Introduction to psychedelic-assisted therapy (PAT)
Whatever prior knowledge or experience you have with psilocybin or other psychedelics, at Sachi we are focused on their legal and approved use as part of psychedelic-assisted therapy.
What is psychedelic-assisted therapy (PAT)?
Psychedelic-assisted therapy (PAT) is a process combining traditional psychotherapy techniques with one or more doses of psychedelics, under the guidance of a team of guides, therapists, clinicians, and/or other staff. The entire support team is an important part of this process, helping to guide through the process, provide safety, and “hold space” for the participant to go through the process on their own.
PAT is much more than taking a simple dose of a psychedelic to see “what comes up.” The entire journey usually spans several days (or even weeks) of preparation, psychedelic dosing, and post-dose integration.
The stages of PAT
Normally, the trained guide and support team accompany the patient through a three-part journey:
- Preparation for the psychedelic experience (2–3 weeks)
- Guided dosing, where the psychedelic compound is administered during one or more “dosing sessions” (1 day)
- Post psychedelic integration (2–6 weeks)
This process enables the patient to unlock new perspectives, allow mental and psychological change, and facilitate breakthroughs in a supportive and structured therapeutic environment. Depending on the state, city, and local regulations where psychedelic-assisted therapy is delivered, each stage may vary slightly in duration and number of sessions.
“
We’re talking about a very controlled intervention that includes a guided dosing session where patients who are participating are encouraged to look inward to examine what comes up for them.”
The preparation stage
In the preparation phase, the individual meets the guide and prepares for the entire experience. The individual completes important screening to ensure safety and compliance with local regulations. Preparation includes some introductory therapy sessions for the patient to ask questions, set expectations, and learn about the rest of the process. The patient usually sets an “intention” for the entire psychedelic experience (e.g., “I would like to understand my feelings of isolation and loneliness”). Fundamentally, preparation is about establishing safety, rapport, and trust with the guide.
The guided dosing session
In a safe and comfortable setting, the individual receives a pre-set dose of psychedelic with a guide present throughout the session. Depending on the guide, the dosing session could be performed outside or indoors. Wherever the dosing session occurs, the patient should feel comfortable and relaxed. The guide provides a sense of safety and support while holding space for the individual to experience the session in whatever way they choose.
With psilocybin, the dosing session usually lasts between 6–8 hours. For many, music is an important part of the experience. The individual may also wear a blindfold to allow them to focus entirely on their thoughts without distraction. Most of the clinical trials for cancer use a pre-arranged playlist of music. Note: Some participants may prefer silence. The guide/therapist can help the patient determine which setting is best aligned with the patient’s intentions.
“The playlist is divided into segments: background music that plays as the participant arrives for his or her session; music that plays when the drug is starting to take effect, at which point he or she is lying down and wearing eyeshades and headphones; the ascent; the peak; the post-peak; and the “welcome back” music.” 
Reader’s Digest
The integration stage
Following the dosing session, the individual works with the guide to process the experience, transforming insights from the session into key ideas and takeaways for their return to “normal life.” The guide helps make sense of the experience, talking through the thoughts, feelings, and intuitions that emerged during the dosing session. Integration usually includes several therapy sessions, and can go on for weeks (or even months), in order to reinforce and codify the positive mental effects of the dosing session.
Integration also includes a plan for the patient’s return to their normal home life, focusing on things like follow-up therapy, community building, group support, meditation, mindfulness, or journaling. For the psilocybin trials with cancer, integration usually includes some form of hand-off to the patient’s oncology care team.
SACHI’S TAKE
Our experience has been with a single dose of psilocybin supported by several days of preparation and integration therapy.
However, any online search produces a huge number of options for PAT, each with different schedules, timelines, and processes.
At Sachi, our discussion is focused on the protocols used in the clinical trials, and we always advocate PAT under the supervision of a trained and qualified guide, in a safe setting.
The guide and team
A trained guide is involved through the entire process of psychedelic assisted therapy. What makes a trained guide? Psychedelic-assisted therapy is a new offering in the US medical system. As a result, training and qualification methods for therapists and guides can vary widely depending on the location and center where the therapy is delivered. Based on the requirements of your state or jurisdiction, the guide could be a licensed medical doctor, clinical psychiatrist, trained psychotherapist, or a non-clinical practitioner certified in psychedelic therapy.
However the guide is trained and qualified, they are an integral part of the process for Psychedelic Assisted Therapy, and will usually be involved in all 3 stages. They will also have a support team throughout the process. Once again, support staff credentials will vary by state and jurisdiction, but their role is always to provide a nurturing, safe environment for the participant.
Learn more about the differences in regulations for clinical and therapeutic practitioners across the US.
SACHI’S TAKE
Since the industry is still in its early stages, no credentialing or training group has emerged as the governing body. There is no “official” credential or accreditation on par with the American Medical Association for MDs or the American Psychiatric Association for psychotherapists. Regardless of their official credentials, we believe that the most important aspect of a guide is the trust they create with their patient. We know many non-traditional clinicians who have years of experience and many guided psychedelic experiences under their belt.
In particular, we believe the guide must commit to “hold space” for the patient while they are in the dosing session. For a successful journey through PAT, the entire package (mindset, setting, guide, and support staff) come together to help the patient achieve emotional and mental breakthroughs that normally could take years, or might never be achieved.
Continue Learning from Sachi
While most of the clinical studies with psychedelic assisted therapy have focused on individual therapy (sometimes with multiple therapists for each patient), this can be very costly. There is 
encouraging research underway showing the potential power of group work to lower overall cost.
