M11 — Administration · Inner EDGE Navigator · T1 + T2

Tier 1 Module Cover Sheet Faculty & Student Reference · Regulatory Anchor

Phase 3 — Clinical & Practical Applications Phase 3

Module 11: Administration

Session flow and arc · Environment staging · Facilitator presence and attunement · Turbulence response and de-escalation · Emergency Action Plan activation · Documentation and session close · The first module where the facilitator is actually present for the journey.

13 hrs total 9.5 sync / 3.5 async Phase 3 · v1.0

iETA Framework — From Preparation to Presence

M08–M10 built toward this. M11 is where the facilitator is actually in the room. The six preparation coordinates become lived conditions. The safety plan becomes active. The inner guidance the participant was reminded of in M10 now meets the real experience of an altered state. The facilitator's role is the same as it was described in M10 — hold the space, support what arises, navigate toward safety — but the skills required to do it under real conditions are specific and learnable. M11 teaches them.

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Learning Objectives By module completion

PC3 — Clinical Readiness & Participant Safety PC4 — Safety & Crisis Response

1

Explain the session arc in plain language — arrival through postcare — and describe the facilitator's role, attunement tasks, and participant communication options at each phase. Understand Apply K.1 · K.2 · K.5
2

Stage an administration environment using a room checklist and verify readiness with a buddy check before the participant arrives. Apply K.5 · K.2
3

Differentiate supportive from triggering presence across posture, proximity, gaze, and voice — and select scope-appropriate attunement responses to participant signals including withdrawal, scanning, agitation, and retraumatization cues. Analyze Apply K.3 · D.2
4

Execute the turbulence response protocol for five presentation types within scope — and correctly identify the trigger thresholds for Safety Officer escalation and Emergency Action Plan activation. Apply Evaluate K.3 · K.4 · D.8
5

Compose a factual, scope-compliant session note; identify reportable events; and complete the session close including implementation of the transportation plan. Apply K.6 · iETA-K

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Regulatory Crosswalk Colorado NMTP Section K · 10 hrs CO minimum · 12–15 hrs iETA

Source	Code	Standard	Lesson Coverage
CO NMTP	K.1	Dosing strategies and considerations including experiential differences, physiological considerations, delivery mechanisms, and use of secondary doses	L1 — primary
CO NMTP	K.2	Skills to handle natural medicine material effectively including hygiene and assessing material for spoilage or contamination	L1 — primary
CO NMTP	K.3	Effectively working with challenging behaviors during administration sessions including unexpected disclosures, substance-induced psychosis, and suicidality	L2 — attunement · L3 — turbulence primary · Advanced in M15
CO NMTP	K.4	Traumatic stress and its manifestation during natural medicine experiences — trauma-body relationship, re-traumatization risks, and emergency protocols	L3 — primary (M04 established foundations)
CO NMTP	K.5	Set and setting — environmental considerations for administration sessions	L1 — staging · L4 — session close environmental notes
CO NMTP	K.6	Completion of administration session including implementation of transportation plan	L4 — primary
CO NMTP	D.2	Response to psychological distress and creating a safe space for difficult emotional processing	L2 — primary (presence + attunement)
CO NMTP	D.8	Emergency protocols — when and how to activate, including handoff procedures	L3 — primary (EAP activation)
iETA	iETA-K	Documentation protocols during administration sessions — real-time session notes, post-session documentation hygiene, record retention. iETA addition beyond Colorado NMTP minimum.	L4 — primary · Session note template
iETA	A.3 / DISC	Applied DISC communication style insights in the administration session — adapting presence and communication to participant style signals during intensity; one do/one don't per style clash. OSCE bonus.	L2 — primary · OSCE Station A bonus

Prerequisites & Forward Connections

Direct prerequisites: M10 (Preparation — all three lessons completed, OSCE passed). Students must arrive with their completed M10 portfolio: preparation plan, safety plan, support person briefing, and pre-journey briefing checklist. All M10 documents become active in M11 — the safety plan is live, the support person is on standby, the participant's intention is the orientation for the session. M04 connection: K.4 (traumatic stress during sessions) builds directly on M04 trauma-informed care foundations — students who have not consolidated M04 will struggle in L3. Forward connections: M11 documentation becomes M12 (Integration) source material. The session note, any incident reports, and the facilitator's observations all inform the integration conversation. M15 (Advanced Facilitation) addresses complex K.3 scenarios beyond M11's scope.

Colorado NMTP — Section K Compliance Note

Module 11 satisfies the full Colorado NMTP Section K requirement (10 hrs) for administration competency. K.1 (dosing strategies including secondary doses) requires careful framing — the facilitator understands the information to monitor appropriately; decisions about secondary doses follow service center protocol, not facilitator prescription. K.3 (challenging behaviors) is addressed at foundational level in M11 and at advanced level in M15 — the M11 content covers the turbulence types most likely in standard practice; complex multi-factor presentations are M15 territory. K.4 (traumatic stress) builds on M04 — instructors should confirm M04 consolidation before L3. Two OSCE stations are required for Section K competency documentation. All rubrics must be retained with assessor signatures.

── T1 ends · T2 begins ──

Tier 2 Instructor Guide Facilitator Copy · Not for Distribution · All Tools + OSCE Package

Module 11 — Phase 3 Phase 3

Administration — Instructor Guide

Four lessons: session flow and staging (L1), presence and attunement (L2), turbulence response and EAP (L3), documentation and close (L4). Two OSCE stations with DISC bonus. All tools included.

13 hrs total 4 Lessons + 2 OSCE

Tier 2 What This Module Asks of You — and Your Students

Module 11 · Administration

Now We're in the Room

M08 through M10 built toward this. M11 is where everything that was theoretical becomes real — or falls apart under pressure.

The administration session is the highest-stakes context in facilitation training. The participant is in an altered state. Their experience amplifies everything — fear, warmth, discomfort, trust. The facilitator's presence, pacing, voice, and posture are no longer background variables. They are active forces in the room. This is why M11 exists as its own module: presence can be learned, attunement can be practiced, turbulence response can be drilled — but none of it happens automatically. It requires deliberate preparation.

Two things to hold as you teach M11. First: the scope discipline from M08–M10 is even more critical under pressure. Students who are uncertain about boundaries in a screening conversation will revert to clinical framing when a participant is in distress. Watch for it and name it immediately. The turbulence protocol (L3) lives or dies on scope clarity. Second: presence cannot be performed. L2 will surface students who intellectually understand supportive presence but whose bodies do something different. Simulation, feedback, and video review are how that gap closes — not lecture.

Before You Begin

Confirm all students have completed M10 OSCEs and have their M10 portfolio documents with them. The preparation plan, safety plan, and pre-journey checklist are active documents in M11 — not reference materials. Students who arrive without their M10 documents are not ready for M11 content. Also confirm M04 consolidation before L3; K.4 trauma content requires that foundation.

Materials Needed

Session arc reference card (T3 version in SG)
Room staging checklist (T3 version in SG)
Presence/attunement quick reference (T3 version in SG)
DISC session tool — do/don't per style (T3 version in SG · OSCE bonus reference)
Turbulence response protocol (T3 version in SG)
EAP activation protocol (T3 version in SG)
Session note template (T3 version in SG — portfolio artifact)
OSCE assessor packets — Station A + Station B (2 sets per station · primary + alternate scenarios printed separately)
Students' M10 portfolio documents (required — preparation plan, safety plan, pre-journey checklist)

Pre-Session Instructor Prep

Confirm M10 OSCE completion for all students
Confirm M04 consolidation before scheduling L3
Prepare a presence/attunement demonstration — students need to see this before they practice it
Arrange the teaching space for L2 body-based practice — seating that allows movement and proximity work
Prepare two OSCE scenario versions per station before the assessment window
Review Colorado NMTP Section K requirements in the iETA Curriculum Alignment Matrix

Lesson 1 Session Flow, Pre-Brief & Environment Staging · 2.0 hr sync + 1.0 hr async

Lesson 1: Session Flow, Traveler Pre-Brief & Environment Staging

3.0 hrs total · 2.0 hr sync / 1.0 hr async · Colorado NMTP K.1 · K.2 · K.5

L1 establishes the session arc — the journey the facilitator and participant move through from arrival to postcare — and builds the practical preparation skills required before the participant enters the space. This is the first time in the program that the full arc is addressed; it was deliberately withheld from M08–M10 to keep it here where it belongs. K.1 (dosing strategies including secondary doses) and K.2 (material handling) are also addressed here, framed within the facilitator's actual scope.

