Dr. Signi Goldman, MD, is a board-certified psychiatrist and the Co-founder and Medical Director of Living Medicine Institute, which offers psychedelic-assisted psychotherapy training programs. As a certified provider for psychedelic-assisted therapy and research, she has practiced in various clinical settings, including hospital systems and alternative treatment settings. Dr. Goldman also serves as a Psychiatrist and Psychotherapist for Concierge Medicine and Psychiatry’s Ketamine-Assisted Psychotherapy Program for Mental Health.
Dr. Sandra (Sandy) Newes, PhD, is a licensed psychiatrist and the Co-founder and Programming Director of Living Medicine Institute. With over 25 years of clinical experience as a psychedelic-assisted psychotherapist, she specializes in anxiety, chronic stress, trauma, and recovery. Dr. Newes has provided ketamine-assisted psychotherapy through Concierge Medicine and Psychiatry since 2019. She is also an educator and speaker offering workshops, events, and education on psychedelic-assisted psychotherapy and the intersection of nature connection, trauma, and mental health.
Here’s a glimpse of what you’ll learn:
- [2:02] The types of trainees in ketamine-assisted psychotherapy training programs
- [5:10] What are the barriers to a career in psychedelic-assisted psychotherapy?
- [13:58] Dr. Signi Goldman and Dr. Sandy Newes talk about the unexpected elements of psychedelic-assisted psychotherapy training programs
- [20:10] Addressing concerns about ketamine-assisted psychotherapy treatments
- [25:58] How ketamine-assisted psychotherapy can cause harm to patients
- [33:50] Advice for transitioning into the psychedelic-assisted psychotherapy field
- [36:20] Why Dr. Newes and Dr. Goldman became involved in the ketamine-assisted psychotherapy space
In this episode…
Aspiring clinicians often find themselves at a crossroads when considering integrating psychedelic-assisted therapies into their practices. Although ketamine is legal, it remains largely unregulated, prompting concerns surrounding ethical use in psychotherapy settings. What are the essential skills, safety measures, and professional pathways necessary to enter this emerging field successfully?
As early pioneers of the ketamine-assisted psychotherapy space, Dr. Signi Goldman and Dr. Sandy Newes outline the common pathways for clinicians entering the space. The types of people who fit the typical profile include professionals aware of psychedelics’ potential, those with personal psychedelic experiences, and professionals seeking practical application of their knowledge. When transitioning into the field, Dr. Newes and Dr. Goldman emphasize prioritizing safety measures and executing preparation, intervention, and integration techniques to avoid harmful outcomes like fear associated with trauma and broken trust.
In this episode of Living Medicine, Dr. Signi Goldman and Dr. Sandy Newes share tips for breaking into the psychedelic-assisted psychotherapy space. Together, they address concerns about these treatments, the barriers to a career in this field, and how ketamine-assisted psychotherapy can cause harm to patients when implemented incorrectly.
Resources mentioned in this episode:
Quotable Moments:
- “Many people are blown away by just how powerful a ketamine experience can be for them personally.”
- “Our primary responsibility is to do no harm and to do this in the safest way possible.”
- “Therapy skills are important, but there is a mystery and magic that arrives in altered states.”
- “People want to make sure they’re doing it well; they want to be ethical and serve patients.”
- “There is a sense of mystery and magic in this work that is deeply compelling and emotional.”
Action Steps:
- Engage in comprehensive training programs: Participating in structured training programs focused on ketamine-assisted psychotherapy can equip you with the necessary skills and knowledge for safe and effective practices. Such programs offer theoretical understanding and provide practical experience.
- Gain personal experience with ketamine: Experiencing ketamine-assisted sessions personally can profoundly enhance your empathy and understanding of the process from a client’s perspective. This firsthand experience is crucial for clinicians to develop a deeper connection with clients and tailor interventions informed by personal insight.
- Focus on preparation and integration: Emphasizing preparation and integration sessions around the ketamine experience ensures a comprehensive therapeutic process. These sessions are critical for maximizing the therapeutic potential of ketamine by setting the stage for the session and helping clients make sense of their experiences afterward.
