Nurturing Inclusivity: Social Justice and Culturally Responsive Care in Psychedelic-Assisted Therapy
In the realm of mental health treatment, the integration of social justice principles and culturally responsive care is indispensable, particularly in the emerging field of psychedelic-assisted therapy (PAT). As this breakthrough treatment modality gains traction in Western medical and mental health systems, it is critical to center social justice principles that foster belonging, identity affirmation, and community within therapeutic spaces, thereby minimizing harm and increasing the relevancy of and access to the modality. Psychedelic-assisted therapy, viewed through a social justice lens, offers a transformative approach to healing that goes beyond individual well-being. By incorporating elements of cultural humility and inclusivity, PAT can empower clients to reclaim repressed aspects of their identities and reconnect with their communities in profound ways. For individuals who may have felt alienated by mainstream therapeutic approaches, psychedelics can provide a unique opportunity for them to explore their inner worlds and confront societal constructs that have contributed to their sense of being “othered.”
Cultivating Belonging and Revolutionary Healing in Therapeutic Spaces
At the heart of effective therapy lies the establishment of a safe and inclusive environment in which individuals feel a sense of belonging and can explore their identities without fear of judgment or marginalization. In psychedelic-assisted therapy, this is especially pertinent, as the profound nature of the experiences can unearth deeply rooted aspects of one’s identity. When facilitators create spaces where individuals from diverse backgrounds feel valued and understood, it enables them to navigate their journeys with a sense of agency and empowerment.
The psychedelic therapeutic process can be conceptualized as a powerful, even revolutionary process, that allows clients to deconstruct cultural repression. However, the therapeutic container must be consciously created with a client’s identity in mind to enable transformative growth. Because psychedelic medicines are natural amplifiers of underlying emotion it is essential that facilitators ask themselves, “what is present– not only in the light– but also the shadow?” With this in mind, facilitators must examine their own shadow– particularly how biases show up in their own lives’– to ensure they are not unconsciously replicating and perpetuating cultural repression. This process of introspection on the part of the facilitator can then be oriented towards a client. A facilitator who has spent the time interrogating their own shadow can better help their client identify processes of cultural repression in their lives’, ultimately allowing them to reclaim their connection with community, nature, ancestors, and self. This process of reclamation in the face of a repressive dominant culture is by nature revolutionary, and critically reliant on a well constructed therapeutic container.
Psychedelic-Assisted Therapy Facilitators as Agents of Change
Facilitators in psychedelic-assisted therapy serve as agents of change, not only guiding individuals through their healing journeys but also actively contributing to the transformation of therapeutic practices. By embracing principles of social justice and cultural humility, facilitators can challenge traditional power dynamics inherent in therapy and create more equitable and empowering relationships with clients. Rather than the traditional therapeutic dynamic of expert and receipt, psychedelic-assisted therapy offers an opportunity to center a clients’ own inherent capability and capacity for growth in their healing journey. By stoking the fires of internal revolution through the intentional development of inner healing intelligence, psychedelic-assisted therapy facilitators can change both the lives of the individual, as well as the broader mental health treatment paradigm under which they practice..
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Culturally Responsive Care
Harm reduction is a fundamental principle in psychedelic-assisted therapy, encompassing physical, psychological, and cultural safety. To most effectively embody harm reduction into an evolving PAT framework, practitioners should strive for widespread acceptance of culturally responsive care as a foundational component of efficacious PAT. Culturally responsive care acknowledges the diverse backgrounds and experiences of individuals, recognizing the impact of systemic oppression on mental health. A culturally responsive therapy facilitator must also understand the nuance of cultural humility within their broader receptivity to diverse clients. Cultural humility goes beyond solely hoping to understand a client’s cultural identity, and shifts focus towards self-awareness, introspection, and relational engagement. Cultural humility centers an ongoing recognition of a facilitator’s own limitations in understanding and engaging with diverse cultures. Through culturally humble assessment, treatment planning, and intervention, PAT facilitators can mitigate the risk of retraumatization and ensure that therapy is sensitive to the needs of all clients. Recent research indicates that facilitator training should include careful consideration for a client’s emergent experiences, particularly when they include cultural, racial, and spiritual themes. A lack of facilitator knowledge and epistemic humility can lead to far worsened treatment outcomes with underserved populations (Williams, Reed, & George, 2021).
