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The Difference Between a Psychedelic Therapist & a Guide

Stories of psychedelic healing are tales as old as time. Long before there was modern medicine we had plants and herbs with different medicinal properties, utilized in different ways by cultures across the globe. Before there was any concept of a “therapist” many cultural leaders were guiding their people through their own kind of therapeutic healing rituals using psychedelic medicines. 

In the changing world we live in, it’s easy to get confused when discerning the difference between a psychedelic guide/facilitator and a psychedelic therapist. This article aims to help you understand the differences between the two roles. First, let’s start with a little bit of history on how psychedelic therapy came to be.

The History of Psychedelic Healing

Prehistoric artwork and early forms of communication show us the deep and ancient cultural connection that South American cultures like the Aztecs and Mayans had with ‘magic’ mushrooms– used to invoke spirituality and human kinship. 

It wasn’t until the 1940s and 1950s that the Western world began to recognize psychedelic compounds beyond oral traditions of indigenous cultures, for their therapeutic benefits

Swiss chemist Albert Hoffmann discovered the transcendent properties of lysergic acid diethylamide (LSD-25) after first synthesizing it in 1938. Psychedelics then began to pick up speed in institutions of authority who became interested in the “truth-telling” properties that these drugs seemed to elicit. 

It was at this time that a trailblazing Canadian psychiatrist, Humphry Osmond, pioneered an avant-garde and revolutionary form of psychological therapy called “psychedelic therapy”, with early and immediate efficacy for helping people recover from alcohol abuse and dependency

Fun fact: one of the co-founders of Alcoholics Anonymous, Bill Wilson, credits his own sobriety to a psychedelic experience. He believed psychedelics had the power to do the same for others struggling with addiction, saying it was “a matter of finding a power greater than ourselves” (Hill, 2004).

That greater power soon became dubbed “public enemy number one” by President Nixon with the launch of the War on Drugs in the 1970s and the consequent one step forward, two steps back checkered track record for therapeutic use of psychedelics

However, psychonauts around the world continued to advocate for the recognition of psychedelics for transforming people’s outlooks on life, helping people reconnect with themselves and others, and treating both subthreshold and severe mental illnesses. 

Some say we are now living in a “psychedelic renaissance” as clinical research on the medical potential of psychedelic therapy is escalating very quickly to make up for lost time. With modern medicine gradually welcoming psychedelics into mainstream regimens, there can be a lot of confusing jargon and terminology to parse through in the world of therapeutic psychedelia. 

Whether you’ve been following the psychedelic revolution since the ‘60s or you’re a rider of the second wave and new to this research, this article hopes to break down the fundamental difference between a psychedelic “therapist” and a psychedelic “guide.” Without further ado — let’s get into it.

What is a Psychedelic Therapist?

In true form to any other kind of therapist, a qualified psychedelic therapist is a licensed mental health professional who facilitates psychedelic experiences – sometimes in conjunction with another form of psychotherapy or talk therapy. 

Psychedelic therapy, also referred to as psychedelic-assisted therapy, is a practice that takes place in a clinical setting with a clinically-determined dosage administered to the patient. These dosage determinations are currently being authorized by the FDA as government administrations commit to approving regulatory psychedelic therapies.

Ketamine therapy is currently FDA-approved and legal in every state, while both psilocybin and MDMA are in late phases of clinical trials. Oregon is spearheading the movement as the first state in which psilocybin therapy is legal, while Oakland, CA, Santa Cruz, CA, and Denver, CO have decriminalized psychedelic use

Psychedelic-assisted therapy has been widely recognized as a scientifically credible and effective solution for people with PTSD, depression, OCD, anxiety, and substance use disorders.

However, since it has yet to officially be legalized, it is rare that a licensed mental healthcare professional may risk their licensure to perform a therapy that does not have the official green light. Therapists are also new to the psychedelic scene, meaning their facilitation practice will be limited for some time.

Therefore, while therapists may be one of the most common psychedelic clinicians in ten years from now, they are the exception to the rule as it stands. Right now, most therapists are only able to provide psychedelic preparation and integration support, but aren’t able to attend your actual psychedelic experience. 

This means that finding a therapist to conduct psychedelic therapy is currently a little tricky in terms of  comfort and safety, since they may or may not be technically operating illegally. So what is an alternative to a psychedelic therapist for providing a safe, controlled, and therapeutic psychedelic experience? The answer is a psychedelic guide/ facilitator (terms are used interchangeably).

What is a Psychedelic Guide?

Think of a nature guide, a tour guide, or any other kind of professional guide. A “guide” is a knowledgeable and experienced individual in their field who leads and supports others as they embark on their own personal experiences.

A psychedelic guide is a seasoned and qualified facilitator of general psychedelic experiences, providing the same services as psychedelic therapists, except that they don’t have mental health licensure and are in fact able to offer in-person ceremonial support

A psychedelic guide helps journeyers navigate the experience with intentionality and mindfulness. Often, people turn to psychedelic experience to address mental health concerns, life transitions, or to explore the contours of their mind. 

