Intention setting is a means to help the client set a direction or aim for the psychedelic process and has been correlated with peak experiences, well-being, and better outcomes (Carhart-Harris, 2018).
It is considered an important part of the preparation phase, linked to concrete goal setting and the integration that follows the Medicine Session.
Intentions aim to:
The key principles (Watts & Luoma, 2020) include:
Intention setting, as part of the preparation process for psychedelic-assisted therapy, provides the opportunity to educate the client about the value of psychological flexibility, acceptance, and the importance of reducing experiential avoidance. The Numinus approach to psychedelic-assisted therapy, including PHRI, relies in part on principles and techniques derived from Acceptance and Commitment Therapy (ACT) (Watts et al., 2017; Watts & Luoma, 2020).
To learn more about psychological flexibility in the context of supporting psychedelic-assisted therapy, please read Watts & Luoma, 2020.
Intention setting can allow the client to begin to turn toward challenging mind and mood states as a means of contemplating what is wanted from the psychedelic journey, consistent with their values. This can also be reflected in how intentions are stated. This can initiate the process of developing a different relationship with the unwanted or the difficult and beginning to promote de-centering or de-fusion (e.g., teach me how to heal and be with my pain rather than help me get rid of my suffering).
A small but growing evidence-base supports the overlap of stated outcomes of third-wave therapies and psychedelic-assisted therapy. These are those that promote openness, acceptance, cognitive and psychological flexibility, and the enhanced capacity to approach experiences versus trying to resist or avoid them (Walsh & Thiessen, 2018; Watts et al., 2017; Wolff et al., 2020).
There are several models to help establish an intention.
Please ensure that you read through all items before proceeding by selecting each title.
This is a framework to support clients to refine their intentions to keep it simple and focused. It encourages clients to pick either show me, help me or teach me and then a basic emotion (fear, anger, guilt, sadness, shame, joy), essential quality (peace, love, compassion, connection), or a key theme with which they feel they want support. This could be an area they feel stuck, blocked, or a potential resource.
The miracle question, developed by Steve de Shazer & Insoo Kim Berg, can support the client to make an intention and to imagine the possibilities of what would look, feel, and be different if the intended outcomes of the assisted therapy were achieved (Walter & Peller, 2013). The outcomes are stated in positive terms (Watts, 2021).
The miracle question is particularly useful when intentions are vague, or the client feels stuck or hopeless as it allows for broadening perspective. The miracle question can be used as an exercise with the client and may be adapted for psychedelic-assisted therapy:
Setting intentions can take time and may require that the heal professional during integration help to elicit these from the client. It is important that the health professional does not impose their own agenda or make assumptions about what the client needs. Rather, the health professional leads by following the client’s process, reinforcing, and amplifying those aspects of the dialogue that lead in the direction of forming, making overt, and refining the client’s intentions. Here is a set of inquiry questions to assist this process:
The Accept, Connect, Embody (ACE) model is derived from Acceptance and Commitment Therapy and the work of Dr. Rosalind Watts. It consists of a guided visualization method she developed in support of intention setting. The process includes a guided exploration that invites the client into the practice of opening up and connecting with emotions and the felt sense (somatic) of experience (Watts & Luoma, 2020). It utilizes metaphors of natural settings (e.g., the ocean) to explore turning inward and identifying what emerges for the client to then bring into the assisted session.
Intentions can change throughout Preparation Sessions. They can be used to clarify what is important and act as a focus during Integration Sessions. Organizing the intention setting around a specific framework can help clarify the intention and keep it more accessible during the psychedelic journey.
Carhart-Harris, R. L. (2018). The entropic brain-revisited. Neuropharmacology, 142, 167-178.
Walter, J. L., & Peller, J. E. (2013). Becoming solution-focused in brief therapy. Routledge.
Watts, R. (2021). Psilocybin for Depression: The ACE Model Manual.
Watts, R., & Luoma, J. B. (2020). The use of the psychological flexibility model to support psychedelic-assisted therapy. Journal of Contextual Behavioral Science, 15, 92-102.