- Develop relational skills for non-ordinary states: Building strong relational skills to navigate the unique dynamics of ketamine sessions is vital, as clients are in a particularly vulnerable state. This approach recognizes the relational aspect as a significant component of treatment, helping mitigate risks of harm and deepening therapeutic outcomes.
- Prioritize ethical and safe practice: Ensuring that your practice is grounded in ethical guidelines and safety protocols is essential, given the lack of regulation in the field. This focus addresses concerns about potential harm and reinforces the importance of safeguarding client well-being while navigating an emerging therapeutic frontier.
Sponsor for this episode…
This episode is brought to you by the Living Medicine Institute.
LMI is a training, resource, and membership program educating providers about the legal and safe use of psychedelic-assisted psychotherapy.
To learn more or participate, visit https://livingmedicineinstitute.com.
Episode Transcript
Intro 0:03
Welcome to the Living Medicine podcast where we talk about ethical medical use of psychedelic psychotherapy, teaching skills, examining the issues and interviewing interesting people. Now let’s start today’s show. Hey everyone. Thanks for hanging out with us today.
Dr. Signi Goldman 0:21
I’m Signi, one of your hosts
Dr. Sandy Newes 0:24
Hi, and I am Sandy Newes your other host
Dr. Signi Goldman 0:27
And we’re getting on today to do something a little bit different. As you guys know, if you’ve been listening to our podcast, so far over our careers, we’ve interviewed quite a few experts in the research space, the policy space, other, you know, other important areas of psychedelics. But what we really want to talk to you guys about today are the kind of things you’ve been asking us for, which is how to get into this field, like, what to know? In other words, a lot of people approach us and say, what is it that I need to know that I don’t know? Do I really need to do this or that thing that I’ve been told I need to do. How did you guys get started? How do you coach or mentor people into getting started? And these kind of questions. So we had started this podcast, really to talk to you guys, those of you out there who are clinicians, whether you’re therapists or medical providers or other adjacent specialties, who want to get into psychedelic work using ketamine, legal ketamine, assisted psychotherapy and clinical settings. And you guys have a lot of questions. It’s not there’s not a clear pathway out there, even though there’s a lot of great resources. So um, we’re here today to just talk a little more informally about things that we wish we had known or things we think that you guys might need to know. So let’s just think through the kinds of things we tend to get asked, Sandy, what do you think like, who’s the typical trainees that we see or the typical person that comes in? You know, given that we’ve been doing this for about two years, yeah.
Dr. Sandy Newes 2:02
I mean, it’s a wide range, so I just so I do the initial interviews, the initial meetings with people who do the inquiries and that, you know, we have two tracks. There’s the clinical professionals, and then there’s the medical professionals. You know, at our program, it’s mostly licensed or licensed eligible people. So that kind of brings in kind of a different that, in and of itself, is a bit of a gatekeeper. And it is very much people who are aware of the psychedelic movement, if we’re going to call it that, you know, the kind of the publicity, the research, they’re aware of it. They’re tracking it. They’re confused by it, they’re intrigued by it, and they’re wondering about how to get in, in on it. So that’s kind of one of the tracks like, I’m aware of this. What is this? How do I learn about it? Tell me more about it. It seems like you guys are experienced at this kind of tell us about it. That’s the one track. Then there’s the other track of people, again, professionals who have really had profound psychedelic experiences of their own. And maybe they read Michael Pollan’s book, or saw the series, and they’re like, whoa. And, you know, maybe they were called to this by their, you know, by the publicity, and they got into it often, kind of later in life, and they see the power of it for themselves, and then they’d like to apply that in their career. And then the third track is really people who already know that they want to do this, and maybe they’ve already had some education, maybe that it didn’t quite meet their need for direct clinical application. Like, how do we do it? Like, I’ve learned about this, I’ve read about it, maybe I’ve done some other trainings, but I want to know how to do it, and I’m ready to incorporate this into my practice or into my clinic, and I’m ready to go. So it’s the kind of like general people who are aware and unclear how to get into it. They’re looking for that clear pathway. They’re looking for people to teach them and to mentor them. There’s the people who’ve had their own experiences and see that this is profound and impactful. And then there’s the people who actually know about it but are just unclear about how to get from where they are to how to actually begin to see clients, or to begin to put that into their clinics. And those three pathways are ultimately related, but those are kind of the three areas that people most identify with, I think,
Dr. Signi Goldman 4:35
