist and taken within the confines of an approved treatment program. Other psychedelics remain in Schedule 9 under Australian law, meaning they are classed as having a high risk of misuse and should be available for research purposes only. Schedule 9 places psychedelics within the same classification as drugs with known detrimental health outcomes and addiction risk, such as heroin. Recreational use of psychedelics will remain illegal. 

As of July 1st 2023, psychedelic therapy is legal under strictly controlled circumstances for  treatment-resistant feelings of despair and hopelessness, or for symptoms stemming from past traumatic events. There are currently only 2 legal compounds. Psychedelic therapy involving other psychedelic substances may only be legal within the confines of a research study. Additionally, individual requests to access psychedelic therapy may be assessed by the TGA Expanded Access Programme in cases of life-threatening illness, however, this is uncommon. 

From July 1st 2023, psychedelic therapy is legally accessible for patients who have been assessed for eligibility with specific mental health conditions through authorised prescribing psychiatrists and within the context of an approved treatment program. That also involves therapists with specialist training in facilitating psychedelic therapy. 

Patients interested in seeing if they’re eligible can register via Enquiries on this site.

Psychedelics can be categorised in a number of ways such as classical psychedelics and non-classical psychedelics which can refer to psychedelic compounds either synthetically made or plant derived.

Another way of classifying psychedelic medicines is by their pharmacological profile. Classic psychedelics exhibit their action through serotonin receptors, primarily 5-HT2A. Some substances are classed as entactogens, inhibiting the reuptake of serotonin and dopamine. Dissociative anaesthetics such as ketamine act on NMDA receptors in the brain, while atypical hallucinogens interact with multiple neurotransmitter systems.

Each initiates altered states of consciousness associated with psychedelic experiences, though not all create the stereotypical visual hallucinations.

Modern research is exploring all of these psychedelic substances in varying contexts. Of course, such treatment does not work for everyone.

Some medications or health conditions can put individuals at increased risk for side effects or adverse events. Most psychoactive medications to treat mental illness or psychiatric conditions interact with similar pathways and receptors as psychedelics.

By blocking or influencing neurotransmitter processes, medications like antidepressants, anti-anxiety, antipsychotic and drugs for other conditions can reduce the effectiveness of the psychedelic experience and pose a risk of developing serotonin syndrome, where excess serotonin can result in mild to severe life-threatening symptoms. Research is currently underway to help better understand the nature of the risk of serotonin syndrome in psychedelic therapy. 

Trials of psychedelic-assisted psychotherapy generally exclude patients with uncontrolled hypertension, cardiovascular, liver or kidney pathology given the limited data around safety in such conditions. Any history of borderline personality disorder, psychosis or schizophrenia are also contraindicated in psychedelic therapy.

Even though the GoodMind clinic takes the highest possible care with its patients, it’s important to understand that patients can still be vulnerable during psychedelic-assisted psychotherapy, and like any medication, even legal psychedelic substances can have potential side effects.

According to the TGA, potential adverse effects of one psychedelic substance legally prescribed by GoodMind authorised psychiatrists can include a temporary increase in blood pressure and a raised heart rate. There is also some risk of psychosis in predisposed patients.

Potential adverse effects of another substance include feeling faint, high blood pressure and pulse rate, panic attacks, and in some rare cases, loss of consciousness or seizures.

These risks and side-effects are discussed with the patient, and if patients are concerned, they can also discuss the suitability of psychedelic-assisted therapy with their own doctor. Some patients may also be deemed as not suitable for treatment, due to an increased risk of the above side-effects.