Cultivating Safety in Psychedelic Therapy

We encourage you to read and follow for more detailed information regarding MAPS Code of Ethics for Psychedelic Psychotherapy and our practices to create a culture of safety in psychedelic therapy.

You may safely and confidentially direct misconduct reports related to MAPS-sponsored studies, MAPS staff, MAPS PBC staff, or collaborators to MAPS’ Compliance Team via email or by calling (844) 627-7722.

All stakeholders at the Multidisciplinary Association for Psychedelic Studies, MAPS Public Benefit Corporation, and MAPS Europe (collectively, MAPS) are committed to providing quality and comprehensive training and supervision to support therapy providers in delivering safe, ethical care within MAPS-sponsored study protocols. 

We recognize that individuals have been harmed by misconduct in therapy, including psychedelic-assisted therapy, and we embrace our obligation to protect participant safety in MAPS-sponsored studies and the safety of others who are associated with our programs.

In service of these commitments, we are continually examining, carefully developing, implementing, and adapting policies and practices to prevent, reasonably detect, and thoroughly respond to allegations of misconduct and safety concerns.

We hope that our work encourages others involved in psychedelic-assisted therapies to adopt similar commitments and participate actively in creating a culture of safety for psychedelic therapy. We invite you to review the carefully-considered practices outlined here and adapt them for your communities.

Elements of MAPS’ Culture of Safety

MAPS Code of Ethics for Psychedelic Psychotherapy

MAPS’ MDMA Therapy Training Program staff, with contributions from psychedelic therapy practitioners and guidance from professional organizations, began creating the Code of Ethics in 2018 and published the original version in 2019. It was revised in 2021

The Code of Ethics provides the foundation for MAPS’ culture of safety, guiding and informing the practice of therapy within MAPS protocols. It is a living document that will continue to grow through the evolution of the field and the ongoing integration of feedback from participants, practitioners, and experts. 

For the purpose of protecting the safety and welfare of participants, the MAPS Code of Ethics for Psychedelic Psychotherapy outlines ethical principles governing treatment decisions made by providers delivering psychedelic psychotherapy within a MAPS protocol. Therapy providers hold individual and collective responsibility to adhere to the highest standards of integrity and ethical conduct in the following areas, described more fully in the Code itself:

  • Safety: We commit to the safety of study participants, patients, and clients. 
  • Confidentiality and Privacy: We respect the privacy of participants and uphold
  • professional standards of confidentiality.
  • Transparency: We respect each participant’s right to make informed choices.
  • Therapeutic Alliance and Trust: We act in accordance with the trust placed in us by participants.
  • Touch: When using touch in our practice, we always obtain consent and offer touch only for therapeutic purposes.
  • Sexual Boundaries: We do not engage in sexual touch with participants.
  • Diversity: We respect the value of diversity, as it is expressed in the various backgrounds, identities, and experiences of participants and colleagues.
  • Special Considerations for Non-Ordinary States of Consciousness: We attend to special considerations when working therapeutically with participants in non-ordinary states of consciousness.
  • Finances: We maintain clear communication with participants about fees and aspire to increase financial access to services.
  • Competence: We practice within our scope of competence, training, and experience specific to the populations we are working with and the modalities we offer.
  • Relationship to Colleagues and the Profession: We establish and maintain compassionate and positive working relationships with colleagues, in a spirit of mutual respect and collaboration.
  • Relationship to Self: We commit to ongoing personal and professional self-reflection regarding ethics and integrity.

Robust Systems for Reporting & Accountability

MAPS’ Compliance Team is comprised of multiple MAPS staff and a member of the Board of Directors who are responsible for recording, reviewing, and determining the veracity of all received reports of misconduct by individuals employed by MAPS, practitioners conducting therapy in MAPS-sponsored clinical trials, or others associated with MAPS. The Compliance Team recommends appropriate discipline to MAPS leadership and the Board of Directors, which may include additional training or supervision, termination of employment or collaborative activities, and, as applicable, filing formal reports with any governing bodies the accused is associated with.