yeah, and I think that actually is probably who a lot of our audiences were finding. So our intention is to try to be useful to you guys and answering some of these questions. So what are the things that you think people are most stumbling up against, like, what are the stumbling blocks out there that people come in when they do their interviews with you and say, you know, this is what I’m missing? Or this is where I’m getting stuck. Why aren’t people launching into careers, in other words, as easily as they hope to well, you know, initially,
Dr. Sandy Newes 5:10
like initially, up until the summer, when there were regulatory things that sort of back burnered Some of the things around MDMA and psilocybin, it there was a lot of questions about the utility of ketamine and ketamine versus other medicines, and that’s its own separate conversation. But you know the bottom line with that is, when I begin to assure people that it’s very effective, it’s totally legal, and it’s actually really fairly simple to incorporate into a clinical practice in terms of, like, timing of sessions. And you can do two hour sessions and get people in, and that helps with scheduling. And the arc of the medicine is pretty predictable. People don’t know that, like they don’t understand about ketamine, that it’s actually really straightforward, and learn it, and you can do it, and it fits into, like a regular office practice, as opposed to other medicines that require a lot more time and energy and just aren’t legal, like energy, meaning, like a six hour session or something like that, and a lot of like getting off of meds, and, you know, but, but ketamine is 100% legal. It’s never been illegal. And so when people come to understand that part, that kind of opens up a lot of doorways for them to see it. And, you know, and then there’s the piece about just like, okay, you know, I’m a like, I’m a solid professional, like, you know, more people who come to this who are, like, further along in their careers. It’s not, you know, there are a percentage of people who are brand new and have been just kind of tracking this, and maybe even went to school for this, but a lot of people are further along in their career. They’re they’re maybe bored there may be burned out. They see that there could be something different. They’ve had glimmers that something you know, there are other tools that psychedelics can provide that might really help them deepen more quickly into change with clients. And so they’re intrigued by that, and they also want to make sure that they’re doing it well, like, you know, one of the weird parts about ketamine is it’s totally unregulated, so anybody can technically do it, like, you know, a medical provider can do it, who’s able to prescribe, and can get that license for controlled substance and and you would know more about that than I do specifically. But then on the clinical side, you know, people want to be ethical. They want to do the right thing. They want to make sure that they’re not just jumping in and don’t know what they’re doing so in a way that can almost be a block. And you know, in our training, what we’re trying to do is just be like, we’re going to help you do that. Like we’re going to help you get from being an established professional who knows, like, how to do good clinical work. Who knows how to serve patients? And we’re going to give you a skill set. We’re going to help you practice. We’re going to help you learn about the medicine so that you’re going to be fully ready to at least begin the process and to feel confident that you have the skills to do it.
Dr. Signi Goldman 7:58
Yeah, I’ve noticed similar to that, that what a lot of people don’t have is, like a vision of how they can do it. You know, we talk a lot to people that come to us, so, like, I want to do this, I don’t kind of see exactly how, like, what my path forward is. And also we, you know, we are so used to as professionals going through training programs and certifications and things licensing, where we’re sort of given permission to do something in an established track, and you know that doesn’t exist yet in this world. So how do you, exactly like you said, how do you make sure you’re doing it safely, ethically and appropriately, when there’s not a really obvious person to ask? And so I feel like a lot of those questions we often are fielding a lot of that with our trainees, and really what they’re asking is, how did you guys do it, and how did you figure out how to do it safely and ethically, and because you and I have our eye on the sort of the broader practice community out there, what are the standards that are out there, and being able to answer people about things like that. But there’s not a there’s not a vision. And then I also feel like there’s not a there’s almost like a confidence hurdle, which you spoke to a little bit, which is, you know, this is a weird and different and we get a lot of people that have come gone through other trainings or done online trainings, and they know a lot about it, but that’s not the same as knowing how to do it in the moment. So you and I have talked a lot about this. How, you know, trainings really need to have a lot of focus on actual practical nuts and bolts clinical skills. So a lot of you out there listening, you may find yourself in this position of like, I might have an opportunity to even do this work. I might even have clients that are interested, and I’m already a good therapist or a good clinician, and yet I’m still a little nervous, like I keep not stepping into it, because I’m not exactly sure what to do once I’m in the room on the medicine with the person on a medicine and and so we really, you know, we understand that there’s a that’s kind of a emotional and logistic hurdle that a lot of people are looking for mentoring and actual just like practical advice. On that we that we have found, and so we focus a lot on that kind of thing. Because that’s understandable if this is new, and, you know, you there’s not a, you know, there’s not a lot of people to look to in your immediate community, for most of you who are doing this, so, right? Well, and it’s interesting,
