“When we created EMBARK, we canvassed twenty different psychedelic-assisted psychotherapies. We found that some therapies left out important aspects, like people’s spiritual experiences, somatic experiences, or human relationships. Patients were telling us that these experiences were central to their healing, but many therapies seemed to be missing critical pieces. To address this challenge, we developed EMBARK, which provides an open architecture to support the varieties of psychedelic experience within a coherent therapeutic framework. EMBARK is a patient-centered approach with six domains of treatment and four cornerstones of care—an approach for the whole person.“
-Alex Belser, PhD
EMBARK’s creators, Bill Brennan, PhD and Alex Belser, PhD, Cybin’s Chief Clinical Officer, drew from process evidence in psychedelic clinical practice and the experience of senior teachers and supervisors. The approach builds on proven evidence-based treatments (EBTs) and combines them with demonstrated psychedelic-assisted psychotherapies.
EMBARK is a transdiagnostic treatment model. This means that it can be adapted to different clinical indications and problems including depression, alcohol use disorder, and anxiety. We currently have adapted four different EMBARK therapy manuals. For example, in collaboration with Dr. Tony Back and Ladybird Morgan, RN, MSW, an adapted version of EMBARK has been authored to treat COVID-related burnout and symptoms of depression among frontline doctors, nurses and healthcare workers.
Cybin will use EMBARK as the therapeutic model for all of its clinical trials and is partnering with other leading institutions to adopt tailored treatment approaches. Toward this end, EMBARK’s six-domain structure was designed to be a modular, transdiagnostic framework that can be adapted to address the full range of clinical indications that Cybin intends to study.
Psychedelics are well known to catalyze profound mystical, spiritual, and religious experiences. In recent decades, a large body of research on psychedelic-assisted psychotherapy shows that participants often report profound encounters of an existential or spiritual nature, and that these experiences hold therapeutic benefit, with some participants even claiming that they are among the most meaningful experiences of their lives.
Participants may experience diverse phenomena such as a sense of transcending time and space, a sense of deep insight into the nature of reality, encountering ancestors, entities, or guides, feelings of oneness with the universe, and an awareness of the interconnection between humans and all life. More challenging encounters are also common, such as intense terror of losing one’s sense of self, or confrontations with death. Both beautiful and challenging experiences can be skillfully supported.
It’s important for a therapist administering psychedelic medicines to help foster a frame in which participants can prepare for the possibility of profound and sometimes challenging experiences, surrender to them if they do arise, and understand and integrate them afterward. EMBARK trains therapists to help participants translate their psychedelic-occasioned spiritual experiences into resources for healing and meaningful change.
In EMBARK, mindfulness refers to the practice of focusing awareness on inner experience, bringing attention to what is happening moment by moment in the present. It centers around cultivating a state of “observer consciousness” that bears witness to thoughts, sensations, and experience. Individuals participating in psychedelic-assisted psychotherapy often find benefits from the practice of mindfulness, such as greater psychological flexibility, less fear and more acceptance of challenging emotions and thoughts, and connecting with a “deeper” or “truer” self that is less identified with one’s emotions and beliefs.
EMBARK employs mindfulness techniques from evidence-based treatments to support participants not only with navigating the psychedelic experience, but also for managing triggers and tolerating distress and achieving their post-treatment goals. EMBARK therapists are trained to support participants in practicing mindfulness throughout the course of treatment to help them foster a nonjudgmental, compassionate approach toward themselves and their experiences, develop a renewed relationship with their own challenging thoughts and feelings, and cultivate an inner resilience essential for growth.
Symptoms of trauma and core beliefs are often held in the body. In psychedelic-assisted psychotherapy, the body can act as a doorway into deep healing. Participants undergoing psilocybin-assisted psychotherapy have described experiencing a range of embodied phenomena such as enhanced or altered perception of their bodies, changed interoceptive awareness, cathartic discharge of trauma through trembling, shaking, movement, or vocalizing, and even changes to their sense of self as embodied beings.
EMBARK embraces the body as a site of wisdom and healing. EMBARK draws from pioneering somatic (body-centered) psychotherapies in the recognition that the mind and body are not separate and it may be more helpful to speak of the mind-body as a single whole, particularly in the context of non-ordinary states of consciousness. The EMBARK approach employs somatic techniques throughout treatment to guide participants to trust the body’s intelligence and natural ability to heal. As somatic experiences may indicate a response to past trauma, therapists receive training to work with emergent somatic material within a trauma-informed frame.
