Anne St. Goar considers herself an unlikely psychedelic leader.
In her three decades as a primary care physician in Boston, she developed an interest in post-traumatic stress disorder, something she hadn’t learned about in medical school but a mental health condition she believed a substantial number of her clients suffered with.
Goar’s interests led her to learn about the PTSD research carried out by the Multidisciplinary Association for Psychedelic Studies. She then met with MAPS executive director Rick Doblin because he lived nearby. That was about 11 years ago. Now St. Goar is the lead facilitator of the new Boston cohort of Center for Psychedelic Therapies and Research of the California Institute of Integral Studies (CIIS), one of the leading organizations training psychotherapists to use psychedelic-assisted therapies.
“If anyone had told me I’d be in this world 13 years ago, I wouldn’t have believed it,” St. Goar said. “I didn’t even know how to spell psychedelic, I don’t think.”
St. Goar is emblematic of the growth and expansion of the psychedelic world, as awareness becomes ever more mainstream and MAPS advances toward approval from the U.S. Food and Drug Administration to use MDMA-assisted psychotherapy for the treatment of PTSD.
MAPS is pursuing FDA approval for a specific form of MDMA-assisted psychotherapy, which would require trained providers to deliver the care.
The Coming Demand for Psychedelic Therapists
Janis Phelps, director of the Center for Psychedelic Therapies and Research at CIIS, said she and her strategic planning committee did the math a few years back: CIIS had trained about 200 people to administer these treatments, MAPS had trained about another 500.
To put that in context, MAPS estimates the need at more than 30,000 trained therapists by 2026 to make MDMA-assisted psychotherapy widely available. Doblin explains that 30,000 therapists equates to 15,000 two-person teams, the protocol currently being considered by the FDA.
If each patient receives three day-long MDMA sessions and the 12 required non-drug preparation and integration sessions, each of the therapist teams could see about 20-30 patients a year, totaling up to 450,000 patients.
That goal may seem ambitious, but it does not come close to treating all those who suffer from PTSD, which affects 7.7 million adults annually, or 3.5 percent of the U.S. population.
“We were fearsomely behind on the level of the need that would be forthcoming,” Phelps said. “We were basically scratching our heads about how we were going to meet the need.”
A $1 million grant from the Steven & Alexandra Cohen Foundation is supporting the operational costs of adding a Boston cohort to the longtime San Francisco-based CIIS therapist training program, plus adding staff to support the growth. With the additional capacity, CIIS now aims to train 1,125 therapists over the next three years.
The Cohen grant is the largest foundation gift that CIIS has received in its 50-year history.
In a story headlined Steven Cohen’s Redemption Tour about Cohen’s purchase of the New York Mets last year, the New York Times wrote, “Since insider trading charges toppled SAC Capital, the hedge fund firm’s billionaire founder, Steven Cohen, hasn’t necessarily shunned the spotlight. But a $1 billion art collection and a new firm carry cachet only in certain circles.”
The Cohen Foundation reports it has given away $625 million over about 3,000 grants in 19 years, with psychedelic projects among the foundation’s declared priorities. The Cohen Foundation declined to comment for this story.
CIIS Pioneers Therapist Training
CIIS offers the first academic post-graduate certification program in the U.S. focused on psychedelic therapy. The rigorous program includes about 150 hours of training to prepare professionals for future FDA-approved psychedelic-assisted and entactogen-assisted psychotherapy research.
Phelps notes that although the program’s graduates can offer integration services and some are prescribing ketamine, many are waiting to see what happens with expanded legal access. She’s also encouraging them to offer harm reduction services in their communities to ensure people understand the risks.
St. Goar has participated in the MAPS MDMA facilitator training and is a therapist for the MAPS phase 3 study in Boston. She was also part of the first CIIS psychedelic training cohort. She said the CIIS program is special because it’s not just about one psychedelic medicine, it’s about the whole landscape, including how different substances complement one another.
“The breadth of training is not matched by any other,” St. Goar said. “To me, it’s the gold standard of training.”
Bringing CIIS training to the East Coast adds a different dynamic, said St. Goar, who prefers the title “fairy godmother” over her official title of lead facilitator for the Boston program. As a founder of the Boston Psychedelic Research Group, St. Goar said Boston has become a hub of psychedelic training and research, but more slowly than the Bay Area.
“I’d like to think that Boston adds some gravitas to the field,” she said, noting that Massachusetts General Hospital now runs a Center for the Neuroscience of Psychedelics, adding to the local gravitas.
This year, about 140 students are part of the San Francisco cohort and another 120 are in a Boston-based group. That’s significantly more than the 65-person rosters CIIS welcomed just a few years ago, but still not enough, Phelps said.
Scaling the Training
CIIS is also working with an intellectual property attorney to explore options to package and license components of its curriculum to universities and nonprofits.
“We could train about three times as many people if we help just five universities,” Phelps said. “We feel like we can help make a huge difference.”
Scaling up their program could also include adding a third city offering training. Chicago and Portland, Oregon are under consideration. It could also include training people with a bachelor’s degree instead of an advanced degree, depending on whether the FDA would allow them to serve as sitters for people undergoing psychedelic-assisted therapies. .
Currently, the CIIS certificate program admits advanced professionals in therapeutic areas such as licensed mental health clinicians, specific medical professionals, and ordained/commissioned clergy and chaplains. Licensed professionals must have an MA/MS, MSW, RN or higher degree in behavioral health, medicine or mental health fields before they apply.
Doing the new math, Phelps first looked at 60-80 students per cohort, the numbers CIIS used to admit to their training program. She roughly estimated how many clients these therapists could potentially serve before they retire at about age 65. That number was around 20,000 clients. Increase each cohort’s size, add a city or two, and the potential to ease suffering is impressive.
“I’m in the right place,” Phelps said. “I feel a moral imperative.”
Image: A class at CIIS San Francisco from CIIS