Practical Guidelines for Supportive Touch in Psychedelic-Assisted and MDMA-Assisted Therapy: A Model for Practitioners and Researchers

The use of supportive touch in psychedelic-assisted therapy (PAT) and MDMA-assisted therapy (MDMA-AT) presents unique ethical challenges and opportunities. While touch can be a valuable component of treatment, its implementation requires careful consideration due to the altered states of consciousness induced by psychedelics and the potential for boundary violations. This paper addresses a critical gap in existing protocols by proposing a comprehensive, conservative model for the ethical implementation of supportive touch within PAT. Our framework features: (1) a structured two-stage consent-assent process distinguishing between permission obtained in ordinary consciousness and psychedelic sessions, (2) a range of touch options with clear categories and boundaries, (3) protocols for ongoing assessment of touch experiences, and (4) practical alternatives when touch is contraindicated. Drawing from clinical experience and ethical principles, we provide specific guidelines for discussing touch during preparation, administration, and integration sessions. The model emphasizes cultural sensitivity, power dynamics, and individual differences while prioritizing client autonomy and safety. We discuss limitations of our approach and suggest directions for future research and the development of specialized training programs. By offering pragmatic guidelines that balance therapeutic potential with ethical constraints, this paper contributes to the development of evidence-based practices in psychedelic-assisted therapy.