Gretchen Kell, UC Berkeley
There’s a resurgence in psychedelics, banned since 1970 by the federal Controlled Substances Act. That law, signed by then-President Richard Nixon, halted what had been promising research into the drugs’ therapeutic and medicinal potential. Today, psychedelics have been shown in recent, approved clinical trials to alleviate mental distress, even addiction. As a result, efforts to legalize their use also are on the rise.
This fall, 24 people in a first-of-its-kind training program at the year-old UC Berkeley Center for the Science of Psychedelics are learning to safely guide patients’ psychedelic experiences in therapeutic and research settings. The group of advanced professionals chosen for the nine-month, 175-hour program includes doctors, nurses, social workers, psychologists, chaplains and others.
Tina Trujillo, an associate professor in the Graduate School of Education (Berkeley Education), helped launch and serves as faculty director of the Certificate Program in Psychedelic Facilitation. She said cohort members “want to be ready to do this work safely and ethically in legal spaces” in states where voters or legislatures are working to enact measures — like Oregon’s Measure 109, approved in 2020 — to allow the supervised administration of psilocybin, the “magic” in magic mushrooms, at licensed centers, or where opportunities exist in research studies and ketamine-assisted therapy clinics.
Berkeley News recently talked with Trujillo about the new certificate program, how she became interested in psychedelic care, and about her own research into the emerging field of psychedelics education.
Q: With common psychedelics illegal federally, how is the UC Berkeley Center for the Science of Psychedelics able to do research — and with human subjects — into the efficacy of psychedelic medicines and psychedelic-assisted therapy?
A: Research that includes human participants needs federal approval, and we have that, from the FDA. Program and non-program participants can volunteer to participate, as healthy subjects, if they are deemed to be medically eligible. and they may be accepted into the study. The study uses fMRI (functional magnetic resonance imaging) scans and psychophysics to investigate how a low dose of psilocybin affects perception and representation, among other things.
While research on certain psychedelics once was legal, after the federal government classified most of them as “Schedule 1” drugs around 1970, they then became illegal, and funding for research into their therapeutic potential dried up. Over the past several decades, however, enough researchers and practitioners have organized to re-approach the government to request federal approval for the scientific study of the efficacy of certain psychedelics in relieving depression, PTSD and other mental health disorders. Their requests build on a sizable body of research evidence. There’s also an emerging body of literature that speaks to some of these substances’ pro-social and other desirable effects.
The psilocybin research at the UC Berkeley Center for the Science of Psychedelics has to fully comply with federal regulatory processes for studies with scheduled substances. It is a very careful process; we’re not just bringing in people and giving them drugs to see what happens. There are very strict protocols.
Q: Why did the center choose to train psychedelic facilitators, or guides, as part of its work?
A: What we see from the empirical work on psychedelics is that it’s not the substance alone that has the effect. Mainstream media articles often mistakenly focus on just the molecule itself: “Look what psilocybin does for you!” But it may likely be the substance that has the effect with a sophisticated course of support. There is a lot of evidence about talk therapy that concludes that what matters is the therapist’s relationship with the client. That’s not that different here. But what is different here is the psychedelic catalyst that may fast-forward the process and can help achieve what might take someone several years to do in talk therapy, or that can help achieve what all other therapies have not. But it must be combined with safe conditions and the right facilitators.
It’s important to disseminate this knowledge to the public, to say that this substance can be really powerful, but it’s irresponsible to just leave it at that. One of the common sayings about this work is that the real work begins after the journey.
Preparation for the journey also is a critical stage. A trusting relationship between the facilitator and the participant needs to be thoughtfully cultivated, and that includes, among other things, the facilitator gathering information about the participant’s history, so the facilitator may be better prepared for some of the material that might surface during the psychedelic experience. Clients must understand, to the extent possible, what they’ll go through, what might happen during the session, what might be comfortable or uncomfortable.
And then there’s the session itself. In the clinical setting, that usually requires two facilitators for at least eight hours.
Q: The certificate program prioritizes the inclusion of members of historically underrepresented groups, as well as culturally-sensitive training. How diverse is the first cohort, and why is this diversity important in psychedelic healing?
