Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice

Abstract

Psychedelic Harm Reduction and Integration (PHRI) is a transtheoretical clinical model for working with psychedelic experiences in therapeutic settings. Drawing from harm reduction psychotherapy, psychedelic-assisted therapy, mindfulness-based modalities, and psychodynamic therapy, PHRI offers a framework for clinicians to assist clients in preparing for and integrating psychedelic experiences without directly administering psychedelics. This approach emphasizes non-pathologizing, client-empowering strategies to address both challenging and positive psychedelic experiences. PHRI incorporates principles such as non-directive and inner-directed approaches, somatic awareness, and psychological flexibility. The model addresses common integration challenges including fear, ego dissolution, and increased emotional sensitivity. By bridging various therapeutic modalities, PHRI aims to support clients in translating psychedelic experiences into enduring positive changes while decreasing potential harms. This chapter outlines the theoretical foundations of PHRI, distinguishes it from existing approaches, and explores its application in clinical practice, with a focus on the integration phase of psychedelic experiences.

Keywords: Harm reduction; Inner-directed approach; Nonordinary states of consciousness; Psychedelic integration; Transtheoretical model.