F. Curriculum Requirements
1. Approved Facilitator Training Programs must offer coursework of at least 150 hours, on the following topics:
a. Facilitator Best Practices (5 hours)
(1) Awareness of the facilitator's personal bias, including examination of the facilitator's motives and the potential issues surrounding transference and countertransference;
(2) Awareness of the "state of the field" in terms of research on natural medicines and how to present this information to participants in a way that is accurate and unbiased;
(3) Awareness of new research related to safety and ethics of providing psilocybin services and resources for professional development following program completion; and
(4) Appropriate measures to mitigate risks associated with psilocybin services, including harm reduction, de-escalation, and conflict resolution.
b. Ethics and Colorado Natural Medicine Rules and Regulations (25 hours)
(1) Colorado's Facilitator Code of Ethics;
(2) Ethical considerations relating to equity, privilege, bias, and power;
(3) Awareness of increased vulnerability associated with altered states of consciousness;
(4) Appropriate use of touch and participant consent to physical contact, including the development of a Touch Contract in preparation session;
(5) Financial conflicts of interest and duties to participants;
(6) Ethical advertising practices;
(7) Providing accurate information about current research on the efficacy of natural medicines and facilitator scope of practice;
(8) Reasonable expectations regarding client outcomes; and
(9) Training in Colorado Natural Medicine rules and regulations.
c. Relation Boundaries and Introduction to Physical Touch (10 hours)
(1) Defining and holding boundaries in the facilitation of natural medicines;
(2) Historical and contemporary abuse of power and boundary violations associated with natural medicine, including sexual, emotional, and physical abuse, and implications for facilitators;
(3) Appropriate emotional and sexual boundaries between facilitators and participants both during the provision of natural medicine services and at other times;
(4) Potential harm to participants for boundary and touch violations;
(5) Consequences for facilitators for breaching relation boundaries;
(6) Consequence for facilitators for breaching the touch contract;
(7) Active monitoring of client-facilitator boundaries, specifically boundaries related to consent and touch;
(8) Participant directed discussion of touch contract to address personalized boundaries around touch, limitations of capacity to request additional touch once natural medicine has been ingested, and the possibility of requesting a co-facilitator and/or videotaping of administration session; and
(9) Practical training and experience in an introduction to the appropriate use of touch during the facilitation of natural medicine.
d. Physical and Mental Health and State (25 hours)
(1) Training in therapeutic presence, including compassionate presence, client communication, openness, receptivity, groundedness, self-awareness, empathy, and rapport, including a non-directive facilitation approach, cultural attunement, and a nonjudgmental disposition;
(2) Response to psychological distress and creating a safe space for difficult emotional experiences;
(3) Training on how facilitators manage self-care;
(4) Identification and facilitation of a variety of subjective natural medicine experiences, including experiences related to physiological sensations, cognitive, emotional, and mystical states, and traumatic memories;
(5) Appropriate modes of intervention for mental health concerns, understanding when intervention is necessary, and when a client may need a higher level of care;
(6) Appropriate modes of intervention for physical health concerns, understanding when intervention is necessary, and when a client may need a higher level of care;
(7) Training in the use of Natural Medicines for chronic pain;
(8) Recognizing and addressing adverse medical and/or behavioral reactions and implementation of a safety plan when necessary;
(9) Scenario training for navigating challenging and unusual situations; and
(10) Models of substance abuse, addiction, and recovery.
e. Drug Effects, Contraindications, and Interactions (5 hours)
(1) Pharmacodynamics and pharmacokinetics of natural medicine;
(2) Physical reactions and side effects of natural medicine;
(3) Drug and supplement interaction;
(4) The metabolism of natural medicine;
(5) The primary effects and mechanisms of action of natural medicines on the brain; including connectivity in the brain and activation of serotonin receptors; and
(6) Awareness of medical, mental health, and pharmaceutical contraindications for natural medicine services.
f. Introduction to Trauma Informed Care (10 hours)
(1) Trauma-informed care, including the physiology of trauma, vicarious trauma, empathic stress, and compassion fatigue;
(2) Trauma-informed communication skills;
(3) Training in how to recognize when someone may be dissociation or going into a trauma response;
(4) Training in understanding sympathetic and parasympathetic nervous system response; and
(5) Role play scenarios focused on helping regulate when participants are in a traumatic stress response.
g. Introduction to Suicide Risk (5 hours)
(1) Understanding suicidality, suicidal ideation, self-injury, and models of assessing risk;
(2) Basics of suicide risk assessment;
(3) How to refer and/or seek emergency mental health services when suicide risk is severe; and
(4) Basics of creating a Mental Health Safety Plan.
