Module 12 - Instructor Guide

Why the 0–72 hr window matters: Psilocybin sessions can surface significant material — grief, trauma, relational pain, existential questions — that the participant is still metabolizing in the days after the session. During this window, the participant may feel raw, tender, disoriented, or expansively open. They may also feel destabilized in ways that weren't apparent immediately after the session. Sleep disruption, heightened emotional sensitivity, and difficulty in ordinary social interactions are common. This is not pathology — it is the experience continuing to process. The facilitator's role is to provide a structured check-in that normalizes what is happening, provides practical guidance, and clearly establishes the contact thresholds for when to reach out.

The 24-hour check-in: A brief, warm contact — call or message per the communication protocol agreed in M10. Not a clinical assessment, not a processing conversation. A genuine check-in: "How are you right now? How did you sleep? Is anything feeling urgent?" Three questions that give the facilitator real information without opening a clinical conversation the participant may not be ready for and that the facilitator is not trained to conduct. The participant's responses inform whether the follow-up plan needs adjustment or whether any of the safety plan thresholds are approaching.

Practical guidance for the 0–72 hr period: The facilitator can offer evidence-informed practical guidance as part of the follow-up plan — not as clinical recommendations but as general practices that support integration. Sleep: the brain continues consolidating experience during sleep; protecting sleep quality in the 72 hours following the session is meaningful. Nutrition and hydration: the body has been through an intensive physiological event; adequate hydration and regular nutrition support recovery. Gentle movement: walking, gentle stretching — not high-intensity exercise that may be dysregulating. Limiting screens and social media: high-stimulation environments can be jarring when the nervous system is still sensitive. Journaling: low-pressure, unstructured — not analysis but noticing. Reduced alcohol and cannabis: substances that alter consciousness during integration can interfere with the natural processing underway.

These are general guidance the facilitator offers — not prescriptions. The participant makes their own choices. The facilitator frames each one: "some people find it helpful to..." and "many people notice that..." Language from M10 applies here too.

Support person brief update: After the 24-hour check-in, the facilitator contacts the support person briefly — how is the participant doing? Is the support person noticing anything that feels concerning? Does the support person have any questions? This is a short contact (5–10 min) that closes the loop opened in the M10 support person briefing and gives the facilitator a second data point on the participant's status.

Post-session note and follow-up plan: The post-session note is a brief documentation of the check-in — how the participant reported doing, any notable responses, and what the follow-up plan looks like. This complements the M11 session note and is completed within 24 hours of the check-in. The follow-up plan sets the schedule for integration sessions, the agreed contact threshold, and any referrals or resources identified.

What integration is: Integration is a structured, participant-led process of making meaning from the experience — incorporating insights into daily life, adjusting patterns and relationships in response to what arose, and connecting the experience to the participant's broader life context and intention. The facilitator provides structure (the integration session format), questions (open, non-directive, meaning-inviting), and presence (regulated, curious, non-interpretive). The participant provides the meaning.

What integration is not (L.4): Integration is not therapy, counseling, clinical interpretation, trauma treatment, or psychological assessment. The facilitator does not diagnose what the participant experienced, interpret the symbolic content of what arose, prescribe a meaning for the experience, or provide clinical treatment for what emerged. When clinical material arises in integration — and it will — the facilitator's role is to hold the space and route toward appropriate clinical support, not to address it themselves.

The scope line in practice: The facilitator can ask: "What do you make of what arose?" The facilitator cannot say: "That sounds like unresolved grief around your father." The facilitator can offer: "Some people find journaling helpful for material that keeps returning." The facilitator cannot say: "I think you need to process that relationship specifically." The facilitator can acknowledge: "That sounds like it was significant and perhaps still tender." The facilitator cannot assess: "It sounds like that activated a trauma response." The difference is consistently this: the facilitator reflects, witnesses, and invites. They do not interpret, assess, or direct.

MAPS-informed model (narrative integration): Developed in clinical trial contexts and relevant to NMTP practice. The integration conversation focuses on what the participant experienced, what themes or images recurred, what felt significant, and how those connect to the intention named in M10. The facilitator listens for narrative coherence — not narrative correctness — and asks questions that deepen the participant's own understanding. This model is highly compatible with the iETA three-space framework: what did this tell me about my healthspace? My mindspace? My lifespace?

Hakomi-adjacent somatic approach: Integration conversations that attend to the body's processing — where in the body does the participant notice this experience living? What sensations accompany the memory of what arose? What does the body know that language hasn't yet found? This approach is particularly useful when participants report that what they experienced was hard to verbalize, or when significant somatic content arose during the session. Scope: the facilitator asks somatic questions; they do not conduct somatic therapy.

