Psychedelics have been used for thousands of years in cultures across the globe. Historically they have been used for spiritual, healing, and self-exploratory purposes. In the past few decades with the discovery of psychedelics by the Western world and their recent re-emergence, there’s renewed interest in their therapeutic, spiritual, and self-exploratory potential. With this re-emergence, people need to approach these medicines with knowledge, informed decision-making, and a certain amount of reverence for their transformative power. The Western world has adopted the psychedelic harm reduction framework to help with mindfully approaching these medicines.
At Elument, we believe in this transformative ability of psychedelics, and we see the need in the community to support clients who are choosing to explore psychedelics on their own, or of course through a supported environment like the work we do. So, with that, we’d love to explore psychedelic harm reduction a bit more for you.
Psychedelic harm reduction is a framework that acknowledges that people will be using psychedelics whether or not they are legal or condoned and helps clients minimize any potential risk while maximizing the benefits. This is different from an abstinence-only approach or the Reagan era “Just Say No”. Harm reduction is based on meeting clients where they are in their journey rather than trying to control anything external to us. With people’s psychedelic use, we want to help provide you with supportive guidance and information including the awareness that most of these medicines are not currently legal to use. In a therapeutic context, harm reduction can include the preparation and integration process, as well as supported journeys with trained therapists.
1. Reduces Stigma and Creates a Safe Space for Discussion
As therapists, we are always conscious of the stigma and associated shame that society can impart on our clients whether it’s with psychedelics or other things such as who you love, what groups you belong to, or what you generally believe in that may not be part of the mainstream culture. With psychedelics and harm reduction, we want to help break down the stigma associated with psychedelics and look at factual, rational, and healthy information. When our clients feel safe and not judged, it allows open discussion, exploration, and learning. Psychedelic harm reduction normalizes this discussion and gives our clients a space to talk openly about their desires, journeys, or experiences around psychedelics.
For clients who have used psychedelics or are considering it, this safe space is vital. Whether society condones this or not, people are using psychedelics, and being able to openly discuss experiences is crucial to healing, growth, and avoiding the lasting effects of challenging experiences. This approach also acknowledges the fact that people may seek non-traditional ways to explore their mental health, and it’s the therapist's role to help guide them safely, not to condemn their choices.
2. Provides Comprehensive Education
Psychedelic harm reduction involves educating clients about both the benefits and the risks of psychedelics and empowers them to make informed decisions. With this, we also don’t idealize psychedelics and put them on a pedestal. They can be powerful medicines and with anything that can be powerful, they must be treated accordingly. Just like learning to drive a car that weighs 4000 pounds and moves along at 70 miles per hour, it’s important to have a framework that can help promote responsible use.
Education under harm reduction can cover topics such as:
• The effects of different substances and how they might interact with your internal (e.g. psyche and mental health) and external systems (e.g. friendships or relationships)
• Set and setting (i.e., mental state and environment) and how these factors influence experiences
• Potential contraindications, especially if the client has mental health concerns like psychosis, bipolar disorder, or is taking medications that might interact
• Strategies to integrate and make sense of experiences post-session
• Cultural beliefs and the effect psychedelic use, or overuse, can have on other cultures (e.g. overuse of peyote by non-indigenous groups)
By offering this kind of information, therapists can help clients feel more prepared, reduce the belief and likelihood of challenging experiences, and provide a grounded view that can guide their choices.
3. Helps with Psychedelic Integration
For many of us, a psychedelic experience can be profound and can lead to powerful, challenging, or insightful parts of our system coming up. With a harm reduction lens, we support integrating the experiences afterward with a therapist, friend, or spiritual elder in your life. This can help with people’s understanding of the experience and help bring the insights and awarenesses from the experience into everyday life.
Integration work is a space where clients can explore what came up during their experiences in a safe, structured environment. This process might involve discussing specific moments from the experience, identifying themes or insights, and thinking through ways to incorporate these into their lives. Integration can also address challenging experiences or "bad trips," reframing these moments in a constructive way that promotes growth and healing. With integration, therapists, or others, can support clients in taking insights beyond the experience and help on the path of reconnection with a more centered, compassionate, and loving life.