Sync Time 2.0 hours — warm-up (10 min) + lecture: session arc + material handling (55 min) + room staging exercise (30 min) + debrief (5 min)

Materials Session arc reference card · Room staging checklist · Physical space for staging exercise

Warm-Up · 10 min

Prompt "You've delivered the pre-journey briefing. Your participant and support person have left. The session is in three days. What do you do now — and on session day, before the participant arrives — to be ready?" Collect responses — students will generate a mix of practical (check the room, prepare materials) and relational (review the preparation plan, revisit the intention, center yourself). Both are right. Use this to frame L1: the session arc starts before the participant arrives, and the facilitator's readiness is itself part of the setting.

This warm-up surfaces the gap between M10 (preparation with the participant) and M11 (the facilitator's own preparation for being in the room). That gap is intentional and real — what the facilitator does in the hours before the session shapes their presence quality in ways that matter.

Lecture · 55 min

"Everything we built in M08 through M10 was preparation for this moment. The participant is arriving. They've been screened, cleared, and prepared. They know their intention and their support person knows their threshold language. Now the facilitator needs to know the arc — what the next several hours will actually look like, what to expect at each phase, and what their role is when it does."

The session arc (K.1, K.5): A psilocybin administration session has a predictable arc with variable timing. Understanding this arc allows the facilitator to hold the overall shape of the experience without being disoriented when a participant moves through it differently than expected. The arc is not a script — it is a map. Participants take the terrain at their own pace.

The arc moves through five phases: Arrival and Grounding, Onset, Swell and Peak, Landing, and Immediate Postcare. Each phase has characteristic participant experiences, characteristic facilitator tasks, and characteristic decision points. Students who know this arc can stay present during intense phases because they understand where the participant is in the overall journey — and what is likely to come next.

"Before I walk through the arc — what do you already know about the psilocybin experience from your M08 medication work and your M10 preparation conversations? What gaps do you notice?" This surfaces existing knowledge and names the gaps that L1 fills.

Material handling and hygiene (K.2): The facilitator is responsible for the safe handling of the natural medicine material. This includes: verifying material identity and provenance from the service center; visual assessment for spoilage, contamination, or degradation; hygiene protocols in preparation; appropriate storage conditions before the session; and chain-of-custody documentation as required by service center protocol. The facilitator does not source, cultivate, or prepare the material beyond what service center protocols authorize — they receive and handle it responsibly.

Dosing strategies and secondary doses (K.1): K.1 requires facilitators to understand dosing considerations including experiential differences, physiological considerations, delivery mechanisms, and the use of secondary doses. This content requires deliberate scope framing. The facilitator is not a prescriber — they do not determine the natural medicine amount. They understand dosing considerations to: (1) provide accurate psychoeducation to participants about what to expect, (2) monitor the participant's experience in the context of what they know about amount and timing, and (3) consult with the service center appropriately when questions arise. Secondary doses — supplemental natural medicine amounts administered during the session — are governed by service center protocol. The facilitator understands when a secondary dose may be considered (fading experience, participant desire, specific preparation-plan provision), follows protocol for initiating the conversation, and documents accurately. They do not decide unilaterally.

"What is the difference between the facilitator understanding dosing considerations and the facilitator making dosing decisions? Why does that distinction matter legally and ethically?" This is one of the most important scope questions in the program. Press for specific, articulable answers.

The participant pre-brief on session day (K.5): Before administration begins, the facilitator conducts a brief check-in with the participant — not a full re-screening, but a genuine moment of contact. How are you right now? How did you sleep? Anything you want to name before we begin? This check-in serves two purposes: it gives the facilitator real-time information about the participant's arrival state, and it gives the participant an opportunity to say something they may not have said in the preparation sessions. It also activates the inner guidance reminder from M10: whatever arises, their own knowing is the compass. The facilitator is here, and they are ready.

Watch For

Dosing drift: Students who understand K.1 content well sometimes start speaking as though they make dosing decisions. "I would adjust the dose if..." is not in scope. "Service center protocol addresses secondary doses in this way, and the facilitator's role is..." is in scope. Name this distinction every time it appears.
The arc as prediction: Students sometimes treat the session arc as a prediction of what will happen. The arc describes a typical progression — real sessions vary significantly. A participant who is still in onset at 90 minutes is not doing it wrong. Keep the arc as orientation, not expectation.
Material handling treated as routine: K.2 content can feel tedious. Name why it matters: contamination or spoilage creates serious safety risk. Visual assessment is a real and required skill, not a checkbox.

T2 Tool · T3 Version in Student Guide · Reference Throughout Administration Session Arc — Arrival to Postcare

Phase 1 Arrival & Grounding Pre-administration · Variable duration

Participant arrives. Transition from the outside world into the session space. The facilitator's groundedness sets the relational tone before anything else is said.

Facilitator role: Warm, grounded welcome. Brief check-in on arrival state. Environment is already prepared. Activate the pre-brief: intention reflection, inner guidance reminder, final consent affirmation. Confirm support person logistics. Begin the session only when a genuine yes is present.

The quality of arrival shapes the entire experience. A participant who arrives rushed, anxious, or unacknowledged brings that state into the onset. The facilitator's calm is not performance — it is the first environmental condition.

Phase 2 Onset Approx. 30–90 min post-ingestion · Variable

Natural medicine begins to take effect. Perceptual shifts, body sensations, emotional stirring. Onset can include nausea, anxiety about the experience starting, or excitement. The transition from baseline to altered state is often the most vulnerable window.

Facilitator role: Calm, consistent presence. Minimal verbal engagement unless the participant initiates. Normalize what is happening without narrating it for them. Monitor for nausea — have appropriate materials nearby. Resist the urge to manage what doesn't need managing.

Onset nausea is common and usually passes within 30–60 minutes. It is not a signal to intervene — it is a signal to be present. If nausea is severe or accompanied by distress, use the turbulence protocol (L3).

Phase 3 Swell & Peak Approx. 1.5–4 hrs · Most intense phase

The most intense phase of the experience. Perceptual, emotional, and cognitive effects are at their peak. This is when difficult material is most likely to surface — and when the facilitator's presence quality matters most.

Facilitator role: Steady, attuned, minimally interventional unless needed. Follow the participant's lead — some want silence, some want gentle contact, some want a hand. Environmental adjustments as needed (light, temperature, sound). If turbulence arises: presence first, then technique. All turbulence response protocols (L3) apply here.

The peak is not a crisis by default — it is intensity. A participant who is crying, moving, or making sounds during the peak is not necessarily in distress. Stay present, stay regulated, and let the experience move. Intervene when safety requires it, not when intensity is uncomfortable to witness.

Phase 4 Landing Approx. 4–6 hrs · Gradual return

Gradual return toward baseline. The participant may be processing, integrating, or simply resting. Emotional tenderness and openness are common. Cognition returns slowly — the landing phase requires patience.

