Interview Consent Form & Information

Background & Study Objectives

I am asking for your voluntary participation in a research interview about the facilitation approaches, practices, and protocols you bring to your work. It is important that you read this consent form to understand the study goals, interviewee criteria, interview expectations, risks and benefits, and confidentiality protocols and procedures. 

Study objectives:

1. The overarching goal of this study is to gather the approaches, practices, and protocols of psychedelic facilitators who are providing therapeutic support to their communities, outside of a clinical setting and among diverse populations. 

2. Through intentionally seeking out and including the voices of those facilitating therapeutic psychedelic sessions in non-clinical settings, the results of the study may reveal more effective, creative, and inclusive ways to facilitate psychedelic healing. 

3. This information may better inform individuals, psychedelic facilitators, under-resourced and marginalized communities, and the broader community as decisions are made about psychedelic use, safety protocols, therapeutic practices, and public policy.

Interviewee Criteria & Info

Interviewees must be over 21 years old, live in the United States, and have at least two years of psychedelic facilitation experience or experience facilitating for over ten clients in non-clinical settings.

• The duration of the interview is expected to be 1-2 hours.  

• The interview will be conducted using Zoom, with your camera off or on depending on your comfortability.

• The interview will be audio recorded.  

• Participation in the interview is voluntary, and at any point, you can refuse to answer a question or end the interview.

• You are free to withdraw your consent and stop taking part in this research study at any time without giving a reason.  Refusal to take part or the decision to withdraw from the study will involve no penalty. 

• By participating in the interview, you agree to allow the use of the unidentifiable quotes and transcriptions for research and education purposes.

Risks & Benefits

There are non-physical risks associated with taking part in this study, such as the risks associated with a breach of privacy or confidentiality.  If your identity were revealed, your potential exposure might put you at legal risk for distributing and/or administering illegal substances. I will do everything I can to keep your participation in this study private and confidential. I will keep all research records that identify you private to the extent allowed by law.  

To protect you as much as possible and minimize the risks of your participation, during the interview, please do not share your name or any identifiable information. Please never disclose details about distributing or administering illegal substances.  I will only ask about therapeutic protocols and practices, not specific information about what type of substance is being used or how it is administered.  

The benefits of this study include reflection of and knowledge gained about psychedelic facilitation practices.  Additionally, participation in this study could make a potential impact in the psychedelic renaissance. There will be no compensation for participants.

Confidentiality Protocols & Procedures

Due to the sensitive nature of psychedelic therapy work, multiple steps have been taken to ensure that the confidentiality of all interviewees and that all data collected are protected. 

1. To protect your identity as much as possible, a signature will not be required of you on this consent form, and you will not need to return the form to me.  Participating in the interview will indicate your consent.

2. After the interview, I will transcribe the audio recording, removing any identifiable information and assigning a code to the interview. 

3. Once transcribed, I will delete the audio recording of the interview. A list linking the code and any identifiable information will be kept separate from the research data in a locked file cabinet at the university. All study data will be stored on my secure password‐protected hard drive. All data collected will be identified only by that code (not by your name).  As a result, no one besides me will know individual level data. 

Consent

By moving forward with being interviewed, you indicate your consent to participate in this research study and authorize Miriam Kaiyo to use and disclose information provided by you for this study, as explained in this document.  Thank you for your consideration in participating in this study.