Psychedelics Assisted Therapy

Psychedelic Assisted Therapy (PAT)

This section of our website is reviewed by Dr. Alex Ertl and shares information learned from his Natural Medicine Clinical Facilitator training in the state of Colorado through the Natural Medicine Health Act. This content is for educational purposes only. It does not constitute medical, legal, or mental health advice and does not promote or facilitate illegal activity.

This page offers evidence-based answers to common questions about Psychedelic Assisted Therapy, specifically psilocybin, and its potential role in mental health care, particularly in the context of Colorado’s Natural Medicine Program. You’ll find helpful FAQs and resources to support both curious individuals and healthcare providers.

While we are not yet offering Psychedelic Assisted Therapy, one of our clinicians, Dr. Alex Ertl from the Colorado Center for Evidence Based Treatment (CoCEBT), is currently in training to become a licensed Natural Medicine Clinical Facilitator under Colorado state law.

We are expecting services in late spring/early summer of 2026 as part of our Colorado services.

Becoming a Natural Medicine Clinical Facilitator Blog Series

Our Trauma, Stress, and Resilience Program Director, Dr. Alex Ertl, is currently in psychedelic therapy training in Colorado. Follow Dr. Ertl as he moves through his training program to learn more about psychedelic assisted therapy. We’ll release one new post each month. Join our email newsletter to be notified of new posts.

Becoming a Natural Medicine Clinical Facilitator (Part 2)

Becoming a Natural Medicine Clinical Facilitator (Part 1)

Helpful Resources

Frequently Asked Questions (FAQs)

What Does Psilocybin Treat

What conditions does the research show it may treat?
Who is psilocybin not for?
What medications are contraindicated with psilocybin?
What are the risks? What if there’s an emergency?

How Psilocybin Works

How does psilocybin work?
Is psilocybin bad for your brain?
What is the default mode network (DMN)?
Is psilocybin safe?
What’s the difference between psilocybin and other psychedelic treatments?

About Psilocybin Assisted Therapy

What does psilocybin assisted therapy look like?
Is this a new treatment?
How many treatments would someone need? Is psilocybin a one-time thing?
What can I expect after the treatment? How would this change my life?
Is this something to combine with talk therapy?
What about micro-dosing?

Accessing Psilocybin Assisted Therapy

Is this legal?
How do I access psilocybin health services in Colorado?

What conditions does the research show it may treat?

Psilocybin-assisted therapy is researched as a potential treatment for a range of mental health conditions, especially those that have been resistant to traditional therapies.

While Colorado’s regulated program does not require a diagnosis to access services, the research has primarily focused on people living with specific conditions.

Conditions with the most evidence so far:

1. Major Depressive Disorder (MDD)

Multiple clinical trials (including at Johns Hopkins, NYU, and Imperial College London) show rapid and sustained reductions in depression symptoms after just one or two sessions.
Psilocybin may help break persistent patterns of negative thinking.

2. Treatment-Resistant Depression

Psilocybin has shown promise for people who haven’t responded to medications or talk therapy.
Some studies report benefits lasting weeks to months after treatment.

3. End-of-Life Anxiety and Existential Distress

In studies with people facing terminal illness, psilocybin has helped reduce fear of death, anxiety, and depression, often leading to a renewed sense of meaning.

4. Post-Traumatic Stress Disorder (PTSD)

While MDMA is more studied for PTSD, early research and anecdotal reports suggest psilocybin may help with emotional processing, trauma reconsolidation, and resilience.

5. Addiction (Alcohol, Nicotine, and more)

Psilocybin has shown strong results in helping people reduce or quit addictive behaviors, including alcohol misuse and smoking, often by shifting self-perception or providing emotional insight.

Conditions Under Emerging Study:

Obsessive-Compulsive Disorder (OCD)
Eating disorders (especially anorexia nervosa)
Bipolar II depression (carefully and with screening)
Cluster headaches and migraines (less common, mostly anecdotal)

Who should proceed with caution or avoid psilocybin?

Psilocybin is not recommended for individuals with:

A personal or family history of psychosis (e.g., schizophrenia)
Active bipolar I disorder or mania
Unstable or untreated mental health conditions that may worsen with altered states

That’s why Colorado requires a licensed facilitator to conduct a health screening before any psilocybin session.

Who can benefit, even without a diagnosis?

In Colorado’s model, psilocybin services are also open to adults who are:

Seeking personal growth, emotional healing, or spiritual insight
Dealing with grief, anxiety, or life transitions
Looking to break through stuck patterns or find deeper meaning

While psilocybin is not a cure-all, research increasingly supports its potential, especially when combined with trained support and integration. Ongoing clinical trials are helping shape future standards of care.

