Psychedelic Therapy: Jury’s Still Out

• By School of Health Professions
• March 12, 2025
• Health

Dr. Michelle Shuler is an assistant professor in the Department of Clinical Counseling and Mental Health at TTUHSC with an emphasis on Addiction Counseling. She has been working in the mental health and addiction counseling field for nearly 25 years and has been teaching at the master's level for nearly 15 years. During that time, she has also worked in private practice, where she first began her journey to learn more about psychedelic therapies after multiple of her clients became curious about potential treatments. 

Dr. Shuler lives in Colorado, where she says the state regulations surrounding psychedelics are different. This allowed Dr. Shuler the opportunity to complete a psychedelic assisted therapy training program. 

We sat down with Dr. Shuler to get her take on psychedelic therapy – what it is, what the research says about it, and the risks and potential benefits. 

What is Psychedelic Therapy?

Psychedelic-assisted therapy is a process of combination of therapy, medicine, application and integration. Psychedelic-assisted therapy is currently undergoing clinical trials, according to Dr. Shuler. She says that typically it looks like a potential recipient or client receiving a minimum of three sessions of pre-screening, essentially determining if it's appropriate for a particular individual to undergo the medicine or psychedelic dosing. 

Depending on the structure of the clinical trial being performed, there most often is a screening process to determine if psychedelic therapy is an appropriate therapeutic approach for that particular individual. After that process, the individual would undergo a psychedelic dosing session with one or two therapists (or guides) supporting the individual through the process. 

After the psychedelic dose runs its course, the individual receives a minimum of three integration sessions with a trained or certified guide or therapist. According to the Multidisciplinary Association for Psychedelic Studies (MAPS), psychedelic integration incorporates a wide variety of strategies. However, the organization notes that every approach ensures that the integration process is intentional and fundamental in not only understanding a psychedelic experience, but also using that experience to build on principles of daily life and personal growth.

Addiction Counseling vs. Psychedelic Therapy

There are similarities and differences between addiction counseling and psychedelic-assisted therapy. For example, both aim to improve mental health and well-being, addressing underlying issues such as trauma, depression and anxiety. Addiction counseling often incorporates motivational interviewing (MI), cognitive-behavioral therapy (CBT), and relapse prevention strategies, while psychedelic therapy integrates these and other psychotherapeutic techniques to maximize benefits.

Major differences include the substances used in treatment and the mechanism of action. Addiction counseling focuses on behavior change, coping skills and structure interventions. Psychedelic-assisted therapy induces altered states of consciousness to facilitate emotional breakthroughs and neuroplasticity to promote new perspectives. Addiction counseling might include medication-assisted treatment (e.g. methadone, buprenorphine), but generally does not use psychoactive substances. Psychedelic-Assisted Therapy incorporates substances like psilocybin, MDMA and ketamine under clinical supervision. 

Although some states have decriminalized psychedelic therapy with the use of psilocybin (such as Oregon and Colorado), it is still important to note the distinction between psychedelic therapy and ketamine therapy. 

Ketamine therapy vs. Psychedelic Therapy

There's some separation between ketamine and the traditional psychedelics. Dr. Shuler shares that ketamine is already an FDA-approved anesthetic being used off-label to treat some mental health disorders.

“It's such a fine line,” she says. “If someone is really struggling and looking for an alternative approach, the only legal avenue would be to look into ketamine therapy because it's not an illegal substance at the federal level.”

However, Dr. Shuler does warn patients to look at the legitimacy of whatever provider they are thinking about approaching, making sure that the therapy is overseen by a physician, including the appropriate screening and overseeing of the dosing, and the integration sessions afterwards. 

The Research

According to Dr. Shuler, the above description of a typical clinical trial session is what's being studied in terms of its efficacy and effectiveness. What does recent research say about psychedelic therapy? The jury is still out, it seems. 

Dr. Shuler says that recently, the FDA denied approval for the MDMA therapy, stating that more research is needed to determine its safety or efficacy. In terms of whether or not this is an appropriate and effective treatment, the FDA uses scientific evaluations and clinical trial processes to either approve or recommend certain psychedelic substances to the U.S. Department of Health and Human Services (HHS) in order to then petition the DEA to begin rescheduling proceedings.

The VA is continuing to run clinical trials around psychedelic assisted therapies applied to particular mental health issues. Dr. Shuler does note that depending on where you look, there is a lot of data indicating that there are positive outcomes with psychedelic-assisted therapies. 

“Other countries are doing clinical trials as well, but here in the United States, we're in that process of trying to go through the FDA approval for the use of this,” she says. 

Incorporating Psychedelic Therapy Education into MSAC Program 

The goal of the Master of Science in Addiction Counseling program at TTUHSC is to provide a practitioner training program focused on the unique needs of diverse communities. The program is committed to training students as entry-level addiction counselors to work competently and ethically through the mastery of evidence-based counseling practices.

While the evidence behind psychedelic therapy is yet to be determined, Dr. Shuler still believes it’s important for students to be informed about the current research and clinical trials being conducted regarding the therapeutic therapeutic effects of psychedelic therapy and addiction treatment. 

“We know people are seeking out alternative approaches to healing, so it is also important to incorporate some knowledge of harm reduction regarding psychedelic use,” she says.

Proceeding with Caution

Ultimately, Dr. Shuler believes that the topic warrants continued research, and that continued investigation could potentially lead to new approaches.

“I'm not advocating for this as a treatment approach at this point,” she says. “I think it warrants more investigation, particularly because there is research to show that so many people aren't necessarily benefiting from the treatments that we have now.”

Dr. Shuler also notes some important topics surrounding the subject overall. While she encourages caution regarding underground treatments going on, she also warns of the potential for the appropriation of the many indigenous communities that have been using plant medicine for centuries. 

“It’s an incredibly important part of their culture,” she says. “So underneath all of this, maybe more attention needs to be paid as to the history of these potentially healing therapies and the way we approach treatment in relation to that moving forward.”