Project
Updates

Australian campaign exposes a mismatch between professional title and psychedelic-specific competence

The Australian Multidisciplinary Association for Psychedelic Practitioners (AMAPP) has opened a consultation challenging how psychologists are treated under Australia’s current rules for psychedelic-assisted psychotherapy. Following the Therapeutic Goods Administration’s 2026 review of the Authorised Prescriber scheme, every therapy team must include at least one practitioner from a specified group: a clinical psychologist with area-of-practice endorsement, a generally registered medical practitioner, a nurse with mental health experience, or an occupational therapist. Within psychology, general registration alone is not sufficient.

AMAPP argues that this creates an unusual asymmetry. Clinical endorsement requires substantial postgraduate and supervised professional training, but is not itself a qualification in psychedelic-assisted therapy. Meanwhile, the TGA separately requires the relevant practitioner to have psychedelic-assisted psychotherapy within their scope of practice and to demonstrate appropriate skills, training and competence. AMAPP is therefore asking regulators to reconsider whether eligibility should depend on psychology endorsement status or more directly on demonstrated competence.

The issue is particularly relevant because the TGA’s own consultation had considered a broader model. Its final recommendations expanded the therapy team beyond psychology and placed substantial responsibility on the Authorised Prescriber psychiatrist to determine the suitability, qualifications and competence of team members, subject to Human Research Ethics Committee oversight. AMAPP is collecting practitioner, consumer, researcher and professional-body submissions until mid-October 2026 for a further submission to the TGA and the Psychology Board of Australia.

ROLES perspective: This dispute makes all five ROLES dimensions visible at once. A professional label and occupational credential determine access to a regulated role, but neither necessarily describes psychedelic-specific learning, expected clinical behaviour, or actual competence. The Australian case therefore raises a central question for workforce regulation: should authority in psychedelic care attach primarily to professional title, demonstrated task-specific competence, or some explicit combination of both?

Further reading

FDA hearing puts provider training, credentialing, and accountability at the centre of psychedelic implementation

A recent commentary by Sarah Norman, published following the U.S. Food and Drug Administration’s September public hearing on the potential future therapeutic use of psychedelic drugs, highlights a shift from questions of efficacy alone toward the infrastructure required for safe clinical implementation. The FDA hearing itself explicitly invited public input on provider training and credentialing, patient safety, access, and data standardisation for psychedelic drugs used in supervised and supportive settings.

Norman describes competency-based training, informed consent and monitoring during altered states, multidisciplinary care, and credentialing built on existing professional licences as prominent themes emerging from the discussion. Her article is commentary rather than formal FDA guidance, but it captures an increasingly important implementation question: psychedelic treatment may require new competencies without necessarily creating a single new profession called a “psychedelic therapist” or “facilitator.”

One workforce finding cited in this discussion comes from a 2024 NORC/BrainFutures survey of U.S. academic programme leaders: 30% reported offering some psychedelic-therapy education, but only 5% reported such content in required graduate-level coursework. Read the ROLES summary of the survey below ↓

This is directly relevant to the ROLES Study. If psychedelic-specific competence is layered onto existing regulated professions, practitioner titles alone become an inadequate description of responsibility. Research and regulation will need to distinguish underlying professional authority, additional psychedelic-specific training, expected clinical behaviour, and scope of accountability — particularly when multidisciplinary teams divide prescribing, monitoring, psychological support, and psychotherapy across different practitioners.

ROLES perspective: The regulatory question is not simply who is trained to be present during psychedelic treatment, but which competencies are required for which tasks, under what professional authority, and who remains accountable when those tasks are distributed across a team.

Further reading

Academic training is not keeping pace with the emerging psychedelic workforce

A U.S. survey conducted by NORC at the University of Chicago in partnership with BrainFutures provides an unusually concrete picture of how psychedelic-assisted therapy is entering mainstream professional education. Among more than 400 responding academic leaders across disciplines including psychology, nursing, counseling, and social work, 30% reported that their programmes offered some form of psychedelic-therapy education, while only 5% reported psychedelic-therapy content in required graduate-level coursework.

The wider findings suggest that this is not simply a question of curricular interest. Only 3% of programmes had a psychedelic-therapy-specific track, while 92% of respondents reported insufficient faculty to teach advanced coursework. At the same time, 71% said their programmes could potentially fund faculty training. The survey therefore points to a gap between growing institutional interest and the educational infrastructure required to prepare future practitioners.