Facilitator role: Maintain presence. Allow silence. Offer water, light food if the participant is ready. Gentle check-ins — "How are you doing right now?" Brief conversation if the participant initiates, but do not push toward verbal processing. The integration conversation belongs in M12, not in the landing phase of M11.

The temptation to begin integration conversation in the landing phase is strong — both the facilitator and the participant may want to make sense of what happened. Resist it. The material from peak is still settling. Premature verbal processing can fix or narrow what could have opened further with space.

Phase 5 Immediate Postcare & Session Close Following return to baseline · K.6

Session formally closes. Transportation is activated. The support person is contacted. The facilitator completes the session note and any required documentation before leaving the service center.

Facilitator role: Confirm the participant is stable and baseline has returned. Review the safety plan together — remind the participant of their threshold language and how to reach the facilitator. Activate transportation per the plan — do not allow the participant to drive. Contact the support person as agreed. Brief the support person on the participant's state. Session note is completed same day.

Transportation implementation (K.6) is a documentation requirement. Record that the transportation plan was followed and note who the participant left with. If something changed from the original plan, document what changed and why.

T2 Tool · T3 Version in Student Guide · Complete Before Every Session Room Staging Checklist — Pre-Session Environment Verification

Complete before the participant arrives. A checklist completed in the participant's presence is not a prepared environment — it is a reminder that preparation was deferred. Both facilitator and buddy-check partner sign.

Physical Environment

Location confirmed, access secured, privacy verified

Temperature comfortable and adjustable during session

Lighting adjusted per preparation plan — control accessible

Sound/music setup verified — silence or playlist per plan

Comfortable resting surface available (mat, blanket, pillow)

Bathroom access confirmed and path clear

Exit path unobstructed

Materials & Supplies

Natural medicine material — identity verified, visual inspection complete, no spoilage or contamination indicators

Nausea supplies ready (basin, cool cloth, water)

Water and light food available for landing phase

Participant's personal comfort items in place (per prep plan)

Documentation materials ready (session note, incident log)

Emergency contacts accessible (EAP protocol, nearest ER)

Documents & Protocols

Preparation plan reviewed — intention, special considerations

Safety plan accessible — threshold language reviewed

Support person contact confirmed and on standby

Transportation plan confirmed for session close

Service center supervisor/safety officer contact available

Facilitator Self-Check

I have eaten, hydrated, and rested appropriately

I am not managing significant personal stress today

My phone is set to Do Not Disturb (emergency contacts excepted)

I have reviewed this participant's preparation plan and intention

I have done a brief centering practice before the participant arrives

Facilitator

Signature Date Time

Buddy Check — Verified by

Signature Role

Exercise · 30 min · Room Staging Simulation

Stage and Buddy-Check a Session Space · Pairs

Students work in pairs to stage a session space using the room staging checklist for a provided participant scenario (specific sensory sensitivities from preparation plan). One student stages; one conducts the buddy check. Full checklist must be completed and signed before the debrief. Then roles reverse with a different scenario.

Round 1: Stage the space per scenario one's preparation plan and complete the checklist. 10 min
Buddy check — partner verifies and signs; identifies one item that was missed or done insufficiently. 5 min
Round 2: Switch roles, scenario two. 10 min + 5 min buddy check

Debrief · 5 min

Debrief Questions

What was missed in the first pass that the buddy check caught? What does that tell you about why the buddy check exists?

Which item on the facilitator self-check section felt most personally relevant? What would your actual morning-before-a-session preparation need to look like?

L1 Async Assignment — Due Before Lesson 2

Session arc study + material handling reflection: Using the session arc reference card, write a brief description of what you would do and what you would be monitoring for at each phase for your M10 practice participant specifically — based on what you know about their three-space picture. Where in the arc are you most uncertain about your role? What would you need to practice before a real session? Submit to portfolio.

Lesson 2 Presence, Attunement & Support Communication · 2.0 hr sync + 1.0 hr async

Lesson 2: Facilitator Presence, Attunement & Support Communication

3.0 hrs total · 2.0 hr sync / 1.0 hr async · Colorado NMTP K.3 · D.2 · iETA DISC Application

L2 addresses the facilitator's body, voice, and relational presence as clinical instruments. Supportive presence is not instinct — it is a learnable, practiceable set of behaviors with specific do's and don'ts. Attunement microscenarios give students concrete response options for the participant signals they are most likely to encounter. DISC communication insights are applied to the administration context specifically — this is where the M03 and M09 DISC work pays its highest dividend.

Sync Time 2.0 hours — warm-up (10 min) + lecture: presence + attunement (40 min) + presence demonstration (15 min) + attunement microscenario practice (35 min) + debrief (20 min)

Materials Presence/attunement quick reference · DISC session tool · Space arranged for body-based practice

Warm-Up · 10 min

Prompt "Think about a time someone's physical presence in the room made you feel safer — or less safe. What specifically was it? Their posture? Proximity? Where they were looking? How they were breathing?" Collect responses — students will name specific, embodied qualities. Use this to anchor the lecture: presence is not a concept. It is a set of observable, learnable behaviors that a participant in an altered state registers before conscious thought. The facilitator cannot control whether they have an effect — they can only choose what kind.

This warm-up needs to stay embodied. If students start talking abstractly about "holding space," redirect: "What specifically did they do with their body?" The lecture that follows depends on students having a concrete, sensory reference point for what presence actually means.

Lecture · 40 min

"A psilocybin participant in the peak phase has a radically altered perception of their environment. What is background noise in an ordinary state is foreground during the experience. The facilitator who is anxious communicates that anxiety. The facilitator who is bored communicates that. The facilitator who is genuinely present and regulated communicates safety — which is the single most important environmental condition during the experience. This lesson is about making that not accidental."

Supportive versus triggering presence (D.2): The facilitator's presence operates across five dimensions: posture, proximity, gaze, voice, and power dynamics. Each one has a supportive quality and a triggering quality. The supportive qualities — open posture, respectful distance, soft and attentive gaze, calm and unhurried voice, minimal hierarchical framing — create the conditions for the participant to feel safe enough to go where the experience takes them. The triggering qualities — contracted posture, hovering proximity, fixed or absent gaze, tense or directive voice, clinical authority framing — create a counter-current that the participant must manage in addition to the experience itself.

Power dynamics are worth explicit attention. The facilitator is in a position of authority — they hold the space, they know the arc, they have the emergency protocols. A participant in an altered state is acutely sensitive to power. The facilitator who uses that authority as reassurance ("I'm here, you're safe, I know what this is") supports the participant's sense of agency. The facilitator who deploys authority as management ("you need to breathe," "just relax," "try to stay calm") removes it.

"Give me a specific example of a facilitator behavior — not a general quality — that you think would be triggering during peak intensity. And one that would be supportive. Something specific enough that someone could see it and replicate it." Push for behavioral specificity throughout this lecture.

Attunement — reading and responding (K.3, D.2): Attunement is the facilitator's capacity to read what the participant is communicating — often nonverbally — and to respond in a way that meets them without directing them. It is not empathy (though empathy helps). It is a specific, observable skill: noticing what the participant's body is doing, checking in appropriately, and calibrating the facilitator's response to what is actually needed rather than what the facilitator assumes is needed. The attunement microscenarios that follow each present a specific participant signal and ask students to identify the appropriate response — and just as importantly, the inappropriate responses that might feel right but aren't.

Neutral observation (K.3): While the participant is in session, the facilitator maintains real-time awareness across physical, emotional, and behavioral domains. Physical: breathing, color, movement, posture changes. Emotional: facial expression, vocal quality, apparent affect. Behavioral: eye contact, body position, requests or withdrawal. What the facilitator observes shapes attunement decisions in real time — and becomes the material for the session note afterward. The standard is factual and non-interpretive: "participant showed elevated respiratory rate and visible tension in jaw and shoulders, lasting approximately 10 minutes" not "participant appeared anxious."

