Beyond Phelps’s Essential Competencies

Phelps’s (2017) review focused primarily on therapist competencies, however there are many more roles and providers that are integral to the diverse care teams that deliver psychedelic-assisted therapy.

Building on the six essential competencies, below are some additional considerations for all roles working within this field.

Video: Attunement to the Present Moment

3:11

Each Medicine Session can look very different, even with the same client. Therefore, being attuned to the unfolding moments during a Medicine Session is a key skill for health professionals in this field.

Question

What is the difference between bottom-up and top-down processing?

Bottom-up and top-down processing are two processes that we use to perceive and make sense of the world around us (including our own thoughts and sensations). These processes are often used to explain how information is processed in the brain.

Top-Down Processing

For example, a client with social anxiety may have strong feelings of fear and avoidance in certain social situations. Through top-down processing, the health professional and client can work together to identify and challenge the client's negative thought patterns and beliefs (for example "I'm being judged by others").

Bottom-Up Processing

For example, a client who has experienced a traumatic event may show signs of emotional distress (such as increased heart rate or shallow breathing) when the trauma is being discussed.

Video: Inner-Directed Therapy

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In this video, Dr. Christie talks about inner healing intelligence and how health professionals can best support this in their work.

Video: Connection

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Connection is another key competency of health professionals working in psychedelic-assisted therapy. Due to the relational nature of psychedelic medicines, especially empathogens like MDMA, it is important for health professionals to prioritize relationship-centered care.

Video: Additional Competencies

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There are some additional competencies which are beneficial to health professionals working in psychedelic-assisted therapy. Dr. Christie reviews these from a high level.

Learn More

In the Fundamentals of Psychedelic-Assisted Therapy course, you will be introduced to the Numinus care model (or guiding principles for psychedelic-assisted therapy) as well as the Numinus therapeutic stance which includes 10 essential competencies for health professionals. Both of these models are at the heart of how Numinus approaches psychedelic-assisted therapy with clients and in our courses.

References

Brennan, W., & Belser, A. B. (2022). Models of psychedelic-assisted psychotherapy: A contemporary assessment and an introduction to EMBARK, a transdiagnostic, trans-drug model. Frontiers in Psychology, 13.

DeAngelis, T. (2019). Better relationships with patients lead to better outcomes. 50(10), 38.

Guss, J. (2022). A psychoanalytic perspective on psychedelic experience. Psychoanalytic Dialogues: The International Journal of Relational Perspectives, 32(5), 452-468.

Mithoefer, M. C. (2015). A Manual for MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder. MAPS.

Murphy, R., Kettner, H., Zeifman, R., Giribaldi, B., Kartner, L., Martell, J., Read, T., Murphy-Beiner, A., Baker-Jones, M., Nutt, D., Erritzoel, D., Watts, R., and Carhart-Harris, R. (2022). Therapeutic Alliance and Rapport Modulate Responses to Psilocybin Assisted Therapy for Depression. Frontiers in Pharmacology, 12(788155).

Vaid, G., & Walker, B. (2022). Psychedelic Psychotherapy: Building Wholeness Through Connection. Global advances in health and medicine, 11, 2164957X221081113.