A: It is a diverse group, both in its demographics and in the clientele our learners could serve. We have MDs, therapists, social workers, chaplains, a pastor, nurses. Thirty-nine percent of the cohort is BIPOC (Black, Indigenous, and other people of color). We knew we couldn’t diversify to the extent we wanted without financial resources to offset the full enrollment fee ($10,000), so we sought funders’ support. One funder generously committed to providing diversity and need-based scholarship support, and everyone who applied was able to receive aid.
We also consistently address diversity and inclusion in the curriculum. It’s one of our core instructional areas. Part of this work includes accessing the voices that have been traditionally excluded from most mainstream conversations about psychedelics, as that’s been primarily an elite conversation among white and/or more economically privileged populations.
We want to develop potential facilitators who will look like the clientele we need to reach and who will bring cultural humility and sensitivity to their work with members of underserved communities . If you’re a BIPOC, you may have experienced a lot of intergenerational trauma and marginalized identity formation, and when this comes up in therapy, we need facilitators who won’t say, “I don’t see race. I’m like you.” We need people who are aware of how complex that trauma is for the BIPOC community. If you have a group of facilitators from primarily privileged backgrounds and underprivileged clients sharing experiences that may include legacies of the war on drugs or governmental attempts to racialize and demonize certain substances over time, what will happen when that material surfaces? We need to be sensitive to that.
Q: Describe the training program. Is it unique, and are there many others in the country?
A: We meet six times throughout the year, from September to May. There are six in-person meetings: Four are three-day, one is four-day, and one is a five-day. The first five meetings are on campus, and all are in person, unless you have COVID or have been exposed or have symptoms. We also meet in small groups virtually, and there is homework. The curriculum is interdisciplinary — clinical science; psychotherapeutic methods; spiritual care; contemplative science, like mindfulness; ethics; diversity, equity and inclusion; and ancestral entheogenic traditions.
We teach our learners about the ancestral histories of mushrooms that existed long before science did, hundreds or thousands of years before the Age of Enlightenment, and the ceremonial use of psychedelic plants. We teach professional ethics, what it means to provide this kind of care with an impeccable level of ethical integrity and safety, and about some of the ideal characteristics of a psychedelic facilitator. We learn about neuroscience and what it offers this work.
We have a team of six regular instructional team members. Each time the learners get together, they’re taught by the same core instructors. In most training programs, there’s a very small staff and lots of one-time guest speakers. I didn’t want that. At the heart of this educational work, you need relationships, ongoing relationships with your instructors. So, we didn’t go with the common model, and we use guest experts more sparingly.
I’m not aware of any other training program that looks like ours. I would argue that we’re very unique. We’re at the top tier public university in the world, which means one of our responsibilities is to closely connect the research to the practice, to evaluate, to systematically study what we’re doing. So, we do that here. I’m studying our program from multiple angles.
There are a small number of research universities that are beginning to develop their programs for psychedelic facilitation, but most are in the design phases. No other research university is doing something quite like this yet, though we do have programs from non-research universities like Naropa (in Colorado) and CIIS (California Institute of Integral Studies) and elsewhere. We also have received approval to be a licensed provider of psilocybin facilitation training for the state of Oregon. It’s our intention to disseminate what we learn from our research and evaluation of this program to others in the field.
Q: Which psychedelic substances does the training program focus on, and why?
A: We’re not looking at every psychedelic. We do learn about other substances, but we’re emphasizing psilocybin. The trajectory of research on psilocybin has shot up in recent years, and the area is ripe for potential authorization to use it for federally-approved treatment. And there was support for focusing on psilocybin when we solicited early feedback from field experts about the curriculum.
If you look at most psychedelic training programs, many are rather generalist in nature, with only some exposure to each medicine or drug. What we learned in talking with different leaders in the field is that going deep in a particular area could contribute a more specialized type of learning that doesn’t exist very much in the field.
Our program offers a certificate in psychedelic facilitation that emphasizes psilocybin. The 24 students who successfully complete the program will have knowledge of different aspects of psilocybin and the legal opportunities they have to work with it. There are opportunities for research studies, and Oregon already has legalized psilocybin use in clinical settings, with trained facilitators. It is just starting to roll out training and licensing for training. No one is a licensed facilitator there yet. It is all very new.