Team communication in low-noise environments (K.3): In sessions with a co-facilitator or where team communication is required, verbal communication in the room must be minimal and non-disruptive. Established hand signals or earpiece communication allows facilitators to coordinate without verbal exchange. Headcount and coverage protocols apply in multi-participant settings — each participant must have an assigned point of contact, and coverage must be maintained when a facilitator needs to step out. These protocols are introduced here and addressed comprehensively in M15 group facilitation.

DISC insights in the administration session: The M03 and M09 DISC work now applies in a new and higher-stakes context. A participant's communication style tendencies — how they signal distress, what they need when frightened, whether they want words or silence or touch — are shaped in part by their style. A D participant who becomes frustrated during the peak may pull toward resolution in a way that increases agitation rather than reducing it. An S participant who says "I'm fine" during the peak may need a more direct check-in than the S tendency to take at face value. These are not diagnoses — they are signals to watch for, calibrate to, and adjust based on what is actually observable in this person right now. DISC is a lens to hold lightly, not a protocol to apply mechanically.

Watch For

Managing vs. supporting: Students who are anxious about participant distress will manage rather than support. "Try to breathe," "just relax," "let it pass" are all managing responses — they place the facilitator's comfort above the participant's experience. "I'm here" and physical stillness are often more supportive than any words.
Presence as performance: Some students understand presence conceptually but perform it rather than embody it. Video feedback in the practice exercise will surface this. Name it without embarrassment — it is the most common gap in L2 and it closes with practice, not insight.
DISC as a checklist: Students who over-apply DISC will pre-decide how to respond to a participant based on their style profile rather than reading what is actually in front of them. Reinforce the distinction from M03 and M09: DISC is observational, not prescriptive.

T2 Tool · T3 Version in Student Guide · Reference During Session Supportive vs. Triggering Presence — Quick Reference

Supportive Presence

Posture: Open, relaxed, grounded — neither rigid nor collapsed. Oriented toward the participant without hovering
Proximity: Respectful distance unless touch contract is active — close enough to be present, not so close as to crowd
Gaze: Soft, available — not fixed, not scanning the room. Willing to make eye contact, willing to look away
Voice: Calm, unhurried, low. Minimal words. "I'm here" carries more than most sentences
Power dynamic: Authority as reassurance — "I know this space" — not authority as control
Internal state: Regulated, present, curious. Genuine interest in what the participant is experiencing

Triggering Presence

Posture: Tense, contracted, or slumped — anything that communicates anxiety or disengagement
Proximity: Hovering too close; or sitting too far removed as though managing from a distance
Gaze: Fixed stare (overwhelming); distracted scanning (abandonment); or avoided entirely (discomfort)
Voice: Tense, directive, rushed. Filling silence because silence is uncomfortable for the facilitator
Power dynamic: Authority as control — "you need to," "try to," "just" — removes participant agency
Internal state: Anxious, reactive, self-monitoring. The participant registers the facilitator's discomfort

Attunement Microscenarios — Participant Signals + Appropriate Responses

Withdrawal

Participant turns inward — eyes closed, body curled, minimal response to check-ins

Honor the inward turn. Reduce verbal check-ins. Maintain quiet presence. Check in gently and infrequently: "I'm here." Only intervene if withdrawal is accompanied by distress signals.

Scope: supportive presence and quiet monitoring. Not interpretation of the content.

Scanning

Eyes open, tracking the room, seeking visual anchors. May look to the facilitator repeatedly

Provide a calm, steady visual anchor. Gentle eye contact if welcomed. Brief grounding statement if needed: "You're in the room. I'm here with you." Keep your own body still and open.

Scope: orienting support. Do not interpret what they are scanning for.

Startle Response

Sudden physical startle, flinch, or sharp intake of breath — often in response to a sensory stimulus

Remain still and calm. Gently name the stimulus if it was identifiable: "That was a sound from outside." Offer grounding presence. Adjust environment if the stimulus is ongoing (sound, light).

Scope: environmental adjustment and grounding. Do not project fear or interpret the startle as crisis.

Seeking Verbal Connection

Participant opens eyes, turns toward facilitator, initiates speech or verbal check-in

Respond warmly and briefly. Reflect what they say without adding interpretation. "Yes. I'm here." If they are asking for direction, redirect gently toward their own knowing: "What does it feel like you need right now?"

Scope: responsive presence. Do not provide clinical interpretation or direct the content of the experience.

Distress — Unverified

Increased agitation, audible distress sounds, rapid breathing — cause and severity not yet clear

Move closer (if not already near). Ground yourself first — regulated presence before any words. Soft grounding statement: "I'm here. You're safe. This is part of the experience." If distress escalates or doesn't resolve within a few minutes, activate the turbulence protocol.

Scope: presence and grounding. Do not diagnose, label, or claim to know what is happening internally.

Touch Request

Participant reaches toward facilitator, requests physical contact, or non-verbally signals desire for touch

Refer to the Touch Contract from M06. If touch was pre-authorized in the preparation plan, offer it as agreed. If not: "I'm close by. I'm right here." Do not initiate touch beyond what was agreed regardless of the participant's state.

Scope: strictly per Touch Contract. No contact beyond what was established in preparation. In-session modifications require explicit verbal consent when the participant is coherent.

T2 Tool · T3 Version in Student Guide · Activates M03 + M09 DISC Work · OSCE Bonus DISC Insights in the Administration Session — One Do · One Don't Per Style

These are session-specific extensions of the DISC attunement work from M03 and M09. They describe what to watch for and how to adjust communication in real time. DISC is observational — these are signals to watch for, not profiles to pre-apply. The OSCE Station A bonus applies when the candidate explicitly names a style-appropriate communication adjustment and states the rationale.

D — Dominance

Session signal: May resist intensity — trying to "get through" or "do" the experience rather than moving with it
Do: Brief, direct acknowledgments — "You're in it. Stay with it." Validate the intensity without pathologizing it
Don't: Give extended reassurance or narrative explanations — D energy under pressure wants efficiency, not comfort talks that feel like stalling

I — Influence

Session signal: May seek verbal connection frequently — turning the session into a conversation rather than an inward journey
Do: Honor the relational warmth briefly, then redirect toward inner experience: "Yes — and what's happening inside right now?"
Don't: Get pulled into extended verbal exchange that keeps the participant at the surface. Match warmth briefly, then go quiet

S — Steadiness

Session signal: May minimize distress — saying "I'm fine" when physically or emotionally tense
Do: More frequent gentle check-ins — "How's your body feeling right now?" creates an opening beyond "fine." Trust your physical observations over their verbal reports
Don't: Accept "I'm fine" at face value during peak intensity. S participants protect the facilitator from concern — monitor their physiology

C — Conscientiousness

Session signal: May try to analyze the experience in real time — intellectualizing as a way of managing altered perception
Do: Brief orienting statement that acknowledges the analytical impulse without feeding it: "Your mind is working hard. Let it settle — you can make sense of it later"
Don't: Engage with the analytical questions during the session. This pulls the participant further from inward experience

Reminder: DISC is one lens among many. Session behavior is shaped by the experience itself, the participant's history, their current emotional state, and what arises — not just their communication style. Hold DISC lightly. Set it down the moment this specific person needs you to see them more clearly than any framework allows.

Demonstration + Exercise · 50 min

Instructor Models Demonstrate a 5-minute window of supportive presence with a volunteer student as "participant" in a simulated landing phase. Use: open posture, appropriate proximity, soft check-in, one-phrase grounding response. Then demonstrate the same scenario with triggering presence — and ask students to name what specifically they observed that created the different effect. The contrast demonstration is essential. Students can understand the difference conceptually but need to see it embodied to practice it. The debrief after the triggering demonstration almost always surfaces observations that students are surprised they can see — this is the point.