Psychedelic guides may lead a ceremony more ritualistically and spiritually, but will adapt to the needs and wishes of the journeyer. Qualified guides have facilitated a number of ceremonies and may have developed an idiosyncratic style or approach. 

Much like traditional counselors or therapists who specialize in different kinds of therapies and have different approaches to leading a therapy session, guides may differ in their individual healing philosophies and approaches to leading ceremonies.

How to Choose a Psychedelic Guide

Guides and therapists are meant to support your journey in whatever direction it unfolds, but they will not steer the wheel for you. Think of a guide as a friend in the passenger seat. You’re doing the driving, but they are right next to you and along for the ride for company and support. In the case of dangerous driving conditions, they’re equipped with road safety knowledge and tools.  

A guide can also help with intention-setting, a crucial and valuable part of preparation for a psychedelic experience. That said, it is not a guide’s role to try to influence your mindset, your intentions, or the experience itself. It is a guide’s role to create a safe space and comfortable environment that makes you feel at ease and comfortable being vulnerable in their presence. 

Don’t underestimate the power of reading a vibe, picking up energy, or trusting your gut when choosing who you want to lead you through a psychedelic experience. Like any therapist-patient relationship or a guide-guidee relationship, a sense of familiarity and natural rapport will create more space for vulnerability- the core ingredient to a successful psychedelic healing experience. 

Should You Choose a Psychedelic Therapist or a Guide? 

Much like any other type of therapist, finding a qualified facilitator who is right for you and your needs is essential for undergoing psychedelic treatment of any kind. It is not so much a matter of “pros” and “cons” when choosing a therapist versus a guide, so much as it is a matter of prioritizing factors that align with your reasons and expectations for seeking a psychedelic experience. 

One of the key qualities a good psychedelic guide or facilitator should have is first-hand experience with using psychedelics themselves. Like the examples of nature guides or tour guides, it only makes sense that you are going to feel most comfortable being guided through a journey by someone who is well-versed with the experience themselves. 

For this reason, psychedelic guides may actually be preferable to some people over therapists because they are more likely to have more history with psychedelic experiences than someone with a counseling profession who chooses to facilitate psychedelic therapy. 

Additionally, the uptick of approval for psychedelic therapies are based on their therapeutic benefits for mental illnesses, and though mental health is a spectrum, someone who doesn’t meet the official diagnostic threshold for a mood disorder, may not be approved for psychedelic therapy in clinical settings.

Therefore, a benefit in connecting with a psychedelic guide is that there is no cutoff or qualification for participating in the experience. Reasons for partaking in a psychedelic ceremony run the gamut from debilitating mental health disorders, to simple desires for changing perspectives and outlooks on life, or connecting with oneself in a new way. 

Some people who are seeking openness and wishing to expand their horizons may prefer doing so under the guidance of a ceremonial psychedelic guide, rather than in a clinical setting. Psychedelic facilitators will preach the importance of set and setting – the mindset going into the experience and physical environment of choice. 

Being in a clinical environment may not always be the most inviting or warm place for experimenting with psychedelics. Most facilitators, including those at Psychedelic Passage, have the ability to either host journeyers on their own property, or to travel to any destination where the client is most comfortable. Most clients choose to journey from the comfort of their own home.

On the other hand, for people with little to no experience with psychedelics, undergoing more of a medical “treatment” in a clinical setting may feel safer and more controlled, akin to working with any other kind of doctor on a treatment plan. 

There is credibility that is associated with medical practices, and by moving psychedelic practices into that space, we might start to see greater reception among a wider demographic of people who have not always been familiar with psychedelics or who think of them exclusively in a Woodstock context. 

Ready To Connect With a Psychedelic Guide?

Psychedelics have always been medicine, but as we’ve seen throughout history, different cultures, societies, and time periods influence the acceptance and usage of different medical models. 

This is not only because science is constantly evolving, but because people are too. Change can feel scary to some, but it’s also the one constant that makes us uniquely human. One of the biggest lessons in psychedelics is that we all have the plasticity to change our thoughts, our beliefs, and our ways.

So speaking of changing our minds, did this article change yours about whether you want to connect with a therapist or a guide? If you’re still not sure on the type of facilitator who would be right for you, we encourage you to book a consultation with us. 

We are more than happy to talk you through your intentions, expectations, reservations, or questions and give you an educated recommendation for the most personally fitting experience. If you’d like to learn more, we invite you to check out our resources page on all-things-psychedelic!

Looking for a professionally supported in-person psychedelic experience?

Take the first step and book a consultation call with us today. We'll walk you through every step of the process after getting to know you and your unique situation.

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At Psychedelic Passage, we offer professional 1-on-1 guidance and companionship on your journey of healing. We simply can't sit back and let Americans continue to sit in silent suffering trying to battle mental health issues within a broken health care system, all while knowing that effective alternatives exist. We stand for the sacred, at-home, ceremonial use of psychedelics for consciousness exploration, which we believe to be a fundamental human right.


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