Psychedelic Psychotherapy is still developing. There have been various approaches in trying to define what kind of psychotherapeutic approach and technique would be the most useful.

One common approach is to use shamanic techniques. These are age-old methods that have helped countless people over the ages. They work on identities, reality creation, catharsis, and non-verbal material. There are differences in various indigenous cultural rites but a fundamental premise is that a shaman is a person who in recovering from their hurt, learned how to heal. This approach currently is not regulated. Many people who do not have training or experience are currently practicing this technique. The advantage of this approach is its emphasis on embodiment rather than talking. Processing of feelings is through non-linear methods. So people often walk away with not knowing why they feel better, but there is an improvement in the crushing weight they usually carry. It however is not for everyone. A person has to have some openness to participate in the shamanic ritual. The greater the familiarity with the ritual, the more the benefit. Some level of ego strength is needed in this ritual since a lot of the internal exploration is self directed.

Another similar approach is to use psychotherapy in the model of a shamanic ritual. Oftentimes this kind of psychotherapy is the major type of psychotherapy being practiced under the name of Ketamine Assisted Psychotherapy. It is eclectic in nature and is being offered in training by organizations like MAPS, CIS etc. Its advantage is that it creates a space in which a person can work through their difficulties. There is a combination of the embodiment working-through of the Shamanic ritual with the verbal working-through of the traditional psychotherapy. The therapists usually are trained in knowing how to sit with a person and create a safe space. The biggest skill for the therapist is that of a focusing coach. The therapist frequently encourages the person not to be distracted by familiar narratives and behaviors. But rather keep the focus on the intention and their intuition. The broader the experience of the psychotherapist, the better they can adjust to the unique needs of the journeyer. The weakness of this approach lies in its strength. Whereas this approach can adapt to multiple situations, often it is not focused enough to produce lasting change. It runs the risk of being fragmented. There are flashes of insight but no integration of the insight into a person’s narrative.

There are others who are bringing various schools of psychotherapy into the psychedelic space. EMDR, IFS, CBT, Hypnosis, Somatic experiencing, Polyvagal theory, and existential psychotherapy are all various approaches that are being tried in combination with Psychedelic psychotherapy. The advantage of this approach is that there has been research and experience behind most of these psychotherapy techniques. However, there is no research and experience behind the application of these psychotherapy techniques.

Most often these psychotherapies are being used for indications of depression, anxiety, trauma, obsessive-compulsive disorder, and substance use problems.