4. Supports Personal Agency and Empowerment
One of the guiding principles of harm reduction is respecting clients’ autonomy and agency. With a harm reduction lens, we want to support your ability to have a choice in how you choose to grow, change, and gain insight, or fun, in your life. We want to create a partnership with you where we support your humanness, not a hierarchical relationship.
For many clients, this respect and empowerment can be deeply healing, especially if they’ve felt dismissed or patronized in previous therapeutic or medical settings. Knowing that they have the support of a non-judgmental professional can boost clients' self-confidence, encourage self-compassion, and foster a greater sense of personal responsibility.
5. Recognizes Cultural and Historical Contexts
Psychedelics have cultural and spiritual significance in many Indigenous and traditional cultures worldwide. The harm reduction framework acknowledges these historical contexts, fostering respect for the cultural roots of these substances. This approach helps therapists support clients who may come from backgrounds where psychedelics play a role in spiritual or cultural practices, or who may feel a personal connection to these traditions.
For clients who view psychedelics through a spiritual lens, a harm reduction approach creates space for exploring how these experiences connect to their identity, beliefs, or sense of purpose. This respect can deepen the therapeutic relationship and create a more holistic approach to healing.
6. Reduces Risk of Adverse Psychological Outcomes
While psychedelics can offer positive outcomes, they’re not without risk, particularly for people with certain mental or physical health conditions. A harm reduction approach addresses this by preparing clients for what to expect, equipping them with tools to navigate challenging experiences, and offering guidance on minimizing potential harm.
For example, clients with a history of trauma may have powerful responses to psychedelic experiences, and suppressed feelings or memories can arise. Awareness of this possibility can help you establish coping or grounding strategies if this comes up as well as provide a space for upcoming integration. Or from a physical health perspective, an example can be discussing the cardiovascular effects of medicines like MDMA and having informed consent on whether or not you feel that risk is worth it for you.
7. Prepares Therapists for a Changing Landscape
As psychedelics become more widely accepted and potentially legalized, more clients may turn to therapy with questions about their use. Adopting a harm reduction approach now equips therapists to meet this growing need ethically and professionally. Therapists trained in harm reduction can offer relevant support and provide the benefits discussed above.
8. Recognize that Psychedelics Can Also Be Used Recreationally
Given the work we do with clients on their growth and healing journeys, it’s important to also acknowledge the joy, fun, and recreational experiences that clients can have with psychedelics. In both traditional and Western cultures psychedelics have been used recreationally. Although they’re still powerful substances in those contexts also, the experience can be quite different, as well as the benefits. Reconnection with childlike wonder, playfulness, and fun can be incredibly enjoyable and healing.
Practical Ways Therapists Can Implement Psychedelic Harm Reduction
For therapists interested in using this approach, here are a few practical ways to start:
• Education and Training: Many resources, such as workshops and certifications, focus on psychedelic harm reduction and integration. Building this knowledge helps therapists feel prepared and confident when these topics arise. At Elument we offer consultation services to other therapists interested in learning more about psychedelics.
• Open Communication: Start by creating an open environment where clients know they can discuss psychedelics without fear of judgment.
• Integration Therapy: Offer dedicated sessions for integration work if clients have had or plan to have a psychedelic experience. For starting out this can be especially helpful if you partner with an experienced therapist who has worked with clients from a harm reduction lens.
• Safety Planning: Encourage clients to consider dose awareness, mindset going into the experience, and the setting in which you’re going to journey.
As more people explore psychedelics for personal and therapeutic reasons, the demand for safe, informed, and compassionate support will only increase. Adopting a harm reduction approach allows us to recognize the intelligence, autonomy, and self-power that clients have in their life journeys. By prioritizing education, reducing stigma, and providing tools for safe integration, harm reduction frameworks not only help minimize risks but can also enhance the therapeutic process, making space for insights that can lead to profound personal growth.