Credentialing psychedelic practitioners: 5 Questions for Board of Psychedelic Medicine and Therapies CEO NiCole Buchanan

Buchanan discusses the Board of Psychedelic Medicine and Therapies and their credentialing plans.

Many of Michigan-based clinical psychologist NiCole Buchanan’s clients come to her with complicated and lengthy trauma histories. Reading about psychedelic-assisted therapy made her want to better understand how such a modality might help mental health practitioners like herself help patients navigate their way toward well being. In 2021, Buchanan was elected to the inaugural board of directors of the American Psychedelic Practitioners Association, which was formed in 2018 to serve as a membership organization for practitioners interested in psychedelic-assisted therapy. Last year, Buchanan became the interim chief executive officer and director of the Board of Psychedelic Medicine and Therapies (BPMT), a sister organization that seeks to set certification standards for psychedelic practitioners. The two groups work together, Buchanan says, with the association focused on membership and accrediting training programs and the board focused on certification for practitioners. The Microdose spoke with Buchanan about the group’s credentialing plans. 

What is the Board of Psychedelic Medicine and Therapies and what does the organization do?

Right now, we’re developing a test for psychedelic practitioners that allows them to demonstrate they’ve had appropriate training and experience. If they can pass the test, then they get certified. It’s a way of helping to ensure the public that people they're going to for services are credentialed by an organizing body that’s looked at their history and education. 

One of the more significant pieces is being able to provide a resource to the public where they feel like they can trust a practitioner. Eventually we hope it will become a place where the public can make reports if they encounter behavior or treatment that is inappropriate or unsafe.

State medical or nursing licensing boards can revoke medical professionals’ ability to practice altogether. What consequences might practitioners face from your organization if they behave inappropriately? Also, I’m guessing there are guides and practitioners in this space who don’t want to take a test or be licensed by a board. How do you see your  credentialing program getting buy-in from the greater psychedelic practitioner community?

We’re envisioning that inappropriate behavior could have consequences for credentials. It’d be graduated based on the nature of offense — some cases may simply require re-education, while others might require additional supervision. Those are things we can help build a bridge across rather than cutting people out of the profession. But there might be behaviors that there is no excuse for, behaviors that were intentional and deliberate, like sexual inappropriateness with a client. The consequences for that would be more dire. 

As for buy-in, in my interactions with people in the community, it’s very clear that people are committed to making sure there’s safe access to psychedelic-assisted therapy. Credentialing is one way to create that while building public trust. Part of that is talking with individuals about the possibilities, and making connections with other key players. For instance, insurance companies covering treatments may want to see that practitioners have been vetted. 

What progress has the  Board of Psychedelic Medicine and Therapies made on developing this credentialing exam?

We’ve recently brought in a new board, which was no small feat — we wanted to bring in a diverse group of practitioners to help develop this. We’ve started a new partnership with a test development company that has done testing and credentialing for a variety of other organizations and companies. They’ve worked in the field of psychedelics, too — so they’re the right people at the right time to develop an exam that has high validity and reliability, and that we can disperse to people from a variety of professions. 

Most credentialing or licensing programs are doing work for a single profession. What makes this unique, and also infinitely complicated, is that practitioners may come from a variety of backgrounds and training. So right now, we’ve compiled a group of subject matter experts that are creating the domains we’ll need to include in this test, and they are writing test questions. Then we’ll be piloting those and refining them to hopefully have our testing applications open in 2024.

In Oregon, the licensing standards for psychedelic practitioners offering psilocybin sessions has led to some contentious discussions around who is included, or not, in such regulated programs. What types of practitioners would be eligible to take this test? For instance, could people who don’t have professional mental health training take this test and become accredited? I’m thinking here of psychedelic guides who have been working underground but who might not have any formal training. The first phase will apply to clinical and research practitioners – these are individuals who already have a licensed degree in another domain, like clinical psychology, pathology, or nursing. There’s a wide group of professionals that already have demonstrated knowledge and experience addressing mental health concerns.They already have extensive training, specifically in psychedelic medicine, or credentials in their particular field.

But we’re also looking into how we can create a process that applies to lineage and legacy practitioners. That is infinitely more complicated. There isn’t a traditional path for this. We can look to some other fields, like clinical herbalism, and see how they’ve done this work. But first, it’s going to require an environment where people who are doing this work feel safe coming forward. Having legal protections for these practitioners will require some work in states that haven’t already created processes for legal use. We’re going to be collaborating with professionals in states where there already is such a process to move forward — places like Oregon and Colorado. 

Some experts estimate that it will take hundreds of thousands of practitioners to fulfill future demand for psychedelic-assisted therapies. What do you make of those demand estimates and what role do you see the Board of Psychedelic Medicine and Therapies playing in that?

There’s going to be a period of time where there’s far higher demand than there are practitioners to meet that demand. The amount of training to get to a point where people can practice independently is significant. Until training is available more widely, it will be difficult for people to find opportunities to complete all phases of their training. Currently, that work is largely happening through clinical trials. If requirements are opened up to allow people to have clinics, those practitioners can provide supervision and spread their expertise further. We’re going to have at least a decade of trying to get enough clinicians in a position to give this care. This is where lineage and legacy practitioners can come in — to meet that need, we need to have a process to bring them in, too. The medical model is not the only model; if we’re changing our lens to focus on the needs of society, it will be critically important to find other pathways.

This interview has been edited and condensed for clarity and length.