Attunement Microscenario Practice — Triads · 30 min

Triads: facilitator, participant, observer. The participant receives a microscenario card (from the six scenarios above) and expresses the signal. The facilitator responds. The observer notes: Was the response supportive or managing? Did it use words when silence would serve better? Was there a DISC consideration that applied? Rotate roles and scenario cards. Full group debrief focuses on the most commonly missed scenario (touch request — most students under-apply the Touch Contract).

Round 1 — facilitator responds to assigned microscenario. 5 min + 3 min observer debrief
Round 2 — switch roles and scenario. 5 min + 3 min
Round 3 — all to touch request scenario. 5 min + 4 min full group debrief

Debrief · 20 min

Debrief Questions

What was the hardest microscenario to respond to — and is your difficulty with the response or with tolerating the participant's signal?

In the touch request scenario — what made it hard to stay within the Touch Contract? What would you need in place before the session to make that easier?

Look at the triggering presence demonstration. Which of those behaviors do you think you're most likely to do without noticing? What's the specific situation that would trigger it?

Did your DISC style come up during the microscenario practice? What did you notice?

L2 Async Assignment — Due Before Lesson 3

DISC session do/don't (portfolio artifact): Write your personalized do/don't table for the administration session — one specific do and one specific don't for each of the four DISC participant styles based on the session context. Be behavioral and specific — not general principles but things someone could observe. Then write 100 words on the DISC style combination between you and your M10 practice participant that you find most challenging to navigate during intensity, and what you'll do about it. Submit to portfolio.

Lesson 3 Turbulence Response, De-escalation & Emergency Action Plan · 3.0 hr sync + 1.0 hr async

Lesson 3: Turbulence Response, De-escalation & Emergency Action Plan

4.0 hrs total · 3.0 hr sync / 1.0 hr async · Colorado NMTP K.3 · K.4 · D.8 · Builds on M04

L3 is the highest-stakes lesson in M11. It addresses five turbulence presentation types within scope, establishes the escalation thresholds for Safety Officer and Emergency Action Plan, walks through EAP activation steps and handoff procedures, and covers stabilization and documentation. Scope discipline is critical throughout — the facilitator contains, supports, and routes. They do not assess, diagnose, or provide clinical intervention. M04 is the foundation; confirm that foundation is consolidated before this lesson.

Sync Time 3.0 hours — warm-up (10 min) + lecture: turbulence types + escalation thresholds (50 min) + turbulence simulation (50 min) + EAP activation drill (40 min) + debrief (30 min)

Materials Turbulence response protocol · EAP protocol · Scenario cards (5 types, 2 versions each) · Simulated phone for handoff drill

Warm-Up · 10 min

Prompt "You're in the peak phase with a participant. They start crying — loudly. Their body is tense. What do you do first, second, and third? Don't overthink it — what is your actual first instinct?" Collect responses. Most students will instinctively want to do something — ask questions, offer comfort, adjust the environment. This is natural and usually not wrong — but it surfaces the most common L3 error: acting before being present. The answer to "what do you do first" is almost always "be still, be present, and assess what this actually is." Use this to frame the turbulence protocol: presence first, assessment second, technique third.

This warm-up is diagnostic — it tells you which students default to action (management) and which can tolerate not acting immediately. Both can be coached, but they need different feedback. Note it.

Lecture · 50 min

"Turbulence is not failure. It is a normal feature of intensive psilocybin experiences. The facilitator's job is not to prevent turbulence — it is to be prepared for it, to recognize what type of turbulence this is, to respond within their scope, and to escalate appropriately when the presentation exceeds their scope. Intensity is not a crisis. Distress is not danger. The protocol is designed to help you tell the difference — and to act accordingly."

The core turbulence principle: Presence first, assessment second, technique third. Every turbulence response begins with the facilitator's own regulated presence — because a dysregulated facilitator cannot help a dysregulated participant. The facilitator who immediately reaches for a technique has skipped the most important step. A still, grounded, present facilitator is itself a co-regulation resource.

Scope framing: The facilitator's role in turbulence is to contain, support, and route. They do not assess the clinical severity of what they are observing — they describe what they see factually. They do not diagnose what is happening — they recognize patterns that indicate escalation is required. They do not provide clinical intervention — they use presence, grounding, and de-escalation techniques within their training, and they activate the Safety Officer or EAP when those are insufficient. Every technique in the turbulence protocol is designed to support the participant's own resources — not to override the experience.

"What is the difference between 'the participant appears to be having a psychotic episode' and 'the participant is unresponsive to verbal contact, has been speaking incoherently for 45 minutes, and shows no signs of recognition'? Why does that distinction matter?" Clinical interpretation vs. factual observation. This is the scope line in turbulence documentation.

Watch For — L3

Premature escalation: Students who are anxious will want to call the Safety Officer or activate the EAP at the first sign of intensity. The protocol thresholds exist precisely because intensity ≠ emergency. Know the thresholds and teach them explicitly.
Delayed escalation: The opposite problem — students who don't want to escalate because it feels like failure. If the threshold is met, the facilitator escalates. Full stop. Hesitation here is a safety failure.
Clinical language in documentation: After a turbulence event, students will write "participant appeared to be dissociating" or "participant showed signs of psychosis." These are clinical interpretations. The session note uses factual behavioral descriptions only.

T2 Tool · T3 Version in Student Guide · Presence First · Assessment Second · Technique Third Turbulence Response Protocol — Five Presentation Types

All turbulence responses begin the same way: be still, be present, assess what this actually is. The specific technique follows the assessment — not the first instinct. Scope applies throughout: contain, support, route. Not assess, diagnose, or clinically intervene.

Type 1 Anxiety Spike

Rapid breathing, visible tension, verbal expressions of fear or overwhelm, eyes wide or scanning. Often occurs in onset or early peak. The experience is escalating faster than the participant feels ready for.

Become still and present — ground yourself first
Move closer (within agreed proximity) without hovering
Soft grounding statement: "I'm here. You're safe. This is the experience." Brief and unhurried
Invite breath: "Let's breathe together." Model slow, visible breathing without directing the participant
If the participant is lying down: a steady hand on the arm (if Touch Contract allows) can reduce physiological anxiety
If it doesn't resolve within 5–10 min or escalates to agitation: move to Type 2 protocol

Scope: grounding presence and co-regulation. Do not tell the participant what the anxiety means or what they are afraid of.

Type 2 Agitation

Physical restlessness, inability to remain still, raised voice, resistance to the environment. May accompany or follow an anxiety spike. Agitation is more physically active and requires more environmental management than anxiety.

Remain calm and grounded — match the physical level without escalating it
Create more space — agitation often responds to increased room, not decreased
Offer simple, direct options: "Do you want to sit up? Do you want to walk?" Choice restores agency
Environmental adjustment if relevant: reduce sound, adjust light
If the participant moves toward leaving the space: gently offer redirection — "Let's stay together. I'm right here." Do not restrain
If agitation includes verbal expressions of self-harm or incoherence that doesn't resolve: Safety Officer threshold met — escalate

Scope: presence, space, and choice. Physical restraint is never in scope. If verbal de-escalation and environmental adjustment are insufficient, escalate.

Type 3 Nausea / Vomiting

Common, especially in onset. Not a crisis. Has practical management requirements that must be handled calmly and without conveying alarm.

Have supplies within reach before the session (basin, cool cloth, water) — preparation prevents scrambling
Move calmly — do not rush or express alarm. Nausea often resolves within 30–60 min
Support the participant's physical comfort: help them sit or position appropriately, offer the basin
Cool cloth to the face and back of neck if welcomed
Water available after nausea passes
If vomiting is severe, prolonged, or accompanied by signs of medical distress: EAP threshold — escalate

Scope: physical comfort support. Do not frame nausea as negative or alarming — it is normal. Do not administer any anti-nausea medication without explicit service center protocol authorization.