Dr. Sandy Newes 10:15
because one of the things that I kind of tell people that I think is kind of funny, but it is so true. Like, you know, when I first started doing psychotherapy, like, where do you put your hands? You know, it starts to be analogous to that. Or when you learn about, like, psychological theory, and you’re busy in your head trying to figure out, like, Okay, what’s the next step, right? What’s the next thing I’m supposed to do? And there is a little bit of that, but that’s also for people who are established professionals. That’s also a place of insecurity, you know. Like, like, you know, I think it’s so important for people to really know their own strengths as a clinician coming in and to really like one of the pieces of advice you gave me, like, for our listeners who don’t know, I mean, Signi ultimately trained me like, you know, that’s where we started, and, you know, began to work at the clinic with that she and her husband founded, and I did a deep dive. I was, I’m going to do as much of this as I can, to get to learn as much as I can, as quickly as I can, and I did. So, you know, I very much lived that with fuel, and so, you know, like knowing that, like you, there’s an awkwardness to it, and that you’re, you know, you have to figure out the groove, and that that’s just part of doing anything new, yeah, like it’s really more like, it’s just like a novel setting.
Dr. Signi Goldman 11:30
Yeah, I don’t know what you think. You probably agree, but my experience with the many trainee cohorts that you and I have have taught at this point with LMI is the things that really, they really desperately want, and understandably is, what do I actually do, like, in a really granular, kind of detailed way, like, if this happens, do this, if this happens, say this, if this, then this, and almost like simplified down, at least in the beginning, until you kind of get your feet under you and that that sort of like, you know, overt providing kind of a, like a, what is that like? Not a landing strip, but like a launch ramp into the work that’s really, really accessible. And the fact that we show videos, and they get to see a lot of sessions and see what it looks like, people are really hungry for that, because that gives them a vision for themselves, doing it, and something to template after. And I think, you know, I, I went through residency training as a psychiatrist, and you did something similar, where you’re, you know, you kind of have people to model on. And that’s, I think, what’s missing a lot in this space, which is why people are really drawn to having film sessions or having us sort of, you know, role play and walk through what it what it actually looks like, which actually then gets into the importance of having your own sessions. That’s a whole nother topic that we can definitely talk about, but it’s worth dropping in there. If you are listening and you are interested in this work, and you have not experienced this, the medicine that you want to work with, in this case, ketamine, then we have a lot of thoughts on that, but it’s a huge part of your learning. It’s a huge part of your learning for kind of conceptualizing what’s going on in the inner world of your client. But plus,
Dr. Sandy Newes 13:10
it’s interesting. You know, like we see in the people who come through our training program, we do a fair amount of medicine in our training program, and we think it’s essential part of training, but it’s also personally impactful. Like, you know, people come out, they’re like, oh, wow, like that impacted me as a human and not just a professional. Yeah, absolutely professions. Those things are linked.
Dr. Signi Goldman 13:34
So, yeah, what do you and, you know, I haven’t shared these questions with you ahead of time. We just decided to get one in our living rooms and just chat. So this is not a formally thought through interview, but I’m actually curious, like, what do you think surprises people the most? Like, having run the retreats or the trainings we do that, that you think you know, people come in with an expectation and then find out otherwise? Oh, there’s a lot
Dr. Sandy Newes 13:58
of them. Um, one of them is that that ketamine itself is way more powerful than they think it’s going to be. Yeah, like people come in with a lot of biases towards plant medicines and things like that, and having been a person who has also been down those roads and has a shifting, you know, perspective on that over time, I can appreciate that. But people are really blown away by just how powerful Academy and experience can be for them personally, and then what they how much they see it impacts their clients. So this one like, Whoa,
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