TL;DR: Research supports psilocybin for depression, anxiety, PTSD, addiction, and end-of-life distress. It may also help with personal growth. Not for those with psychotic or manic conditions.

Who is psilocybin not for?

While psilocybin has shown therapeutic potential for many people, it is not safe or appropriate for everyone. In Colorado’s Natural Medicine Program, licensed facilitators are required by law to screen participants for physical and mental health risks before allowing access to regulated services.

Here’s who psilocybin may not be appropriate for, based on clinical research and Colorado’s screening requirements.

Psilocybin is generally not recommended for people with:

A personal or family history of psychosis

Includes conditions such as schizophrenia, schizoaffective disorder, or psychotic features in bipolar I disorder
Psilocybin may increase the risk of triggering or worsening psychotic symptoms

Bipolar I disorder

The risk of manic or mixed episodes may be elevated after psychedelic use
Some providers may cautiously consider psilocybin for Bipolar II, but only with strong clinical support

Certain psychiatric medications

Some medications (like lithium, MAOIs, or antipsychotics) may either reduce psilocybin’s effectiveness or create serious safety risks (e.g., seizures or serotonin syndrome)
These must be disclosed and assessed during the required facilitator screening

Unstable medical conditions

Cardiovascular issues, epilepsy, or other health concerns may make psychedelic use physically risky
Psilocybin can elevate heart rate and blood pressure temporarily

Pregnancy or breastfeeding

The effects of psilocybin on fetal or infant development are unknown
Colorado strongly advises against use in these cases

Psilocybin is also not appropriate for:

Individuals in acute crisis, such as recent suicidal behavior or hospitalization
Anyone unable to consent or communicate clearly during a session
People seeking psilocybin for recreational purposes within the regulated program (Colorado’s legal model is therapeutic and supportive, not for casual use)

Colorado’s protections

In Colorado, facilitators must assess all of these factors during the preparation phase. If risks are identified, the facilitator may:

Refer the participant to a clinical facilitator (a licensed mental health or medical professional), or
Determine that psilocybin is not appropriate.

Being “not a good fit” for psilocybin now doesn’t mean “never”. It means ensuring that the safest and most supportive conditions are in place before proceeding.

TL;DR: Not recommended for people with psychosis risk, bipolar I disorder, certain meds, pregnancy, or unstable mental health. Screening is required to assess individual fit.

What medications are contraindicated with psilocybin?

Some medications may reduce the effects of psilocybin or increase the risk of adverse psychological or physiological reactions. That’s why Colorado law requires facilitators to screen participants for medical and psychiatric medications before any session.

If you’re currently taking medication, it’s essential to disclose it fully during your screening process with a licensed facilitator or clinical facilitator.

Common medications that may be contraindicated or require caution:

1. Antidepressants

SSRIs, SNRIs, MAOIs, and tricyclic antidepressants can blunt or block the psychedelic effect of psilocybin.
Long-term use may require a tapering period before psilocybin is effective, but stopping antidepressants abruptly can be dangerous and should only be done under medical supervision.

2. Antipsychotics / Neuroleptics

Medications like olanzapine, risperidone, quetiapine (Seroquel), and aripiprazole (Abilify) can significantly reduce or block psilocybin’s effects.
These are typically prescribed for schizophrenia, bipolar I disorder, or severe mood disorders, all of which may also be contraindications for psilocybin therapy.

3. Benzodiazepines and Sedatives

Drugs like Xanax, Ativan, Klonopin, or Valium can dull the effects of psilocybin and may interfere with emotional processing.
In some cases, benzodiazepines may be used intentionally to manage acute distress during a session but routine use may require special care.

4. Stimulants

Prescription stimulants like Adderall (amphetamine) or Ritalin (methylphenidate) may increase heart rate and anxiety, potentially compounding psilocybin’s stimulating effects.
Risk of overstimulation or cardiovascular effects is a concern.

5. Mood Stabilizers and Anti-Seizure Meds

Lithium (for bipolar disorder) is of particular concern: there are reports of severe adverse reactions, including seizures, when combined with psychedelics.
Other anti-epileptic drugs may reduce effectiveness or present interaction risks.

6. Monoamine Oxidase Inhibitors (MAOIs)

These older antidepressants, such as phenelzine (Nardil), can interact dangerously with serotonergic psychedelics and increase the risk of serotonin syndrome, a potentially life-threatening condition.

Important: Never stop or change medications without guidance

If you are taking any of these medications, do not discontinue them on your own. Facilitators in Colorado are required to refer clients to a clinical facilitator or healthcare provider when safety concerns arise due to medications or medical history.

Safety is the top priority. Patients should always disclose current medications during screening and work with qualified professionals to determine if psilocybin is appropriate.

TL;DR: Antidepressants, lithium, antipsychotics, MAOIs, and stimulants may reduce psilocybin’s effects or increase risks. Never stop meds without medical guidance.