Type 4 Dissociation

Participant appears absent, unresponsive to verbal contact, glassy-eyed, or reports feeling disconnected from their body or surroundings. Distinguished from inward focus by unresponsiveness — a participant in inward focus will respond when called; a dissociating participant may not.

Do not attempt to pull the participant back verbally — sudden re-entry can increase distress
Gently reduce environmental stimulation: lower sound, steady light
Soft grounding contact if Touch Contract allows — a hand on the arm or back can anchor physical awareness
Calm, simple orienting language at low volume: "I'm here. You're in the room. Feel the ground."
If the participant does not respond to orienting attempts within several minutes or shows signs of medical distress: Safety Officer threshold — escalate

Scope: grounding and orienting. Do not diagnose. Document factually: "Participant was unresponsive to verbal contact for approximately X minutes; responded to grounding touch at [time]."

Type 5 Retraumatization Cues

Trauma material arising during the session — not inherently a crisis, but requiring careful and scope-appropriate facilitation. Characterized by: participant reports or shows characteristics of reliving a past experience (as opposed to observing it), intense emotional flooding, freeze response, or trauma-specific physical responses (bracing, flinching, gasping). Connects directly to M04 trauma-informed care foundations.

Remain present and regulated — do not pull back in response to the intensity
Do not redirect or try to move the participant away from the material — this can compound the trauma response
Grounding, not containment: "I'm here. You're safe in this room. This is the experience." Orient to the present without dismissing the past that is arising
Follow the participant's lead on what they need — some want silence, some want contact, some want to speak
If the participant becomes acutely unsafe — suicidal statements with specificity, inability to be grounded, or medical emergency presentations: EAP threshold — escalate immediately

Scope: present-moment grounding and support. Not processing the trauma — that is M12 Integration territory and requires therapeutic training. The facilitator holds the space while the material moves through; they do not direct or interpret what arises.

T2 Tool · T3 Version in Student Guide · Know This Cold · Know the Thresholds Emergency Action Plan — Escalation Thresholds + Activation Steps

The EAP exists because some situations exceed the facilitator's scope. Knowing the thresholds — exactly — is what allows the facilitator to act decisively when they are met rather than hesitating. Uncertainty at the escalation point is a safety failure.

Safety Officer Threshold — Escalate to Service Center Supervisor

Any of the following: sustained verbal expression of self-harm ideation (not fleeting) · agitation that does not respond to facilitator intervention and involves potential for physical harm · dissociation unresponsive to grounding for more than 5–10 minutes · unexpected disclosure of severe trauma history that appears to destabilize the participant beyond facilitator scope · facilitator significant uncertainty about participant safety

Contact service center safety officer immediately. Do not leave the participant alone. Continue monitoring and supportive presence while awaiting guidance.

Emergency Action Plan Activation — Call 911 / Emergency Services

Any of the following: suicidal ideation with plan or means expressed and immediate (M05 protocol activates) · active psychosis unresponsive to grounding and de-escalation · medical emergency — chest pain, difficulty breathing, loss of consciousness, seizure · participant becomes a danger to themselves or others in a way that cannot be contained · any situation where the facilitator's honest assessment is "I cannot ensure this person's safety without emergency services"

Call 911. Activate M05 suicide risk protocol if applicable. Do not leave the participant. Contact service center supervisor. Document time of decision and activation.

EAP Activation Sequence — Memorize

Remain with the participant — do not leave
Call emergency services if medical emergency or imminent danger (911)
Notify service center safety officer or supervisor immediately
Activate participant's emergency contact per safety plan if appropriate
Implement M05 protocol if suicidal ideation with plan is present
Document time, trigger, and actions taken — factually, not interpretively
Support participant until handoff to emergency responders or safety officer is complete
Complete incident report same day — before leaving the service center

Handoff Communication — What to Say When You Call

"This is [name], a certified natural medicine facilitator at [service center name and address]. I have a participant who has ingested psilocybin mushrooms approximately [X] hours ago. They are currently [factual behavioral description — not clinical diagnosis]. I need [what you need: emergency medical services / behavioral health response]."

Give the address clearly and stay on the line. Do not use clinical diagnostic language. Describe behavior factually. Name the substance.

Exercises · 90 min

Turbulence Simulation · Pairs + Full Group Debrief · 50 min

Pairs receive scenario cards (one per pair, rotated). Facilitator receives only the scenario label (not the behavior). Participant performs the scenario. Facilitator responds using the turbulence protocol — presence first, assessment, technique. Observer notes: did the facilitator ground themselves before acting? What technique was chosen? Was it in scope? Full group debrief focuses on the most instructive moments from each pair.

Pairs simulate assigned turbulence scenario. 8 min
Observer debrief within triad. 5 min
Full group — three pairs share: one thing they did well, one thing they would change. 15 min

EAP Activation Drill · Full Group · 40 min

Two scenarios — one Safety Officer escalation, one 911 activation. Students work through the activation sequence from memory (no notes). One student plays the facilitator on the phone; instructor plays the 911 dispatcher. Debrief: was the threshold correctly identified? Was the language factual? Did the student stay with the participant while making the call? Was the handoff communication complete?

Scenario 1: Safety Officer escalation — identify threshold, activate, document. 15 min
Scenario 2: 911 activation — handoff language drill with simulated dispatcher. 15 min
Group debrief on both scenarios. 10 min

Debrief · 30 min

Debrief Questions

In the turbulence simulation — what was your first instinct, and how did it compare to "presence first"? What would have happened if you'd followed the instinct?

In the EAP drill — what was the hardest part of the handoff language? What made it difficult to describe behavior factually instead of diagnostically under pressure?

Which turbulence type are you least confident about — and specifically, is your uncertainty about recognizing it, responding to it, or knowing when to escalate?

Retraumatization cues (Type 5) — what is the line between staying with the material and directing the material? What would crossing that line look like?

L3 Async Assignment — Due Before Lesson 4

Turbulence protocol consolidation: Without looking at your notes, write the activation sequence for both the Safety Officer threshold and the EAP. Then write the factual observation language for each of the five turbulence types — what you would actually document, not what you would interpret. Compare to the protocol when done. Identify your gaps and address them before the OSCE window.

Lesson 4 Documentation & Session Close · 2.5 hr sync + 0.5 hr async

Lesson 4: Documentation & Session Close

3.0 hrs total · 2.5 hr sync / 0.5 hr async · Colorado NMTP K.5 · K.6 · iETA-K

L4 closes the administration module. Session documentation — the factual session note, incident reports, and headcount logs — is both a clinical and a legal obligation. The standard is consistent: factual, non-interpretive, completed same day. Session close includes the transportation implementation and the immediate postcare handoff. L4 also serves as the bridge to M12 Integration — what the facilitator documents here becomes the foundation for the integration conversation.

Sync Time 2.5 hours — warm-up (10 min) + lecture: documentation standards (40 min) + session note drafting exercise (50 min) + session close roleplay (30 min) + debrief (20 min)

Materials Session note template · Incident report form (service center format) · Session close roleplay scenario cards

Warm-Up · 10 min

Prompt "You've just finished a session that had a 20-minute turbulence episode in the peak phase. The participant is now in the landing phase, calm and present. You sit down to write the session note. What are you tempted to write — and what should you actually write?" Collect responses. Most students will offer interpretive language in their "tempted to write" answers — "they seemed to be processing grief," "the episode appeared to be anxiety-related." The contrast with factual documentation is the entire point of L4. Use the warm-up responses directly as documentation examples to analyze and revise.