Q: Earlier, you mentioned there were ideal characteristics for a psychedelic guide. What are they? And do the trainees take psychedelics themselves, to understand their benefits?
A: A strong facilitator fosters a safe, trusting setting for the client and is impeccable in her/his/their respect of ethical boundaries. Those conditions cannot be overemphasized. They also don’t “guide” or steer a client to go a particular direction in their session; they support them to focus on whichever directions or material may come up for them. They’re deeply attuned to the physical, emotional, spiritual, psychological and potentially mystical dimensions of the psychedelic experience. They are non-judgmental. They stay fully present at all times for their client, regardless of how challenging the experience may be.
While it’s less commonly discussed, I believe that to be a strong facilitator you need to be cognizant of the social context in which the facilitation is taking place. How might the broader societal settings or histories influence the session itself? How might the client’s social position be related to the material that arises? Relatedly, how might the socio-cultural identities of the facilitator and client interact during the work?
In general, good facilitators have done their own deep work, taken the time to understand what their own vulnerabilities are, their own personal areas of healing and growth. Whether they should have taken psychedelics themselves is contested, and there is no one answer. But I have an opinion, and my opinion is yes. The way I think about it is that I wouldn’t want my facilitator in a research study on psychedelics to not have experiential knowledge of what I’m going through.
I’m not just saying they should have done psychedelics, but have done so in a safe, systematic way, have done the hard work, deep personal work. But there is big debate about this.
If clients all of a sudden encounter material during a psychedelic experience that includes, perhaps, spirits, or something mystical that isn’t observed in this dimension or realm, and they’re experiencing something we can’t experience in our normal state of consciousness, how can facilitators know how to address that without some degree of experiential learning, some empathy?
How do you gain this experience? Some of our learners can participate in the research study at the center. We’re also planning a voluntary “pilgrimage” to Oaxaca, to one of the communities that has preserved ceremonial healing work with mushrooms for hundreds, even thousands of years. There, successful graduates of the program will be able to learn about the historical and modern-day uses of mushrooms, as well as the community-based rituals, practices and values around those and other forms of healing. We also have a practicum as a part of our curriculum.
Q: When the trainees get their certificates, what kind of work will they be able to do, and will it depend upon laws changing in their cities and states? Will they need a certificate, like the one the Berkeley center provides, to do this work?
A: Clinical studies on psychedelics are burgeoning, and skilled facilitators are needed. One of our responsibilities is to help our graduates find ways to engage with this work. Many of our applicants also expressed a more general desire to go through the program so that they could expand their professional networks with like-minded colleagues who are interested in one day doing this work in legal spaces, even if those possibilities don’t all exist yet.
In January, Oregon will be the first state licensed to provide psilocybin in therapeutic settings. In other jurisdictions, there are movements to decriminalize psilocybin — change is coming. In our case, graduates who meet additional requirements will be qualified to apply for a Psilocybin Facilitator License in Oregon in 2023. Those working in other states will leave us with specialized knowledge about the field of psychedelic facilitation. Health care providers may be able to support psychedelic care or research, where regulations permit, in their licensed roles. Religious professionals may be able to offer psychedelic preparation and integration support to members of their faith communities who undergo psychedelic care, where regulations permit, in a health care or research setting.
It’s important to note that learners who complete the program will not be licensed, certified or otherwise sanctioned to provide psychedelic care in settings where regulations do not permit this work.
There is a lot of curiosity about psychedelics among various professionals, those in the religious and spiritual care profession, social workers, nurses, people in palliative care. There’s a curiosity about ways in the future to serve their patients and clients. Some of our learners want to go through this program to teach others. A doctor or nurse, for example, might want to bring this knowledge to medical residents.
Q: How did you become interested in this field? Has this been an area of focus in your work at Berkeley Education?
A: Most of us in the field of psychedelic science probably ended up here because of personal experience, personal motivation, myself included, not just as a purely detached intellectual endeavor. Psychedelics have been part of my own personal development and care. Maybe it’s because of my personal experiences that I don’t view them from a Pollyanna perspective. I don’t see them as a cure-all. I view psychedelics with a healthy dose of skepticism.
But I also see their potential. I’ve had experiences that have led to surprising outcomes I was not seeking and outcomes I was seeking. And at end of day, I know that the outcomes were not just attributable to the substance itself, but all the hard work that I did along with it. What mattered was the context and the facilitation and the commitment to disciplined practice afterward.