What are the risks? What if there’s an emergency?

While psilocybin is considered low-risk physiologically, it can bring up strong psychological and emotional reactions. That’s why Colorado’s regulated model includes trained facilitators, required preparation, and safety protocols to reduce risks and ensure support if anything difficult or unexpected arises.

What are the risks of psilocybin?

Psychological or emotional risks:

Distressing experiences (“challenging trips”) involving fear, confusion, or panic
Reactivation of trauma or intense emotions during or after a session
Potential to trigger or worsen symptoms in people with underlying psychiatric conditions, such as psychosis, bipolar disorder, or untreated PTSD
Confusion or disorientation in the days following a session

Medical risks (less common):

Elevated heart rate and blood pressure during the session
Nausea, dizziness, or body discomfort
In rare cases, adverse interactions with certain medications (e.g., lithium, MAOIs, or certain antidepressants)

Colorado law requires a full health and medication screening before your session to minimize these risks.

What happens if there’s an emergency during a session?

Colorado’s regulations require facilitators to be trained in:

Recognizing signs of psychological distress or physical discomfort
Grounding techniques and non-directive emotional support
Knowing when and how to escalate to medical professionals, if needed

In the case of a serious mental health or medical emergency:

Facilitators are trained to contact emergency services (911) when appropriate
All licensed service locations must have emergency protocols and support plans in place
If needed, a clinical facilitator (someone with a healthcare or mental health license) may be brought in

How Colorado reduces risks:

Required preparation sessions and mental health screening
Only licensed facilitators may guide sessions
No group dosing unless all participants are individually assessed
Clear consent policies for things like touch, communication, and follow-up care

TL;DR: Risks include emotional distress, medical interactions, or psychological triggers. Colorado law requires trained facilitators, emergency protocols, and participant screening.

How does psilocybin work?

Psilocybin is a naturally occurring psychedelic compound found in certain species of mushrooms. When ingested, the body converts psilocybin into psilocin, the active compound that affects the brain and produces its psychological effects.

In the Brain

Psilocin primarily works by binding to serotonin receptors, especially the 5-HT2A receptor, which plays a key role in mood, cognition, and perception. This altered activity leads to changes in how different regions of the brain communicate with one another.

One of the most significant effects is on the Default Mode Network (DMN), a group of brain regions associated with self-referential thought, rumination, and ego (e.g., our experience of our “self”). Overactivity in the DMN is often linked to conditions like depression and anxiety. Psilocybin appears to reduce activity in this network, which may allow the brain to form new patterns of thought rather be stuck in old patterns. Neuroplasticity, which is the brain’s ability to form new physiological patterns and connections within itself, is increased drastically.

For example, imagine someone has a chronic pattern of thinking “I’m unlovable.” This belief has probably become associated with, and triggered by, numerous experiences in their life, such as when they ruminate about their lack of friendships or think about how they “don’t have much to offer.” Their mind has become conditioned to notice all these elements in their life and take them as supporting evidence for this viewpoint. Quieting the DMN potentially allows this person to break out of this web of thought patterns and consider new alternatives. Emotions often become enhanced on psilocybin, so there’s an opportunity to feel these new things as well. So, in our example above, perhaps during treatment the person can remember and feel the love they received at one point in their life, and they come to new conclusions about their ability to be cared about by others.

In Mental Health

Research suggests that psilocybin-assisted therapy can help with conditions like:

Major depressive disorder
PTSD
Anxiety, including end-of-life anxiety
Addiction (e.g., alcohol, nicotine)

These effects are not just due to the chemical itself, but also the experience it can create: a deeply introspective, emotionally significant state that may help people process trauma, reframe negative beliefs, and gain new psychological insights. When used in a structured, supported environment, such as with a trained facilitator in Colorado’s regulated Natural Medicine Program, psilocybin may enhance mental flexibility, emotional openness, and resilience.

Note: Psilocybin is not for everyone. It can carry psychological risks, especially for those with a personal or family history of psychosis or bipolar disorder. It is not a replacement for professional mental health care unless part of a supervised treatment plan.

TL;DR: Psilocybin affects serotonin receptors and increases brain connectivity, often helping disrupt rigid thought patterns. It can support emotional insight and healing when used with guidance.

Is psilocybin bad for your brain?

Short answer:
There’s no strong research evidence that psilocybin, when used occasionally and in safe, controlled settings, causes brain damage or long-term cognitive harm. In fact, some studies suggest potential beneficial effects, like improved emotional regulation and neural connectivity related to flexibility and mood.