Central to the practice of culturally responsive therapy is the ongoing exploration of personal and professional identities, as well as historical cultural contexts for the field within which one works. Psychedelic-assisted therapy facilitators must critically examine their own biases, privileges, and assumptions to provide effective care. This process involves continuous learning and self-reflection, and a commitment to implementing inclusive strategies that honor the diversity of human experiences. Additionally, psychedelic-assisted therapy facilitators must understand, and accurately convey, the history and extractive legacy of psychedelic-assisted therapy.
Facilitators must first recognize that any effort to help a client with physical, psychological, or spiritual growth is directly taken from Indigenous practices around the world. Responsible care includes a component of discussion with a client that clearly states that psychedelic-assisted therapy is a practice stretching back thousands of years, that is currently being adapted for a modern context. Moreover, the opportunity to adapt Indigenous wisdom– much of which was extracted without any effort towards reciprocity– is an incredible privilege that must be experienced with a culturally conscious frame of mind. Practically, this can look like a facilitator encouraging their clients to explore their own ancestral history, community, and cultural emergence within the medicine session. While some clients may be resistant to this process, the act of offering the opportunity to explore these culturally significant aspects of healing honors the historical lineage of psychedelic medicine work.
- “[P]sychology should not exist in a vacuum of disconnected theory where classrooms, research, and clinical encounters are considered apart from conflicts and suffering in society, where personal history is severed from the historical context and social institutions one has inherited” (Watkins & Shulman, 2008).
For instance, facilitators should make efforts to decenter whiteness in the therapeutic container, a process that involves acknowledging the ways in which white supremacy permeates all aspects of society– including mental health care– and actively working to counteract its influence. By centering the experiences and voices of marginalized communities in the literature they read, professionals they look to, and clients they work with, therapists can foster a more equitable and just therapeutic environment. By critically examining the ways in which racism manifests within therapeutic practices, oftentimes at the hands of centuries old racist medical practice now accepted as commonplace, therapists can identify and address inequities that perpetuate harm.
Resisting the systemic biases widespread in Western medicine can start with therapeutic tools as simple as authentic dialogue. Authentic dialogue encourages open and honest communication between therapists and clients, creating space for meaningful exploration of cultural identity and social justice issues. A therapeutic container in which a client feels safe enough to express doubt around any aspects of a facilitator’s approach is a powerful re-imagined version of mental health care.
Cultivating Community
Cultivating community within psychedelic-assisted therapy extends beyond the therapeutic relationship to encompass broader networks of belonging and support. By fostering connections among clients and providing access to culturally affirming resources and spaces, psychedelic-assisted therapy facilitators can help clients feel more grounded and resilient in their healing journeys. Community-centered approaches to therapy promote collective empowerment and social change, recognizing the interconnectedness of individual and societal well-being.
By emphasizing community engagement, particularly in the integrative stages of the therapeutic experience, clients are encouraged to draw upon their cultural heritage, traditions, and support networks as sources of strength and resilience. Community care providers, whether they be facilitators themselves, harm-reduction specialists, or community leaders, can facilitate integration-oriented discussions that honor diverse perspectives and experiences, creating a space where clients feel validated and empowered in their identities. Moreover, by recognizing the interconnectedness of individual healing and collective well-being, this approach fosters a sense of social responsibility and solidarity within the community.
Ultimately, psychedelic-assisted therapy that prioritizes community engagement not only enhances the therapeutic process for individual clients but also contributes to broader efforts towards social justice and equity. By centering cultural responsiveness and inclusivity, psychedelic-assisted therapy facilitators can enable clients to navigate profound transformations that resonate far beyond the therapy room, fostering healing and empowerment within communities marginalized by systemic injustice.
Beckley Academy has developed a resource centered around a guided mindfulness exercise that focuses on the idea of community. It’s designed to get a client ready for psychedelic-assisted therapy by helping them tune into what community feels like, both somatically and emotionally.
References
Watkins, M., & Shulman, H. (2008). Toward Psychologies of Liberation. Palgrave Macmillan.
Williams, M. T., Reed, S., & George, J. (2021). Culture and psychedelic psychotherapy: Ethnic and racial themes from three Black women therapists. Journal Name, Volume(Issue), 125–138. https://doi.org/10.1556/2054.2020.00137