Participants receiving psychedelic-assisted psychotherapy are often opened to deep emotional experiences beyond what they are able to access in their daily lives or regular psychotherapy. Many describe transcendent feelings of joy, bliss, and love, and also moments of emotional difficulty like despair, fear, sadness, and grief, often in the context of a healing catharsis. At other times, participants find themselves confronting challenging beliefs about themselves with a directness that they would normally avoid. With appropriate integration support, these openings can lead to lasting psychological change.
The EMBARK model supports participants with identifying, welcoming, and experiencing affective (emotional) states more fully. EMBARK training prepares therapists to support participants through extreme emotions and coming face-to-face with core psychological wounds. EMBARK trained therapists employ cognitive techniques to help participants confront, accept, and shift seemingly intolerable thoughts and feelings, and encourage participants to understand how negative feeling states often drive behaviors in everyday life.
EMBARK’s approach centers the idea that people are not lone, atomized individuals, but rather deeply connected and embedded in human relationship. Often in psychedelic experiences, people have experiences of seeing their mother or father, siblings, grown children, past romantic partners, and other meaningful life connections.
Psychedelic medicine holds a unique capacity to dissolve boundaries between self and other, and to bring the ways that a participant has been shaped by relationship to the forefront. Their relational history, including attachment ruptures and relational trauma, often from childhood, can emerge in their internal experience or may be brought to life in their relationship with the therapists. When responded to skillfully, these emergent dynamics within the therapeutic relationship can offer corrective emotional experiences and opportunities for relational repatterning.
EMBARK goes further than other approaches to psychedelic-assisted psychotherapy in emphasizing the relational domain. Therapists are trained to attend to relational cues as they arise in the present moment, guiding participants to bring awareness to how their past has shaped their present way of relating. Participants can then explore different ways of relating, setting healthy boundaries, experiencing greater safety in relationship, and expressing themselves more authentically. With therapeutic support, participants can internalize and integrate these new experiences and carry them into their lives as new beliefs about themselves and new ways of relating to others.
Psychedelic-assisted psychotherapy presents a critical, neuroplastic window to make changes in one’s life according to your own goals. After a medicine session, participants often emerge with a new perspective on life and a strong readiness and motivation to make changes to the way they live. With appropriate integration and therapeutic support, this moment of enhanced motivation offers an opportunity for making and sustaining such desired shifts, bringing the insights and healing of the psychedelic journey into everyday life.
Keeping momentum refers to this process of integration, translating altered states into altered traits. In planning for the future, EMBARK recognizes that setbacks are inevitable, but setbacks don’t have to become full-blown relapses. EMBARK prepares therapists to support participants in taking concrete steps towards meaningful change in their lives.
EMBARK is also built upon a foundational belief that efficacious treatment is ethical treatment. As such, any EMBARK approach to a specific indication will be built upon the model’s four Cornerstones of Care:
Psychedelic-assisted psychotherapy presents unique ethical challenges, including the potential for heightened participant suggestibility, the likelihood of stronger and more complex transference and countertransference, and the need for particular sensitivity regarding consent, specifically around boundaries and touch. These challenges present a greater risk for therapists to be drawn into boundary transgressions, and a greater need for therapists to use their role power ethically.
EMBARK responds to this heightened potential for relational harm by interweaving ethical considerations and training into all aspects of its approach. EMBARK therapists are supported in their own self-reflection and professional growth through ongoing supervision and participation in peer consultation groups, to normalize ethical challenges and elicit accountability within a community of practice.
The presenting symptoms and conditions that bring participants to psychedelic-assisted psychotherapy are rooted not only in their own personal experiences, but in cultural and historical trauma, societal inequities, discrimination, and environmental stressors. EMBARK therapists attend to the larger context of participants’ challenges through all aspects of treatment. EMBARK training supports therapists in attending to these factors when understanding and treating participants’ presenting challenges, and offers recommendations to therapists on how they can broaden their role and become more holistic advocates for the participants they have committed to serve.
Cybin is committed to making psychedelic psychotherapy accessible to underserved and marginalized populations by partnering with multicultural clinics focused on community mental health to offer affordable and equitable care and adapt treatment protocols to meet the unique needs of diverse communities.