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We recently published charters to demonstrate our commitments to patients and therapists

Psychologist Dr Elizabeth Nielson is a therapist on clinical trials of psilocybin-assisted treatment of alcohol use disorder, MDMA-assisted treatment of PTSD, and psilocybin-assisted treatment of treatment-resistant depression. She is one of the lead trainers on our therapist training programme and co-author of a paper on our therapist training programme for psilocybin therapy, published recently in Frontiers in Psychiatry.

Tell us a little about your background

I’m a psychologist, based in New York, with an interest in helping to find better and more compassionate ways of helping people who are suffering from addiction and related problems, specifically PTSD and mood disorders.

I have a strong interest in harm reduction, drug policy and the social constructs around drug use; specifically, our relationship to drugs and different substances and questions relating to why one person develops a problem and another doesn’t.

After my undergraduate degree in psychology, I did a masters with a focus on harm reduction and addiction studies. My doctorate was in clinical psychology because I wanted to be involved in research and in developing more compassionate, humane ways to engage with people who are suffering.

How did you become involved in psilocybin therapy?

During my doctorate I studied different ways of working with people, and saw varied approaches, modalities and settings where people were struggling with problems like alcohol and drug abuse. Towards the end of my doctorate, I came across a posting looking for a therapist to work on a study on psilocybin-assisted treatment for alcohol disorder – it was an excellent fit from an academic, skillset and interest perspective.

Through that work I was able to train in psilocybin therapy and received a National Institute of Health-funded post doctorate fellowship to build out my own programme of research in the field. This included qualitative research around people’s experience of psilocybin therapy and how psychotherapists relate to the work that they are doing with psychedelics.

Tell us about your interest in therapist training

My interest in therapist training emerged because I could see that this would be one of the greatest challenges in our field. It also offers one of the greatest opportunities to ensure that psychedelic therapy reaches the broadest spectrum of people. In expanding access we must preserve the unique aspects of working with non-ordinary states of consciousness in a therapeutic environment, in a way that is ethical and equitable and that will promote healing.

Towards the end of my fellowship I decided to further my interest in therapist training. I started working with Compass who were just beginning to train therapists for their phase 2b trial in the US. I completed the training in 2019, became a therapist on their trial, and now also assist with training of new therapists as well as developing the therapist mentoring programme.

What do you think of our Therapist Charter?

Compass was keen to involve therapists in the development of the charter so I contributed to it. I think a charter is a really good idea because it clarifies the company’s commitment to certain principles. The end result works because it is really clear that Compass takes a rigorous and considered approach to working with therapists.

Here’s what the different charter elements mean to me.

Professional recognition – Compass is committed to creating a rigorously trained and recognised group of mental health care professionals working in psilocybin therapy

Compass is developing a world-leading training programme in the field and setting a precedent in a lot of ways. Therapists need to know that there is a specific skillset, knowledge base, set of ethics and ways of working that are unique and important to psilocybin therapy.

Therapists and the public don’t necessarily know why psilocybin therapy is different or special or what level of knowledge, education and skill development is needed to provide this therapy. Professional recognition is important for setting standards and establishing a level of professionalism and professional practice in this field.

Wellbeing – Compass is committed to supporting therapists’ wellbeing

Self-care is a really important aspect of this work. Having an environment that facilitates conversations about self-care and supports therapists in this is really important to be able to do this work in a meaningful and sustainable way.

Diversity and inclusion – Compass is committed to developing and supporting a diverse community of therapists

Having diverse populations represented within the therapist pool encourages recruitment of a diverse range of participants to clinical trials. And if therapists are representative of the communities they aim to serve, this can help to navigate cultural barriers.

If the results of our research are to be applicable to the entire population of people we’d like to make this therapy available to, then diversity in therapists and trial participants is vital.

Knowledge – Compass is committed to creating opportunities for shared knowledge among therapists so they can support patients through meaningful and transformative experiences

Shared knowledge is a fundamental principle of Compass therapists’ training. The number of trained therapists in this area is quite small, so having access to each other for support and sharing of knowledge is critical. By bouncing things off of each other, learning from each other’s best practices and helping to answer each other’s questions, we evolve as a community.

From the outset Compass created platforms and activities that encourage sharing. Therapists are encouraged via monthly sessions to share cases, experiences and knowledge as well as mentoring newer therapists and sharing resources.

Our vision is a world of mental wellbeing, what does this mean to you?

To create a world of mental wellbeing we need to find ways to think “outside of the box” to bring new insights and new ways of understanding mental suffering. The process of thinking “outside of the box” is actually what we believe psilocybin therapy might be enabling.  We need to continue to evolve our understanding of the causes and constructs of mental health.

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