ACT-adjacent values-based approach: Connects the experience to the participant's values and the life they want to live. What did the experience clarify about what matters? What patterns does the participant want to bring forward? What would living in alignment with what arose actually look like in the next month? This model translates well into the 30-day integration plan (L4) and is particularly useful when the participant's intention was values- or direction-oriented rather than therapeutic.

Ethics of integration practice (L.4 continued): Three specific ethical decision points in integration. First: when clinical material requires referral. The facilitator's job when clinical content arises — active trauma symptoms, suicidal ideation returning, significant relational disruption that looks like clinical depression — is to acknowledge, hold, and route. Not address. The referral conversation is its own skill (covered in L3). Second: dual relationship risk in integration. The intimacy of the integration relationship can generate attachment dynamics that require careful management — the facilitator maintains their role and does not become a support person, friend, or therapist across the integration arc. Third: the risk of integration dependency. A participant who returns for integration sessions indefinitely without movement toward life-integration may be developing a reliance on the facilitator that serves neither of them. The integration relationship has a natural arc toward completion.

Appropriate integration resources (L.2): The facilitator is not the only integration support — and should not try to be. Identifying appropriate resources across three domains is part of every follow-up plan. Emotional support resources: licensed therapists, counselors, or psychologists with psychedelic-informed training; grief support; trauma-informed practitioners. The facilitator provides options — not referrals to specific practitioners as endorsements. Relational support: couples or family therapy referrals when the session material significantly implicated relational patterns; peer integration circles; facilitator-run group integration (L5). Community and meaning resources: spiritual or contemplative communities that fit the participant's values; nature-based practices; somatic movement or body-based communities; creative arts as integration practice.

The referral conversation: The facilitator identifies that something beyond their scope has arisen — clinical material, relational complexity, or participant need that exceeds integration facilitation — and names it directly and warmly. "I want to make sure you have the right support for what you're carrying. I can continue holding the integration space with you, and I also want to connect you with someone who has specific training in [area]. Here are some options — how does that feel?" The referral is an addition, not a handoff. The facilitator continues integration support alongside clinical referral unless the clinical situation requires otherwise.

What the facilitator evaluates before recommending a resource (L.2): Scope match (does this resource address what the participant needs?), cultural fit (does it align with the participant's values, background, and identity?), accessibility (is it financially and logistically available to this participant?), and safety (for clinical referrals — does the provider have psychedelic-informed training, or will they potentially pathologize the experience?). A therapist who will diagnose the participant based on their psilocybin experience rather than support the integration of it is not an appropriate referral.

Story framing — the facilitator's opening move: Before any model-specific questions, the facilitator invites the participant to tell the story of their experience — what happened, what arose, what was present. Not what it meant — what happened. This narrative opening gives the facilitator orientation to what they're working with and gives the participant the experience of having their account witnessed before it's explored. "Tell me what the experience was like — from arrival to when you left." This is not re-administration. It is the integration starting point.

The quality of integration questions: Integration questions have three qualities: they are open (not leading toward a particular answer), they are meaning-inviting (they explicitly or implicitly ask the participant to make meaning, not describe facts), and they are participant-centered (they locate authority in the participant's own knowing, not the facilitator's interpretation). Examples: "What do you make of that?" "What felt most significant to you?" "What does your experience with [image/theme] tell you about what you care about?" "If that moment had a message for your daily life, what might it be?" These questions resist interpretation. They require the participant to do the meaning-making work — which is both the point and the mechanism of integration.

Cognitive patterns within scope: Integration facilitators do not diagnose cognitive distortions — that is clinical CBT. They can, however, notice and gently name patterns in how the participant is framing their experience that may be limiting the integration. Common ones: all-or-nothing framing ("this either changed everything or meant nothing"), self-blame framing ("if I had gone deeper it would have worked"), external attribution ("the medicine didn't work"), and dismissal framing ("it was probably just the drug, nothing real"). The scope-appropriate response to each is a reframing question — not a correction. "What if there was a version of this that was both significant and still unfolding?" "What would it mean if the experience was doing exactly what it needed to, even if it wasn't what you expected?"

What meaning-making is not: It is not interpretation ("I think what this was really about was..."), it is not validation of a specific reading of the experience ("Yes, that was definitely about your mother"), and it is not reassurance that removes the participant's agency ("That makes perfect sense — here's why"). All three close what should be open. All three locate the meaning in the facilitator rather than the participant. All three feel caring in the moment and undermine the integration over time.