Lecture · 40 min

"Documentation is not a summary of what you experienced. It is a factual record of what you observed — what the participant did, what you did, and what happened. If you write 'the participant appeared anxious,' you have written your interpretation. If you write 'the participant's breathing was rapid and audible, their hands were visibly trembling, and they verbalized "I'm scared"' — you have written the facts. The first is the facilitator's psychology. The second is the record."

The documentation standard (iETA-K): Session documentation has three defining characteristics: it is factual (describes observable behavior, not interpretation), it is scope-compliant (does not include clinical diagnoses, assessments, or treatment language), and it is completed same day (before the facilitator leaves the service center). These are not stylistic preferences — they are legal and ethical requirements. A session note completed three days later from memory is not a session note. It is a reconstruction.

The session note serves multiple purposes beyond legal compliance: it is the source document for the integration conversation in M12, it is the record in the event of a regulatory audit or adverse event, and it is the professional accounting of what the facilitator did and why. A sparse or vague session note does not protect the facilitator — it removes the record of responsible practice.

What goes in a session note: Session details (date, start/end time, location, amount administered); participant observation across the session arc (arrival state, onset, peak, landing — factual behavioral description); any notable events (turbulence episodes — described factually, not diagnostically; secondary dose if administered — what, when, why per service center protocol); facilitator actions taken; session close details (when baseline returned, transportation implementation, who participant left with, support person contacted). The session note does not include: clinical interpretation of participant behavior; speculative statements about what the participant was experiencing internally; facilitator personal reflections on the experience.

Reportable events and notification (K.6): Colorado NMTP requires notification of certain adverse events. Facilitators must know their service center's reportable event definitions and notification procedures. General categories: adverse medical events; any EAP activation; significant participant safety concerns; and any departure from service center protocol. Notification procedures vary by service center and are covered in service-center-specific training — M11 establishes the obligation and the documentation requirements; service center onboarding specifies the procedures.

Multi-participant session logs (K.6): In group sessions, documentation requirements expand to include headcount logs (tracking participant presence and coverage throughout), incident logs by participant, and any co-facilitator documentation division. These are addressed in the context of group facilitation fundamentals here and comprehensively in M15.

Session close and transportation (K.6): The session formally closes when the facilitator has confirmed the participant has returned to baseline, implemented the transportation plan, briefed the support person on the participant's current state, and reminded the participant of their threshold language and facilitator contact. The transportation implementation is documented in the session note — who the participant left with, time of departure, confirmation that participant was not driving.

Watch For

Interpretive language in session notes: "Appeared to," "seemed to," "looked like" — these are interpretation phrases. Redirect to behavioral description every time: what specifically did you see that led to that interpretation? Write that instead.
Incomplete session close: Students often complete documentation but skip the explicit support person call or the reminder to the participant of their threshold language. Both are required and documented. The session close is not complete until the participant has left with a known, briefed support person.
Delayed documentation: "I'll do it when I get home" is a pattern that must be interrupted. Same-day, before leaving the service center, is the standard. This is both a professional norm and a legal protection.

T2 Tool · T3 Version in Student Guide · Portfolio Artifact · Complete Same Day · Before Leaving Service Center Session Note Template — Factual · Scope-Compliant · Same-Day

Write what you observed — not what you interpreted. Every entry should pass this test: could a third party observe this and verify it? If the answer is no, rewrite it as behavioral description.

Session Details

Date: _______________ · Start time: _______________ · End time: _______________

Location / Service Center: ____________________________________________

Facilitator name and certification: _____________________________________

Participant ID (per service center protocol): ____________________________

Natural medicine: Psilocybin · Amount administered: __________ · Time of administration: __________

Secondary amount (if applicable): __________ · Time: __________ · Reason (per service center protocol): __________

Session Arc — Factual Behavioral Observation

Arrival / Grounding: Participant arrival state, pre-brief outcome, final consent affirmation

Onset (time range, behavioral observations):

Peak (time range, behavioral observations, any notable events):

Landing (time range, behavioral observations, return to baseline):

Notable Events (if applicable)

Turbulence episode(s) — type, time, factual description, facilitator response, outcome:

Safety Officer contacted: No ☐ Yes ☐ · Time: _______________ · Reason (factual): _______________

EAP activated: No ☐ Yes ☐ · Time: _______________ · Incident report attached: ☐

Documentation standard: describe behavior factually. "Participant's breathing was rapid, hands were trembling, participant stated 'I'm scared'" — not "participant appeared anxious." Clinical language is never used in session notes.

Session Close

Baseline confirmed returned: Yes ☐ · Time: _______________

Safety plan reviewed with participant: Yes ☐ · Participant has copy: Yes ☐

Support person contacted: Yes ☐ · Name: _______________ · Time: _______________

Transportation implementation: participant left with _________________ at _______________ (not self-driving confirmed)

Any participant reportable event to note: No ☐ Yes ☐ — see incident report

Facilitator Attestation

I attest that the above documentation is a factual, accurate, and complete record of the session completed on the above date, completed before leaving the service center.

Facilitator signature Date Time completed

Exercises · 80 min

Session Note Drafting · Individual + Peer Review · 50 min

Each student receives a session scenario (written vignette — includes peak turbulence episode and secondary dose administration). Students draft a complete session note using the template. Peer pairs then exchange notes and identify: any clinical or interpretive language that should be rewritten, any required elements that are missing, and any documentation that could not be verified by a third party. Return with written feedback.

Individual session note drafting from scenario. 20 min
Peer review — identify language violations and missing elements. 15 min
Revision based on peer feedback. 10 min
Full group: one interpretive phrase that multiple students wrote — and its factual rewrite. 5 min

Session Close Roleplay · Pairs · 30 min

Using their M10 practice participant profile, pairs conduct the session close sequence: (1) confirm baseline return, (2) review safety plan with participant, (3) call the support person and brief them on participant state, (4) confirm transportation, (5) note the close in the session note. Debrief on completeness and tone — the session close should feel genuine, not procedural.

Facilitator conducts session close sequence with participant and support person call. 12 min
Partner debrief — was every required element present? Did it feel like genuine care or checklist? 5 min
Switch roles. 13 min

Debrief · 20 min

Debrief Questions

Look at your session note before and after peer review. How many phrases did you have to rewrite from interpretive to factual? What made factual language hard in those moments?

The session close is the last thing that happens in M11 and the first thing that activates M12. What did you say in the session close that the participant would most need to hear going into the integration period?

Documentation is a legal protection as much as a clinical record. What would your session note communicate to a licensing inspector who reviewed it tomorrow?

L4 Async Assignment — Due Before OSCE Window

Session note revision (portfolio artifact): Revise your session note draft from the exercise incorporating all peer feedback. The final version should contain no interpretive language, no missing elements, and should read as though completed same-day in a real session. Submit to portfolio. Review the OSCE Station descriptions in your Student Guide before your assessment window. OSCE Station B requires a written note — practice this under time pressure.

Full OSCE Two 10-minute stations · Assessor copy — not for distribution

M11 OSCE — Station A + Station B

Two 10-minute performance stations · 4 domains × 25 pts per station · Cut score: 70 overall / min 15 per domain · One retake per station

Station A — Mid-Swell Turbulence Vignette

Scenario Brief — Candidate Copy

Scenario: Candidate is facilitating a participant approximately 90 minutes post-ingestion (mid-swell phase). The participant begins showing signs of increased agitation — they are no longer lying down, have moved to sitting, are breathing rapidly, and verbalize "I need to get out of here." The candidate has 10 minutes to respond.

At 5 minutes: The assessor introduces a complicating disclosure — the participant says "I didn't tell you before, but my mom died two months ago and this is all coming up."

Candidate instruction: Respond to this participant from the moment the agitation begins. Use your turbulence protocol. Presence first. Assessment second. Technique third. At no point leave the participant or make a phone call during the station — this scenario does not reach EAP threshold unless the candidate escalates prematurely.