Introduction to psychedelic-assisted therapy
Whatever prior knowledge or experience you have with psilocybin or other psychedelics, at Sachi we are focused on their legal and approved use as part of psychedelic-assisted therapy.
What is psychedelic-assisted therapy (PAT)?
Psychedelic-assisted therapy (PAT) is a process combining traditional psychotherapy techniques with one or more doses of psychedelics, under the guidance of a team of guides, therapists, clinicians, and/or other staff. The entire support team is an important part of this process, helping to guide through the process, provide safety, and “hold space” for the participant to go through the process on their own. PAT is much more than taking a simple dose of a psychedelic to see “what comes up.” The entire journey usually spans several days (or even weeks) of preparation, psychedelic dosing, and post-dose integration.
The stages of PAT
Normally, the trained guide and support team accompany the patient through a three-part journey:
- Preparation for the psychedelic experience (2–3 weeks)
- Guided dosing, where the psychedelic compound is administered during one or more “dosing sessions” (1 day)
- Post psychedelic integration (2–6 weeks)
This process enables the patient to unlock new perspectives, allow mental and psychological change, and facilitate breakthroughs in a supportive and structured therapeutic environment. Depending on the state, city, and local regulations where psychedelic-assisted therapy is delivered, each stage may vary slightly in duration and number of sessions.
“
We’re talking about a very controlled intervention that includes a guided dosing session where patients who are participating are encouraged to look inward to examine what comes up for them.”
The preparation stage
In the preparation phase, the individual meets the guide and prepares for the entire experience. The individual completes important screening to ensure safety and compliance with local regulations. Preparation includes some introductory therapy sessions for the patient to ask questions, set expectations, and learn about the rest of the process. The patient usually sets an “intention” for the entire psychedelic experience (e.g., “I would like to understand my feelings of isolation and loneliness”). Fundamentally, preparation is about establishing safety, rapport, and trust with the guide.
The guided dosing session
In a safe and comfortable setting, the individual receives a pre-set dose of psychedelic with a guide present throughout the session. Depending on the guide, the dosing session could be performed outside or indoors. Wherever the dosing session occurs, the patient should feel comfortable and relaxed. The guide provides a sense of safety and support while holding space for the individual to experience the session in whatever way they choose.
With psilocybin, the dosing session usually lasts between 6–8 hours. For many, music is an important part of the experience. The individual may also wear a blindfold to allow them to focus entirely on their thoughts without distraction. Most of the clinical trials for cancer use a pre-arranged playlist of music. Note: Some participants may prefer silence. The guide/therapist can help the patient determine which setting is best aligned with the patient’s intentions.
“The playlist is divided into segments: background music that plays as the participant arrives for his or her session; music that plays when the drug is starting to take effect, at which point he or she is lying down and wearing eyeshades and headphones; the ascent; the peak; the post-peak; and the “welcome back” music.” Reader’s Digest
The integration stage
Following the dosing session, the individual works with the guide to process the experience, transforming insights from the session into key ideas and takeaways for their return to “normal life.” The guide helps make sense of the experience, talking through the thoughts, feelings, and intuitions that emerged during the dosing session. Integration usually includes several therapy sessions, and can go on for weeks (or even months), in order to reinforce and codify the positive mental effects of the dosing session.
Integration also includes a plan for the patient’s return to their normal home life environment, focusing on things like follow-up therapy, community building, group support, meditation, mindfulness, or journaling. For the psilocybin trials with cancer, integration usually includes some form of hand-off to the patient’s oncology care team.
SACHI’S TAKE
Our experience has been with a single dose of psilocybin supported by several days of preparation and integration therapy.
However, any online search produces a huge number of options for PAT, each with different schedules, timelines, and processes.
At Sachi, our discussion is focused on the protocols used in the clinical trials, and we always advocate PAT under the supervision of a trained and qualified guide, in a safe setting.
The guide and team
A trained guide is involved through the entire process of psychedelic assisted therapy. What makes a trained guide? Psychedelic-assisted therapy is a new offering in the US medical system. As a result, training and qualification methods for therapists and guides can vary widely depending on the location and center where the therapy is delivered. Based on the requirements of your state or jurisdiction, the guide could be a licensed medical doctor, clinical psychiatrist, trained psychotherapist, or a non-clinical practitioner certified in psychedelic therapy.
However the guide is trained and qualified, they are an integral part of the process for Psychedelic Assisted Therapy, and will usually be involved in all 3 stages. They will also have a support team throughout the process. Once again, support staff credentials will vary by state and jurisdiction, but their role is always to provide a nurturing, safe environment for the participant.
Learn more about the differences in regulations for clinical and therapeutic practitioners across the US.
SACHI’S TAKE
Since the industry is still in its early stages, no credentialing or training group has emerged as the governing body. There is no “official” credential or accreditation on par with the American Medical Association for MDs or the American Psychiatric Association for psychotherapists. Regardless of their official credentials, we believe that the most important aspect of a guide is the trust they create with their patient. We know many non-traditional clinicians who have years of experience and many guided psychedelic experiences under their belt.
In particular, we believe the guide must commit to “hold space” for the patient while they are in the dosing session. For a successful journey through PAT, the entire package (mindset, setting, guide, and support staff) come together to help the patient achieve emotional and mental breakthroughs that normally could take years, or might never be achieved.
Continue Learning from Sachi
While most of the clinical studies with psychedelic assisted therapy have focused on individual therapy (sometimes with multiple therapists for each patient), this can be very costly. There is encouraging research underway showing the potential power of group work to lower overall cost.