Participant safety concerns during integration (L.3): The integration period carries specific safety risks distinct from the session itself. Delayed adverse reactions: some participants experience significant psychological distress not in the session but in the days or weeks following — heightened anxiety, intrusive thoughts, relational disruption, or what some describe as a destabilization of previously stable psychological functioning. These are not always predictable from the session experience and require the facilitator to stay alert in follow-up contacts. HPPD (Hallucinogen Persisting Perception Disorder): rare but real — persistent perceptual disturbances following a session. The facilitator recognizes this as outside their scope and refers immediately to a psychedelic-informed medical provider. Relational disruption: sessions that surface significant relational material can create acute disruption in the participant's relationships — with partners, family, friends. The facilitator provides integration support and may refer to relationship or family therapy. This is not the facilitator's role to address directly. Suicidal ideation returning: M05 protocols remain active. A participant who expressed no suicidal ideation during the session may experience it in the integration period — particularly if the session surfaced material related to hopelessness, loss, or fundamental self-worth questions.

Appropriate intervals between administration sessions (L.5): Colorado NMTP L.5 requires discussion of appropriate intervals and related safety concerns. The general evidence-based guidance: a minimum of four to six weeks between administration sessions, with many practitioners recommending significantly longer periods. The reasoning: the integration of a psilocybin experience is not complete in the immediate weeks following — meaningful integration may take months. A second session before the first is integrated may compound rather than deepen the work. Additionally, some research suggests neuroplasticity enhancement windows of several weeks post-session during which integration is particularly productive — a second session during this window may interrupt rather than extend it. The facilitator does not determine session intervals — service center protocol governs this. But the facilitator informs the conversation about why intervals matter when a participant requests another session before their integration work is complete.

The 30-day integration plan: The integration arc from session to daily life benefit spans weeks to months. The 30-day plan provides structure for the participant in the immediate post-session period — not a clinical care plan, not a life plan, but a practical structure for honoring what arose in the session through action in the first month. It is built with the participant, drawing on their intention (M10), what emerged in the session (M11), and what they are bringing forward from integration sessions (M12). The facilitator provides the template and the co-design process; the participant provides the content.

A 30-day plan has four elements: one or two practices to continue or begin (behavioral changes the participant identified — journaling, a regular walk, reduced alcohol, a specific conversation they want to have), supports to activate (which resources from L2 the participant is pursuing — therapy, community, creative practice), a check-in rhythm (how often and through what channel the participant will touch base with the facilitator), and a simple self-reflection practice (what the participant will notice and track about their own experience — not clinical outcome measurement but genuine self-awareness practice).

Simple outcome measures (L.4 scope): The facilitator is not a clinical researcher and does not administer validated psychological assessment instruments. Within their scope, they can: invite the participant to identify what they hoped this experience would do for their life (connecting to M10 intention), invite the participant to reflect periodically on whether they are noticing movement toward what they hoped for, and document participant-reported experience in their own words. This is not outcome research — it is participant-centered progress awareness. The facilitator uses what they observe to inform integration support, not to make clinical claims about efficacy.

Responsible reporting (L.4 scope): When participants report significant positive change, the facilitator holds that with appropriate humility — acknowledging the participant's experience without making causal claims about the session ("the medicine did this"). When participants report difficulty or lack of movement, the facilitator holds that without dismissing it or re-attributing it. The facilitator's documentation of integration outcomes uses the same standard as all documentation: factual, in the participant's words, without clinical interpretation.

Community and cultural anchors in integration: Integration does not happen in isolation. The meaning-making work of integration is deepened when it has community context — when the participant can bring what arose into relationships, practices, and communities that support the ongoing lived experience of those insights. The facilitator's role is to help the participant identify what their communities of meaning are — or could be — and to support the bridges from the session to those communities. This is the L2 resource identification applied at community scale.

Cultural anchors are the specific practices, traditions, and community frameworks that give the participant a context for what they experienced. A participant with a contemplative practice already has a community of meaning. A participant with no such anchor may be in greater need of support in finding one — or in building one from scratch. The facilitator is not a cultural authority — they offer questions and options, not prescriptions. "What communities or practices have felt like home to you?" "Is there a context in which what you experienced would feel understood?" These questions invite the participant to locate their own cultural anchor.

The group integration circle (iETA-L): The group integration circle is an iETA-specific protocol for facilitating collective meaning-making among participants who have undergone individual or group administration sessions. It is not group therapy. It is a structured, facilitated space where participants share elements of their experience, are witnessed by peers, and make meaning in community. The protocol's four non-negotiables: equitable airtime (each participant receives equal time — enforced by timekeeping), voluntary sharing (no one is required to share more than they choose), confidentiality (what is shared in the circle stays in the circle), and scope maintenance (the facilitator does not interpret, analyze, or therapeutically process what is shared — they witness, contain, and facilitate transitions).

The group integration circle is distinct from group therapy in its non-directiveness, its lack of therapeutic intervention, and its peer witnessing structure. The facilitator's job in the circle is to hold the container, keep time, prevent the circle from becoming either a debriefing or a processing group, and close it in a way that grounds participants before they leave.