Domain	Exemplary (23–25)	Meets Standard (17–22)	Below Standard (0–16)
1 · Presence First Grounded before acting · Not managing	Candidate is visibly still and grounded before responding. Does not immediately reach for a technique. Their own regulated presence is the first intervention.	Candidate grounds reasonably but moves to verbal response quickly. Some tension visible but manageable. Presence is present, not absent.	Candidate immediately begins managing — verbal directions ("try to breathe," "just relax") without grounding themselves first. Presence is reactive.
2 · Technique + Scope Correct turbulence type · In scope · No clinical framing	Correct identification of agitation (Type 2) with appropriate response — space, options, environmental adjustment. Retraumatization cues (Type 5) recognized and held appropriately after the disclosure. No clinical framing throughout.	Agitation recognized but response may mix Type 1 and Type 2 approaches. Disclosure handled with presence but without clearly distinct Type 5 approach. Minor scope slips self-corrected.	Incorrect turbulence type identification or inappropriate technique. Disclosure handled as a clinical presentation — interpretive language, redirection of content, or evident discomfort with material. Scope violations present.
3 · Escalation Judgment Threshold correctly identified · Not premature · Not delayed	Candidate correctly does not escalate (this scenario doesn't reach threshold). Demonstrates awareness of what would trigger escalation if asked. Does not prematurely call Safety Officer.	Some uncertainty visible about escalation threshold. May briefly consider escalation but correctly decides against it. Can articulate threshold when asked.	Premature escalation (calls Safety Officer before threshold is met) or significant confusion about what would constitute an EAP trigger in this scenario.
4 · Communication Quality Minimal · Non-directive · Non-interpretive · Participant agency maintained	Language is minimal, grounding, and non-directive. "I'm here. You're in the room. This is the experience." Participant agency maintained throughout. No interpretive statements about what the participant is experiencing.	Language is mostly appropriate with 1–2 directive or interpretive statements ("you seem to be processing something difficult" or "try to breathe through it"). Generally non-managing.	Multiple directive or managing statements. Clinical interpretation language present ("this appears to be a trauma response," "you're dissociating"). Participant's agency undermined by facilitator's framing.
Station A Total

DISC Distinction — Optional +5% Bonus · Applies to Station A

The candidate explicitly identifies a style-appropriate communication adjustment based on observable DISC signals from the participant during the scenario, and states the rationale. Example: "I kept my responses brief and direct because this participant was showing D-style resistance to the experience — I didn't want extended verbal engagement to amplify the agitation." The adjustment must be grounded in observable behavior, not profile assumption. Bonus is not required to pass — it rewards explicit, articulable DISC application.

Station B — EAP Activation with Handoff Call and Note

Scenario Brief — Candidate Copy

Scenario: Candidate has been facilitating a participant for 4 hours. The participant has been increasingly agitated for the past 30 minutes. In the last 5 minutes, the participant has made two statements referencing self-harm: "I just want this to stop, I'd rather not be here" and then, more specifically, "I keep thinking about the pills in my bathroom." The participant is physically present and responsive but clearly distressed.

Candidate instruction: This scenario has crossed the EAP threshold. Activate the EAP. You have access to a simulated phone. An assessor will play the 911 dispatcher. After the call, you will have 3 minutes to complete the incident documentation section of a session note. You may use the EAP protocol card during this station.

Domain	Exemplary (23–25)	Meets Standard (17–22)	Below Standard (0–16)
1 · Threshold Identification Correct threshold · M05 protocol activated	Candidate correctly identifies EAP threshold (suicidal ideation with specificity — the pills reference constitutes a plan element). Activates M05 protocol. Calls 911. Does not leave the participant.	Threshold correctly identified but activation sequence has 1–2 gaps (e.g., Safety Officer notified before 911, or M05 not explicitly named). Participant not left alone.	Threshold not correctly identified — candidate either escalates to Safety Officer only (insufficient) or hesitates to activate EAP. Participant left alone at any point.
2 · Handoff Communication Name + address + substance + factual description + needs stated	Call includes: name and credential, service center name and address, substance and approximate time of ingestion, factual behavioral description (no clinical framing), what is needed. Stays on line. Calm and clear.	Core information present but one element missing or unclear (e.g., address not stated clearly, or diagnostic language used once). Generally coherent communication under pressure.	Missing critical information (address, substance, or what is needed). Clinical framing throughout ("patient is experiencing suicidal ideation"). Caller does not stay on line.
3 · Continued Participant Support Never left alone · Presence maintained · Safety plan active	Candidate maintains presence with the participant throughout the call — does not leave the space, remains grounded, continues soft verbal contact with participant while on phone. Safety plan is referenced for emergency contact.	Candidate stays in proximity but may physically turn away from participant during call or reduce visible presence. Safety plan not explicitly referenced but participant not left.	Candidate leaves the participant to make the call. Or: presence quality deteriorates to the point where the participant is effectively alone despite physical presence.
4 · Documentation Factual · Specific · Time-stamped · No clinical framing	Incident documentation section uses factual behavioral language ("participant stated [exact quote]" not "patient appeared suicidal"), is time-stamped, includes facilitator actions, and is complete within the time window. Professional and legally defensible.	Documentation is mostly factual with 1–2 interpretive phrases. Time-stamps present. Generally complete. Some elements missing or vague.	Documentation uses clinical framing throughout, lacks time-stamps, or is so incomplete as to not constitute a usable record. Missing the exact participant quotes that constitute the threshold evidence.
Station B Total

Alternate OSCE Scenarios — For Retake Use

Station A Alternate

Scenario: Candidate is facilitating a participant approximately 2.5 hours in (peak). The participant has been in deep inward experience, mostly silent, for 45 minutes. Suddenly they open their eyes, sit up, and say "Something is wrong. I can't feel my body." They look at their hands with evident confusion and distress.

Key test: Correct identification as dissociation (Type 4), not agitation. Appropriate orienting response. At minute 7, introduce: "The participant begins trying to stand up and walk toward the door." Tests whether the candidate can maintain the dissociation protocol vs. shift to agitation protocol without escalating to EAP (this scenario does not reach EAP threshold).

Station B Alternate

Scenario: Candidate has been facilitating for 3.5 hours. During peak, participant disclosed childhood sexual trauma in detail. The participant is now in early landing, calmer, but has said: "I don't want to go home. I don't want to see my husband. He reminds me of the person who hurt me." The candidate must conduct the session close — including implementing the transportation plan (the husband was the named support person) — appropriately. This tests: does the candidate recognize the safety concern, does the candidate problem-solve the support person situation (contact service center supervisor for guidance), and does the candidate document the situation accurately without clinical framing.

Remediation Protocol

For Candidates Below Cut Score

Written domain-specific feedback from assessor delivered within 48 hours
Domain-targeted coaching: Station A Domain 1 (presence) — body-based practice session; Station A Domain 3 (escalation) — threshold review + drill; Station B Domain 2 (handoff) — phone communication drill; Station B Domain 4 (documentation) — factual language rewrite exercise
One retake per station using the alternate scenario within the M11 assessment window
Candidates who do not pass Station A retake may not begin M12 (Integration) until a remediation plan approved by the program director is completed
All OSCE attempts must be documented with assessor rubrics retained in the student's program file

Bridge to Module 12

M11 closes with the participant in the care of their support person, safety plan active, threshold language fresh. Module 12 — Integration is where everything that arose in the session gets to settle, be explored, and become meaningful. The integration conversation is participant-led, non-directive, and facilitated with the same scope discipline that has governed every module from M08 forward. The session note from M11 is the starting point. What the facilitator observed during the arc — what arose, what the participant named, what seemed significant — informs how they hold the integration space. Bring your M11 documentation to M12.

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Module 11 - Instructor Guide

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