Psychedelic Therapy: Ethical and Professional Lapses
As psychedelic-assisted therapies gain traction across clinical, research, and wellness domains, the need for ethical rigor, professional oversight, and physical safety has never been more urgent. While modalities like ibogaine, MDMA, and psilocybin hold immense therapeutic promise, the lack of regulation and inconsistent standards in emerging markets has exposed clients to unsafe, unethical, and at times outright negligent practices.
Recent reports of experiences within South Africa’s psychedelic retreat landscape have revealed systemic gaps, ranging from misrepresentation of credentials to improper substance use protocols and troubling lapses in safety infrastructure. Unfortunately, these incidents are not isolated anomalies but rather indicators of a field advancing faster than its accountability structures can manage.
Misrepresentation of Credentials and Professional Status
One case involved a therapist providing ibogaine treatments and integration therapy without formal registration with the relevant professional psychology board. Despite this, the individual routinely signed official communications using the title “PhD,” despite not yet having earned the qualification. Misstating credentials, particularly in clinical settings, undermines trust and violates foundational ethical standards.
Clients undertaking profound inner work—often in vulnerable states—deserve full transparency about the qualifications and professional standing of those responsible for their care.
Needless to say that overstepping and violating ethical and professional boundaries including the abandonment of clients throughout the critical post-ibogaine integration phase and breach of confidentiality adds to the concerns in that regard. More information on the topic can be found in this blog.
Improper Substance Use and Regulatory Violations
During one multi-day retreat, a range of psychoactive substances, psilocybin and changa, were administered or discussed. Some are classified Schedule 7 substances under South African law and are not approved for therapeutic use outside of approved research frameworks.
While the therapeutic potential of these entheogens is well-documented, their administration in a therapeutic context within jurisdictions where they remain illegal raises serious ethical considerations.
Additionally, participants were reportedly provided contact details for an individual who could facilitate access to further substances, including MDMA. MDMA-assisted therapy was offered as a potential treatment path and allegedly delivered by an individual with no formal training or accreditation in its clinical application.
Such casual and unregulated management of high-risk compounds is not only reckless, it erodes the legitimacy of the entire psychedelic field.
Pharmacological Practices and Questionable Team Conduct
While benzodiazepines were administered with client consent during treatment, the routine use of such sedatives in psychedelic contexts demands closer scrutiny. Their potential to suppress or blunt the therapeutic process must be carefully weighed, and protocols should be medically justified and transparently communicated.
More concerning was the report that certain team members intended to take microdoses of ibogaine themselves during retreat operations “to remain attuned” to clients. This approach lacks clinical grounding, compromises professional objectivity, and raises serious questions about boundaries and judgment in altered-state care environments.
Gaps in Clinical Presence and Emergency Preparedness
Despite the high-risk nature of the work, neither of the two assigned therapists was present on-site for the full duration of the retreat. Instead, responsibility for client safety was deferred to facilitators and medical staff. No immediate crisis intervention plan was in place should participants experience psychological distress or medical complications.
I personally identified additional serious safety concerns. Emergency exits were absent, and treatment rooms were only accessible via a narrow spiral staircase, conditions that pose a grave risk in the event of a medical emergency, particularly given ibogaine’s potential for side effects such as temporary paralysis. These infrastructure shortcomings are not cosmetic—they could prove life-threatening. It is imperative that such risks be addressed immediately to ensure future client safety.
Oversight Bodies and Conflicts of Interest
Perhaps the most deeply troubling aspect is that some of the individuals involved in these breaches hold roles on advisory boards and within nonprofit organisations claiming to promote safety, ethics, and professional standards in psychedelic care. When individuals in these regulatory-facing positions are themselves responsible for violating the very standards they claim to uphold, the credibility of these bodies comes into serious question.
A self-regulating industry cannot succeed when its internal mechanisms of accountability are compromised by conflicts of interest and opaque governance.
The Need for Structural Integrity
These are not isolated incidents—they are cautionary examples of what happens when an industry outpaces its own ethical infrastructure. Psychedelic therapy is still in its infancy in many jurisdictions. That makes it all the more critical to build a foundation of transparency, competence, and accountability from the outset.
What must change:
Clear and verified registration of all clinical practitioners
Accurate representation of qualifications in all communications
Evidence-based protocols for substance use, aligned with legal frameworks
Mandatory therapist presence during all high-risk interventions
Independent, conflict-free oversight and review boards
Comprehensive emergency response plans and infrastructure
Psychedelic medicine is not just about transformation—it is about responsibility. Every step forward must be grounded in a rigorous commitment to safety, ethics, and clinical excellence. Anything less is not innovation—it is malpractice.
