Navigating the Evolving Landscape of Psychedelic Conversations in Massage Therapy

By Suz Vera Burroughs

The following blog post was sponsored by Unwind Learning.

Author’s notes: As defined for this article, psychedelic substances refer to mind- or soul-manifesting substances. Also, we do not endorse or encourage anyone to engage in illegal activity or work outside their practice and licensing.

As massage therapists, we often find ourselves on the frontline of complex discussions regarding emerging health topics when other providers are inaccessible, time-constrained, or show little interest. The landscape surrounding psychoactive substances is shifting, spurred by research presented in popular documentaries and reform movements that have piqued interest in their potential benefits. When clients broach the subject of psychedelic substances during sessions, massage therapists need to stay within their scope of practice, be aware of legal implications, and follow harm-reduction best practices.

Renaissance, Revolution, or Reclaiming?

The War on Drugs in the US, which has shaped policies since the 1970s, is transforming. Psychedelic-assisted therapies show promise in treating conditions such as end-of-life anxiety, substance use disorders, posttraumatic stress disorder, and treatment-resistant depression, all of which overlap with conditions we see every day. Illustration of a woman in front of a stained-glass window.Progress has been made recently in advocating for and creating meaningful reform through legislation, ballot measures, local decriminalization, restorative justice efforts, medicalization, harm reduction, and religious freedom protections as they relate to psychedelic-assisted therapies.

Researchers worldwide are developing breakthrough therapies and learning about the nature of consciousness through these substances. Qualified mental health professionals are offering therapies by prescription. Efforts are underway to ensure the recognition and integration of indigenous practices and religious freedom protections into broader systems, with varying respect and support for Western therapeutic, religious, community-oriented, traditional, or indigenous practitioners.

The Biden administration’s call for a review of the drug scheduling system offers hope for clinical use in the US. Rescheduling could pave the way for more research and treatments aligned with the evolving landscape of mental health, holistic care, and traditional spiritual practices. Change could also support harm reduction, especially for communities disproportionately impacted by current policy and enforcement.

Professional Boundaries

What are some things you can do to prepare for these conversations when they come up?

  • Adhere to ethical boundaries and consider varying privacy laws that protect both therapists and clients.
  • Provide active listening and refrain from giving advice. Redirect clients to qualified providers to stay within your scope of practice.
  • Establish clear policies with broad categories like over-the-counter painkillers, prescription medications, ceremonial plants, and recreational substances so  that perception, consent, and communication can flow throughout the session.
  • Learn about harm reduction best practices from local public health organizations and national groups.
  • Develop a list of qualified and trusted providers who can answer client questions. One of them is the Fireside Project, a nonprofit organization that offers compassionate peer support and education to individuals focused on harm reduction and integration.
  • Learn about the five phases of safe use practiced by responsible clinicians and traditional practitioners: (1) detailed health and safety screening, (2) holistic planning including complementary modalities, (3) substantial preparation, (4) administration in a thoughtfully designed setting, and (5) robust integration over time.1

Those cautious about substance use are increasingly asking about ways to create therapeutic experiences and altered states of consciousness without legal risks. Learn more about practices that can create altered states, such as holotropic breathwork, drum journeys, sound baths, meditation techniques, and, yes, massage therapy.

Embracing Change

The dynamic landscape of mental health care invites massage therapists to adapt to new realities while upholding scope, legal, and ethical standards. Guiding clients through this terrain requires a delicate balance of holistic care, compliance with complex laws, staying within our scope of practice, harm reduction strategies, and an informed approach, which positions massage therapists as valuable partners in our clients’ physical and mental well-being.

Learn more about Suz Vera Burroughs’s NCBTMB-approved CE course on this topic at ABMP members use code ABMP and receive 30% off. 


1. Raquel Bennett, KRIYA Institute, brief presentation (unpublished), Dec 3, 2023.



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