On January 25, 2022, the Board of Directors of MAPS recommended, and the Board of Directors of its wholly-owned subsidiary MAPS PBC adopted, a charter to form an Independent Ethics Review Board (IERB). The IERB will include independent experts in ethics and psychotherapy and, in accordance with best practices, an advocate for survivors with lived experience of abuse or misconduct in a psychotherapeutic context. Potential members are currently being evaluated for recommendation to the Boards.

Extensive and Ongoing Therapist Training

Particular attention has been given to provide training on ethical considerations, particularly the use of nurturing touch and emotional or sexual bouandaries. The training module on Integrity thoroughly reviews the elements of the Code of Ethics and provides opportunities for trainees to engage in mock conversations, with each other and trainers, to practice conversations they will have regarding ethical considerations and participant safety. 

In the MDMA Therapy Training Program, practitioners learn to discuss the possibility that nurturing touch may be requested or offered during MDMA-assisted therapy sessions. During preparatory sessions, they are required to discuss and establish boundaries with specificity: Does the practitioner have consent to offer a hand to hold? May they offer to place a hand on the participant’s shoulder?

During the MDMA-assisted therapy session, practitioners are trained to receive additional and ongoing consent for nurturing touch that has already been discussed, checking in and receiving verbal confirmation that the participant would like to have a hand to hold, for example.

Participant Education

Prior to initiating treatment in a MAPS-sponsored trial, participants and practitioners discuss the risks of the treatment, both medical and psychological. This conversation includes all elements of the Informed Consent Form (ICF), a required part of any human clinical trial which is reviewed and approved by an Institutional Review Board overseeing clinical trial ethics. In anticipation of future FDA approval of psychedelic-assisted therapies which may be provided without a required ICF, the Patient Bill of Rights for Psychedelic Therapy was published early this year as a patient-centered enumeration of the patient rights established in the Code of Ethics. 

Each of these documents provides a foundation for an extensive conversation between patients and practitioners during which participants learn about non-ordinary states of consciousness and some of the unique considerations they present, including the possibility of stronger and more complex transference and countertransference.

Clinical Research of Safety and Risks

Since 2004, our ongoing clinical trials and analysis of non-clinical research of MDMA’s effects have provided evidence regarding the safety and risks of MDMA for evaluation by the FDA. From those findings, we are developing psychological and cardiovascular risk mitigation recommendations. Detailed information regarding safety and risks of MDMA is updated annually and available in the Investigators Brochure and Development Safety Update Report.

Continual Improvement

We recognize that policies and practices, no matter how thorough, will not entirely prevent abuses of power. In the interest of continual improvement, we engage in internal practices and stakeholder input solicitation, identifying and addressing opportunities for improvement in our policies, practices, and protocols. 

Certification & Professional Associations

MAPS Public Benefit Corporation’s Therapy Training Program will offer certification in MDMA-Assisted Therapy for PTSD if the treatment is approved, but our program is one of many certifications that practitioners may opt to maintain. We encourage all people seeking medical or mental health treatment, psychedelic or otherwise, to understand and verify a practitioner’s credentials prior to undergoing treatment. 

In addition to certification in particular types of training, independent certification boards and professional associations serve to address a broad range of concerns specific to the expertise needed to competently deliver services. Independent certification boards and professional associations are found in many skilled service industries including financial, construction, legal, human resources, and more. These boards will generally develop and publish service-specific ethical guidelines, standardized training requirements, and continuing education opportunities. 

MAPS is proud to endorse the ongoing development of an independent certification board and a professional association: 

  • The Board of Psychedelic Medicine and Therapies is a non-profit public benefit corporation creating board certification for psychedelic medicine practitioners and educating practitioners, the health care system, and potential consumers about the inherent value of the certification process.
  • The American Psychedelic Practitioners Association was launched in November 2021 with a mission “to support our community of practitioners, scientists, and lineage keepers of the psychedelic field towards the integration of psychedelic care for advancement of health care and humanity.”