For years, I’ve wanted in my research to investigate the relationship between learning and nature. Some of my more recent teaching in education has interrogated how schooling does or does not facilitate a stronger connection between ourselves and the natural world. In the U.S., we usually alienate ourselves from nature when we go to school. But there are other ways to do schooling. In my research with the University of Oslo, I found that one of the central priorities of schooling at all grades is to develop a relationship with the natural community — to learn how to navigate and be with nature, to go hiking, walking in snow, to build a snow cave. That cultural norm is correlated with extraordinarily high levels of happiness of wellness.
We have this way in the U.S. of separating ourselves from the natural world when we go off to learn and develop. Studying psychedelics interested me because sometimes they’re able to facilitate greater feelings of connectedness with nature, which can enhance well-being not just for individuals, but for the collective. And that, to me, relates to what I’ve been teaching and curious about for several years.
Q: In addition to training the psychedelic guides, you’re doing research. What are your research interests?
A: Another area I’ve taught about for many years is epistemology, or ways of knowing. In academia, and even just in the mainstream public, we are trained to trust empirical ways of knowing — classic Western scientific ways of interpreting our world. What can we see and observe and measure and prove?
But civilizations and communities have relied on other ways of knowing for thousands of years, and those epistemologies don’t fit neatly into scientific processes. Should those other paradigms or world views just be relegated to the fringe when studying about education or health care or psychedelics? Is there something we may be overlooking in conventional scientific spaces that could expand our understanding of the phenomena we wish to study?
Traditional ecological knowledge, certain mystical ways of knowing, other ways of knowing — these may all offer valid evidence on certain questions, which could lead to more holistic investigations of certain phenomena. But there are many cultural barriers to doing this in elite academic spaces. So which cultural norms prevail when we try to bridge these ways of knowing? Which epistemologies, and the traditions or communities associated with them, are valued least and most? I’m conducting a long-term ethnographic study of the Certificate Program (in Psychedelic Facilitation) that explores these and other cultural questions.
I am also conducting an internal evaluation of the certificate program. That means that I am systematically studying what works well, what potential pitfalls exist in this area of professional preparation, and more generally, how the program is progressing. That learning is fed back into the program design in real time, like an R & D model, as well as, eventually, to the broader field of research on psychedelic facilitation training.
Q: What is your greatest hope, in training people to advance the use of psychedelics, and for the potential for the psychiatric use of psychedelics to grow?
A: I have so many hopes! I hope that the field of psychedelic facilitation can develop to truly conceive of this learning as professional preparation, not simple technical training. This is sophisticated work that requires an immense amount of professional judgment. Schools of education have deep knowledge of how to prepare practitioners in ways that foster deep learning. I hope to see more engagement with universities’ schools of education.
I hope that as the psychiatric field continues to investigate psychedelics’ potential effects, that researchers look beyond questions of just individual healing and individual wellness. Many of these substances have long histories of use for the purposes of collective healing, of healing our relationships with one another, with our natural environment. Right now, the world could use a heavy dose of healing aimed at the latter. That means we need more scientists who are brave enough to pose different kinds of questions, who will listen to those Indigenous communities who have deep, sophisticated understandings about how and why their medicines should be used, and who will ultimately avail themselves of the full range of knowledge out there about psychedelics.
I also hope that this field doesn’t repeat the mistakes of other fields that have been vulnerable to capitalist pressures to prioritize profits. Like in education and other public sectors, investors are rapidly seizing opportunities to generate wealth off of what, in my view, should be a public good — psychedelics as a form of health or spiritual care. Resisting those neoliberal trends will be tough, but if we wish to cultivate a field that is affordable and that prioritizes opportunities for members of underserved communities to equitably access these forms of care, we can’t go that route, because we know from other sectors that those approaches only exacerbate inequities in access to high quality services.
How do we create access for the most marginalized members of our society? That will be a question for policy makers, but that will also be a question of values for everyone who practices in this field. Who do we wish to take better care of with this work, in our unequal society? And how can we cultivate systems and practices that are based on collective, equity-minded values? I hope we can keep these questions at the center of the work.