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Competencies and Ethical Governance for Psychedelic‑Assisted Therapies: A Practice‑Embedded Quality‑Improvement
Shannon Dames1,2, Keith Williams3,4, Allan Campbell1,5
1Psychedelic-Assisted Therapy Graduate Certificate (PaTGC), Vancouver Island University (VIU), Nanaimo, British Columbia, Canada.
Journal of Evaluation in Clinical Practice
|August 10, 2026
Summary
A new competency framework for psychedelic-assisted therapy (PaT) was developed using a quality improvement process. This framework enhances governance, safety, and ethical practice in diverse settings.
Area of Science:
- Psychedelic-assisted therapy (PaT)
- Clinical governance
- Professional competency frameworks
Background:
- Psychedelic-assisted therapy (PaT) is expanding rapidly across disciplines and settings.
- Lack of standardized research-informed governance frameworks leads to inconsistent safety and ethical expectations.
- Practitioners may rely on guidance with varying evidence bases and rigor.
Purpose of the Study:
- To describe a competency framework for psychedelic-assisted therapy (PaT).
- Developed through a 4-year practice-embedded quality improvement (QI) process.
- Focused on enhancing governance, safety, and accountability in PaT.
Main Methods:
- An iterative QI approach was used within a postgraduate PaT program.
- Integrated evidence-informed literature with feedback from learners, faculty, and cultural advisors.
- Process centered on developmental learning, cultural responsiveness, and safeguards for non-ordinary states of consciousness.
Main Results:
- The framework integrates 'doing' (technical/clinical) and 'being' (relational/ethical) dimensions.
- Includes a program-level Code of Ethics covering safety, confidentiality, equity, and boundaries.
- Operationalizes five competency domains: therapeutic presence, cultural responsiveness, regulatory literacy, clinical knowledge, and trauma/equity-informed process.
Conclusions:
- This framework offers a locally adaptable, QI-derived design logic, not a fixed consensus standard.
- Provides governance-oriented clarification of ethical guardrails and developmental competencies.
- Aims to guide future implementation and evaluation of PaT practices.