For the ROLES Study, the findings sharpen an important distinction: education, training, competence, and professional authorisation are not interchangeable. Exposure to psychedelic content within a graduate programme does not establish competence to provide psychological support or psychotherapy, just as completion of a stand-alone psychedelic training programme does not by itself define a practitioner’s underlying professional scope. This is particularly relevant as a rapidly expanding postgraduate and private training sector develops alongside relatively limited integration into established professional curricula.

The figures should be interpreted cautiously. The study was a survey of academic programme leaders rather than a census of U.S. graduate programmes, and NORC notes the potential for self-selection. Its value is therefore less as a precise national prevalence estimate than as evidence of a structural workforce question: where, how, and within which professional pathway should psychedelic-specific competencies be acquired?

ROLES perspective: “Psychedelic training” cannot be treated as a single credential. Understanding practitioner roles requires separating prior professional education, psychedelic-specific learning, supervised clinical experience, demonstrated competence, and the authority to perform particular clinical tasks.

Further reading

Oregon puts facilitator scope, dual professional roles and training under regulatory review

Oregon Psilocybin Services held the second of two public hearings on 16 September as part of its 2026 rulemaking process. The proposed rules are unusually relevant to professional-role research because they explicitly define facilitator, facilitation, nondirective facilitation, and scope of practice, rather than treating “psychedelic practitioner” as a self-explanatory occupational category.

The proposal draws a particularly informative boundary between the psychedelic facilitator role and established healthcare professions. Scope of practice is defined partly through avoidance of unlicensed medicine or psychotherapy. At the same time, facilitators who also hold specified professional licences — including psychology, medicine, nursing, and social work — may provide healthcare or behavioural healthcare during preparation and integration if their professional status has been notified and disclosed. The rules therefore make role switching and dual professional identity explicit regulatory problems.

Training is similarly operationalised. The proposed framework specifies curriculum hours across core facilitation skills, preparation, administration, integration, and group facilitation, and requires a 40-hour practicum. Practicum students may observe licensed facilitators but may not themselves provide psilocybin services to clients. Annual licence renewal also requires continuing facilitator education.

ROLES perspective: Oregon offers a rare example in which role label, professional background, training exposure, permitted behaviour, and legal scope are separated in regulation. A single person may occupy more than one professional role, but the authority attached to those roles changes across preparation, administration, and integration.

Further reading

Psychedelic-assisted psychotherapy as a complex intervention: what music reveals about treatment elements

A new narrative review by Bacchi and colleagues in npj Mental Health Research examines the role of music in psychedelic-assisted psychotherapy (PAP). Rather than treating music as background stimulation, the authors conceptualise PAP as a complex intervention in which music interacts with the psychedelic drug, therapeutic environment, practitioner, and participant to shape the treatment experience.

Although the review focuses specifically on music, its conceptual argument is highly relevant to the ROLES Study. If outcomes emerge from interacting treatment components rather than from the drug alone, the practitioner and their behaviour also become potential active elements of the intervention. This makes it important to describe not only who practitioners are, but what they actually do during preparation, dosing, and integration, and how those behaviours are trained, adapted, and standardised.

The authors argue that standardisation should focus on function rather than rigid form: for music, this means specifying what it is intended to accomplish while allowing its precise form to vary across participants and contexts. The same distinction may be useful when studying practitioner roles. Protocols may use different labels or specific behaviours while serving similar therapeutic functions — or use the same role label for substantially different functions.

ROLES perspective: Viewing psychedelic-assisted treatment as a complex intervention shifts attention from whether psychological support is present to which treatment elements are active, what functions they serve, and how practitioner behaviour contributes to them.

Further reading

Training in psychedelic-assisted treatment shows substantial heterogeneity

The International Society for Substance-Assisted Psychotherapy (ISSP) currently provides a structured comparison of 10 international training programmes in psychedelic- and substance-assisted psychotherapy. The overview highlights substantial variation in how practitioners are prepared for these emerging clinical roles. Reported programme duration ranges from 66 hours over 27 weeks to 1,400 hours over three years, while entry requirements range from advanced clinical qualifications and professional licensure to programmes in which no formal academic degree is required. Programmes also differ in the amount of didactic teaching, experiential work, practicum, supervision, and direct experience with substance-assisted therapy.

These differences are relevant to the ROLES Study because terms such as trained facilitator or psychedelic therapist do not, by themselves, indicate what professional background a practitioner has, how extensive their training has been, or what competencies have been demonstrated. The ISSP comparison therefore illustrates an important distinction between professional background, training exposure, supervised practice, and demonstrated competence — dimensions that are often collapsed under a single practitioner title.

