Ask the internet whether to tell your therapist you’re thinking about psychedelics, and here’s what you might hear:
“Just do it and tell them later.” “Your therapist won’t get it.” “They’ll just refer you out.” “Don’t tell them. It’ll go in your record.” “Skip the therapist and find a coach.” “Only do it with a shaman.”
Some advice out there is thoughtful. A lot of it isn’t, and much of it assumes the same thing: that your therapist can’t be trusted with this. I’m a licensed therapist who works with psychedelic medicine, so here’s my honest answer: in most cases, yes, it’s worth telling your therapist. I also understand exactly why so many people don’t.
Why so many people keep it to themselves
If you’ve been hesitant, your reasons probably make sense. These are the ones I hear most:
- “My therapist won’t approve.” You’re bracing for judgment, a lecture, or a shift in how they see you. Even for them to try to convince you to stop.
- “My therapist won’t understand.” Most therapists were never trained in psychedelics, and you may not want to educate your own provider.
- “They’ll refer me out or end our work.” After years of building trust, losing that relationship can feel like too big a risk.
- “It’ll go in my record.” Worries about documentation, insurance, or legal consequences are real, especially since psilocybin is still illegal under federal law.
- “I tried once and it went badly.” Maybe you mentioned it and the conversation shut down.
These fears are understandable. Some of them are also more workable than they feel, and staying silent usually costs more than people expect.
Why telling your therapist matters
Medications. Some medications can interact with psilocybin and other psychedelics, or change how you respond to it. Lithium is one combination that has been linked to serious reactions, including seizures, and antidepressants may blunt or change the effects. Your therapist may not prescribe, but they can help you bring the right questions to your prescriber. Please don’t stop or change a medication on your own. There are prescribers out there who are psychedelic-informed and trained to have these conversations.
Your history. A personal or family history of bipolar disorder or psychosis, or certain heart conditions, changes the risk picture. Your therapist already knows your story and can help you weigh it honestly.
Integration & Emotional Support. Psychedelic experiences, including microdosing, can stir up old memories, grief, or emotions. This is the material you’re likely to want to bring up in therapy, and your therapist can offer support for your emotional processing.
How to bring it up
You don’t need a perfect script. Something simple works:
“I’ve been reading about psychedelics, and I’m considering trying [microdosing / a guided journey]. I want to be honest with you so we can talk through safety and how it might fit with our work. How do you feel about that?”
A few things that help:
- Ask how they’d document the conversation. You’re allowed to ask what goes into your chart and records.
- Share what you’re hoping it will help with. Your intentions and reasons for working with psychedelics can help open a deeper conversation with your therapist.
- List every medication and supplement you take, even the ones that seem unrelated.
- Give them room to say they don’t know. Not many therapists have been exposed or trained in psychedelic-assisted healing or therapy, but many are open and willing to learn.
If your therapist isn’t open to it
- They’re uncomfortable but respectful. That can still be a positive experience and relationship. Ask whether they’d be willing to learn alongside you or consult with a psychedelic-trained colleague.
- They refer you out. This can feel like rejection, but often it’s a clinician being honest about the limits of their training. Ask whether they’d keep working with you on everything else while you get psychedelic-specific support elsewhere.
- They shame you or shut the conversation down. You deserve care that sees the whole picture. It may be time to look for a psychedelic-informed therapist. You shouldn’t have to hide aspects of yourself to receive therapy.
About that other advice
“Just do it and tell them later” skips the parts that keep people safe: screening, a medication check, and a plan. Coaches and ceremonial guides can offer real value, but many aren’t set up to understand mental health risk or medication interactions, and “only do it with a shaman” leaves out the clinical side entirely – particularly for those with more significant mental health symptom profiles. You don’t have to choose one path. Many people enjoy working with both: clinical support for mental health, safety and integration; and community or ceremonial support for meaning and connection – different purposes, intentions and environments.
Finding a psychedelic-informed therapist
Questions worth asking any therapist you’re considering:
- What training have you had in psychedelic-assisted therapy or integration?
- How do you screen for medications and mental health history?
- How do you document conversations about psychedelic use?
- What does integration support look like with you?
How I can help
At Intuitive Life Wellness, I offer ketamine and psilocybin-assisted therapy for clients in Colorado and New Mexico, and non-clinical microdose coaching nationwide. If you’d like to talk through whether this work is a fit for you, schedule a free 15-minute consultation.
If you’re a therapist reading this and want to be the provider your clients feel safe telling, my Clinical Microdosing Integration Training is a 16-week certification for licensed clinicians. Cohort 1 begins January 9, 2027.
Related reading: Microdosing Coaching vs. Psilocybin Therapy
A note on legality
In Colorado, personal use of psilocybin is decriminalized for adults 21 and over under the Natural Medicine Health Act, and licensed facilitators can provide regulated services. Psilocybin remains illegal under federal law and in most other states. This article is education, not medical or legal advice. Please don’t stop or change any medication without talking with your prescriber.