Longer answer:

What studies show:

Brain imaging: Psilocybin temporarily reduces activity in certain “hub” areas of the brain (especially the default mode network), which seems to allow for new neural connections. This may help explain its antidepressant and “perspective-shifting” effects.
Neurotoxicity: Unlike some substances (e.g., MDMA or methamphetamine), psilocybin does not appear to be neurotoxic.
Long-term effects: Follow-up studies of both recreational and clinical users show no lasting harm to cognition, memory, or personality other than sometimes mild, positive shifts in openness and wellbeing.

When it can be risky:

During active psychosis, mania, or with a strong family history of such disorders: psilocybin can destabilize mood or trigger psychotic symptoms.
With very high or repeated dosing: while not proven to damage the brain, it can cause confusion, anxiety, or derealization that lasts days to weeks.
Unsafe settings: panic, accidents, or trauma can happen without proper support (“set and setting” matter a lot).

Overall, psilocybin isn’t “bad for your brain” in the usual sense. However, it can cause psychological or emotional harm if misused or taken in vulnerable circumstances.

TL;DR: No strong evidence shows psilocybin harms the brain. It’s not neurotoxic and may even support emotional flexibility and new neural connections. Risks exist for people with certain mental health conditions or in unsafe settings. Context and moderation matter.

What is the default mode network (DMN)?

The default mode network (DMN) is a group of brain regions that are most active when your mind is at rest (like when you’re daydreaming, thinking about yourself, remembering the past, or imagining the future).

It’s basically the brain’s “autopilot” or “inner narrative” system. It’s the background hum of self-referential thoughts that run when you’re not focused on an external task.

Main parts of the DMN include:

Medial prefrontal cortex (mPFC): involved in self-evaluation, social comparison, and emotional reflection.
Posterior cingulate cortex (PCC): integrates memory and self-related information.
Precuneus and angular gyrus: linked with imagery, perspective-taking, and consciousness.
Hippocampus: memory and mental time travel (thinking about past/future).

Why it matters in psychedelics:

Psilocybin and similar compounds temporarily quiet the DMN.
This loosens the grip of the “ego” or the usual sense of self, which is perhaps why people often describe feelings of ego dissolution, unity, or connection.
After the experience, the DMN tends to reintegrate, sometimes with improved flexibility. It’s like a reset for rigid self-beliefs or rumination.

In a way, the DMN is like the brain’s “story of me” network, and psilocybin lets that story loosen up for a while so the brain can explore new connections and perspectives.

TL;DR: The DMN is the brain’s self-reflection system which is active during daydreaming, memory, and identity. Psilocybin quiets it, which can reduce ego and rigid thinking, offering a “mental reset.”

Is psilocybin safe?

Research shows that psilocybin is considered physiologically low-risk and non-addictive, especially when compared to other substances. However, “safe” depends heavily on context including the dose, environment, mindset, and individual health factors.

What we know about psilocybin’s safety:

Toxicity is low: Psilocybin has a wide safety margin, meaning harmful overdose is extremely rare.
It is not physically addictive: Unlike many substances, psilocybin does not lead to chemical dependency or compulsive use. In fact, short-term repeated uses of it can very quickly lead to increased tolerance and diminishing impact.
Side effects are typically temporary: These may include nausea, anxiety, or confusion during the experience.

Psychological risks exist, especially without support:

“Bad trips” can be distressing and include fear, panic, or overwhelming emotions. However, research has found these to be quite rare when treatment is provided in a supportive, controlled environment with proper preparation and precautions. However, it is not uncommon to experience intense challenging emotions during treatment, which can lead to resolution and therapeutic improvement.
In rare cases, psilocybin may trigger psychosis or mania in individuals with a personal or family history of schizophrenia, bipolar disorder, or other serious mental health conditions.
Experiences can be destabilizing without proper preparation and integration.

Colorado’s regulated model prioritizes safety:

In Colorado, psilocybin may only be legally administered within a regulated Natural Medicine Program by trained, licensed facilitators. These professionals conduct health and mental health screenings, guide participants through preparation, supervise the administration session, and support integration afterward. This model is designed to reduce harm, increase therapeutic benefit, and ensure participants are psychologically prepared and supported throughout the experience.

Psilocybin may offer mental health benefits for some, but it is not safe or appropriate for everyone. If you’re considering psilocybin services in Colorado, speak with a licensed facilitator or healthcare provider first.

TL;DR: Psilocybin is considered physiologically safe for most people, but there are psychological risks. Colorado’s regulated model includes screening and support to reduce harm.

What’s the difference between psilocybin and other psychedelic treatments?

There are several substances often referred to as “psychedelics,” but each one works differently, carries distinct risks and benefits, and falls under a different legal status. Some are approved for clinical use or in trials, while others remain federally prohibited. Only psilocybin is currently available in a regulated model in Colorado.

Below is a breakdown of how psilocybin compares to other common psychedelic or psychedelic-adjacent therapies, including who they may help and who should proceed with caution.