The ISSP overview should, however, be interpreted as an illustrative landscape rather than a representative survey of the training field. ISSP states that programmes are preselected and included only when classified as reputable by its board. Although the organisation reports using an extensive set of criteria to assess programmes, the criteria and decision process underlying this initial preselection are not publicly specified. The comparison also relies substantially on information available through providers’ official channels, with unavailable information explicitly marked as such.

Taken together, the overview provides a useful snapshot of the rapidly developing training landscape, while also highlighting a broader methodological issue: “psychedelic training” is not a standardised exposure. Similar practitioner labels may therefore conceal substantial differences in prior professional education, training intensity, supervised clinical experience, and expected scope of practice.

ROLES perspective: Training is not a binary characteristic. What matters is who enters training, what is taught, how competence is assessed, and what practitioners are subsequently expected and authorised to do.

Further reading

COMPASS invests in post-approval provider training for COMP360

COMPASS Pathways has awarded grants to five U.S. organisations to develop independent healthcare provider training programmes for the potential post-approval delivery of COMP360 psilocybin treatment: CME Outfitters, Emory University, Fluence, the Integrative Psychiatry Institute, and Strata Mental Health Solutions.

The programmes are intended to prepare healthcare professionals across the treatment pathway — from preparation and treatment administration through follow-up — and should be scalable, accessible, and aligned with regulatory requirements. COMPASS has also developed separate guidance documents for real-world delivery and consistent provider training, available to healthcare professionals upon request.

The development is particularly relevant to the ROLES Study. COMPASS has emphasised that the monitoring and support used in its clinical trials is non-directive and distinct from psychotherapy. At the same time, the emerging post-approval model requires a specifically trained workforce with defined skills and capabilities. This raises an important question: where does monitoring and psychological support end, and where does a professional therapeutic role begin?

The first concrete curricula are already emerging. Fluence, for example, has announced a 6–9 week certificate programme covering Foundations of Psychedelic Care, Understanding Psilocybin, and COMP360 Certification. The programme is designed for both licensed and non-licensed mental health clinicians and support staff, making questions about professional roles, competencies, and accountability particularly salient.

Further reading

Passie et al. propose a comprehensive training model for psychedelic-assisted psychotherapy

An international group of clinicians, researchers, and trainers led by Torsten Passie has proposed a comprehensive model curriculum for substance-assisted psychotherapy (SAP), encompassing psychedelic-, psycholytic-, and entactogen/MDMA-assisted psychotherapy. The paper is presented as a consensus-based training framework rather than an empirically validated curriculum, and is intended primarily for practitioners who already have professional psychotherapy training.

The proposed pathway is notably extensive. Rather than relying mainly on didactic teaching, it combines theoretical education with observation of experienced therapists, supervised clinical work with patients, supervision and peer supervision, and — although not mandatory — controlled self-experience with altered states. For comprehensive advanced training, the authors envisage a process that may take two to three years, with practical training occurring under actual clinical conditions and preferably within multidisciplinary teams.

Of particular relevance to the ROLES Study is how explicitly the curriculum links training to professional background. The model is designed for licensed psychotherapists and related regulated professionals who already possess accredited psychotherapy training. The authors state that it is not intended as a curriculum for “sitters,” “monitors,” “facilitators,” or “guides” who do not provide psychotherapy. In other words, psychedelic-specific training is treated here as an additional layer of professional competence, rather than as a substitute for an existing clinical profession.

This distinction raises an important ROLES question. As psychedelic care develops, will different practitioners require fundamentally different training pathways depending on what they are expected and permitted to do? Passie and colleagues’ model suggests that advanced psychedelic psychotherapy requires substantial pre-existing professional competencies, supervised practice, and clearly defined responsibility. At the same time, many contemporary psychedelic treatment models use providers with other occupational backgrounds and less explicitly psychotherapeutic roles. The comparison makes the relationship between Occupational Background, Learning & Training, Expected Clinical Behavior, and Scope & Responsibility particularly visible.

The curriculum also illustrates how closely these domains interact. Its theoretical content extends well beyond pharmacology and safety to psychotherapeutic competencies, therapeutic relationships and boundaries, screening, challenging situations, integration, ethics, intercultural issues, and the therapist’s own role and behavior. The authors additionally note that jurisdictions introducing new practitioner licences may require separate attention to scope-of-practice questions.

Further reading