Why you need screening, preparation, and integration for psilocybin therapy

The importance of psychedelic harm reduction, preparation and integration with psilocybin-assisted therapy.

Psilocybin therapy is legal in Oregon thanks to the passing of ballot measure 109 in November 2020 which permits the use of psilocybin mushrooms in licensed service centers under the supervision of trained psilocybin facilitators.

Because psilocybin has the best safety profile of all the psychedelics, it is the first to be broadly used therapeutically to treat depression, anxiety, and other mental health conditions without a doctor’s prescription.

What’s the difference between recreational and therapeutic use of psilocybin?

People have been using psilocybin mushrooms since the 1500s, and more recently — beginning in the 1950s — it has been used recreationally for consciousness expansion or psychedelic entertainment. Magic mushrooms are used at raves, on a hike with friends, or at Phish concerts. Such experiences, however, are very different from the therapeutic use of psilocybin. A recreational psilocybin experience can be pleasurable, or harrowing, but when used purely for “fun”, the opportunity for introspection, personal development, and problem solving is often lost or minimal at best.

Under the supervision of a psilocybin facilitator, an individual having a therapeutic psilocybin experience will receive a screening, and at least one preparation session and one integration session. This three-part format is efficacious and impactful in addressing mental health because the psychological and emotional benefits of psilocybin therapy are not derived from the effects of the mushrooms per se, but in combination with psychotherapy. Talk therapy in the context of psilocybin facilitation helps you clarify expectations and intentions for change, then make meaning from the content of your “trip” in order to improve psychological and emotional wellbeing.

What is psychedelic screening, and why is it necessary?

Psilocybin therapy is not for everyone. Individuals on certain types of medication, who have certain medical conditions, or a family history of schizophrenia may not be well-suited for psilocybin therapy. During a screening, your facilitator will assess if you are a good candidate for this type of therapy, and if it safe for you.

What is psychedelic preparation, and why is it necessary?

The psychological and physiological effects of psilocybin vary from person to person, so no two people will have the same experience. However, it’s helpful to have a general idea of what to expect so you aren’t overwhelmed when you experience biological, psychological, or emotional changes after ingesting the mushrooms. Preparation helps reduce the risk of panic or heightened anxiety that sometimes accompany recreational psilocybin use or adjusting to a novel, non-ordinary state of consciousness. An essential part of the preparation involves intention setting — where your facilitator helps you examine your purpose for having psilocybin therapy and consider what you hope to achieve through the experience.

What is psychedelic integration, and why is it necessary?

Much of the actual inner work that you need to do to improve your mental health and maintain wellbeing happens after you’ve had the psilocybin. During the facilitation session (when you are in the service center under the influence of psilocybin) random thoughts, images, memories, sounds, or emotions arise from your subconscious. After the facilitation, these sensory impressions coalesce into insights — deep understandings about oneself, one’s circumstances, or reality — that can be used to change perceptions, behaviors, or life orientation. After taking psilocybin, many people feel like they’ve received little pieces of a jigsaw puzzle. Integration with a facilitator provides the opportunity to assemble these pieces into a coherent picture of what needs to be done to improve one’s life. In an integration session, working with your facilitator, you’ll explore the material that came up during your psilocybin experience, then identify, and hopefully commit to, making practical changes to achieve what you’ve hoped for.