h. Indigenous, Social, and Cultural Considerations (10 hours)
(1) Historical and indigenous modalities of preparation of natural medicines;
(2) Current and historical use of plant and fungal medicines in indigenous and Western cultures;
(3) Information about the practice of Curanderismo and traditional training for the use of natural medicines;
(4) The Controlled Substance Act and its effect on natural medicine services in indigenous and Western cultures and implications for facilitators;
(5) Cultural equity, its relationship to health equity, and social determinants of health;
(6) Racial justice, including the impact of race and privilege on health outcomes and the impact of systemic racism on individuals and communities;
(7) The impact of drug policy on individuals and communities, especially underrepresented, marginalized, and under-resourced communities;
(8) History of systemic inequity, including systemic inequity in the delivery of healthcare, mental health, and behavioral health services;
(9) Intergenerational trauma;
(10) Understanding of how racial and cultural dynamics affect interactions between facilitator and participant; and
(11) Identification of the unique psychological, physical, and socio-cultural needs presented by persons with terminal illness and awareness of the appropriate knowledge, skills, and approach needed to provide safe facilitation to such persons in a manner consistent with client goals, values, heritage, and spiritual practices.
i. Screening (5 hours)
(1) Discussion of participant's reasons for seeking natural medicine services;
(2) Completion of the mandated screening form;
(3) How to conduct screening for pertinent physical and mental health concerns;
(4) Helping participants connect with different facilitators if needed; and
(5) Role play scenarios of screening sessions.
j. Preparation (10 hours)
(1) How to obtain informed consent;
(2) How to complete and collect participant information forms and intake interviews;
(3) Providing accurate information about current research on the efficacy of natural medicines and facilitator scope of practice;
(4) Discussion of the concept of trusting inner guidance, which may include discussion of topics such as Inner Healing Intelligence, Inner Genius, The Self, Wise Mind, Soul, or Spirit;
(5) Using intake and screening information to assist participants in identifying the benefits of referral to specialized treatment services;
(6) Discussion of the facilitator's role and the limits of the facilitator's scope of practice;
(7) Discussion of the state of scientific research for natural medicines and limitations of this research;
(8) Discussion of "set and setting," including environmental considerations for administration sessions such as lighting, sound, and temperature;
(9) Discussion of the reasonable expectations regarding client outcomes;
(10) Identification of participant safety concerns, including medical history, contraindicated medication, and psychological instability;
(11) Appropriate strategies to discuss facilitator safety concerns, including but not limited to identification of participant's support system;
(12) Determination of whether the participant should participate in the administration session;
(13) Participant directed discussion of a safety plan to address identified safety concerns and transportation plan for the administration session; and
(14) Historical and indigenous modalities of preparation for facilitation and administration of natural medicines.
k. Administration (10 hours)
(1) Dosing strategies and considerations, including the following:
(a) Experiential differences relating to differing dosages;
(b) Physiological considerations in relation to dosage;
(c) Delivery mechanisms of natural medicine; and
(d) Use of secondary doses.
(2) Skills to help facilitators handle natural medicine material effectively, including the following:
(a) Hygiene while handling material; and
(b) Assessing material for potential spoilage, contamination, and other concerns.
(3) Effectively working with challenging behaviors during administration sessions, including the following:
(a) Unexpected client disclosures;
(b) Substance-induced psychosis; and
(c) Suicidality.
(4) Traumatic stress and its manifestation during natural medicine experiences and appropriate facilitator response, including the following:
(a) Trauma's relationship to the body;
(b) Repressed trauma emerging during natural medicine experience;
(c) Trauma and traumatic stress resulting from systemic oppression;
(d) Safety for trauma resolution and risks associated with re-traumatization; and
(e) Protocols ensuring facilitator safety and responding to emergencies.
(5) "Set and setting" environmental considerations for administration sessions, such as lighting, sound, and temperature.
(6) Completion of administration session, including implementation of transportation plan.
l. Integration (10 hours)
(1) Training on how to conduct an integration session;
(2) Identification of appropriate resources that may assist participants with integration, including resources for:
(a) Interpreting feelings and emotions experienced during administration sessions;
(b) Facilitation of positive internal and external changes; and
(c) Enhancement of existing supportive relationships;
(3) Identification of participant client safety concerns;
(4) Facilitator scope of practice; and
(5) Discussion of appropriate intervals between administration sessions and related safety concerns.
m. Group Facilitation (10 hours)
(1) Training in how to conduct groups, including proper ratios for participants and group facilitators;
(2) Special considerations regarding group administration of natural medicine, including understanding boundaries and touch between group members and between group members and facilitators;
(3) Skills required to facilitate natural medicine group sessions, including, but not limited to:
(a) Group preparation sessions;
(b) Group integration sessions; and
(c) Regulatory requirements for group facilitation;
(4) Role play scenarios regarding navigation of challenging and unusual situations when facilitating groups.
n. Facilitator Development and Self-Care (10 hours)
(1) Facilitator self-care as a participant safety concern and facilitator ethical requirements;
(2) How to identify when a facilitator is not in a space to facilitate and what to do about it (including discussion of countertransference);
(3) How facilitators keep themselves safe while working with participants;
(4) How a facilitator can prepare themselves for facilitation; and
(5) How a facilitator can decompress after facilitation.
2. The requirements listed in these rules are minimum requirements. Nothing in these rules precludes an educational program from offering additional modules or hours of instruction.