People come to psilocybin work from many different starting points. Some are already in therapy and see a psilocybin journey as a potential catalyst for work they're already doing. Others have no therapeutic relationship and are seeking psilocybin for personal growth, clarity, or exploration. Some are somewhere in between—aware they're carrying something that might benefit from professional support, but uncertain what kind.

Understanding the different roles involved—facilitator, life coach, therapist—can help you determine what support you actually need. These roles aren't interchangeable, and getting the right configuration matters for outcomes.

What a Facilitator Does

A psilocybin facilitator holds the container for your journey. During the session itself, my role is non-directive presence: I ensure your physical safety, provide reassurance if things become challenging, and support you in whatever arises. I don't guide the experience, interpret what's happening, or tell you what things mean. That's your work.

In Oregon's legal framework, facilitation is distinct from therapy. I'm licensed to facilitate psilocybin sessions, not to provide mental health treatment. This isn't a technicality—it reflects a genuine difference in what the work involves.

Facilitation also includes preparation and integration support. I help you surface material before the journey through journaling and reflective practices. I teach breathing and body awareness techniques that support surrender during the session. Afterward, I help you process what emerged and connect insights to daily life. But the frame for this work is facilitation, not clinical treatment.

What Life Coaching Covers

The extended integration support I offer is life coaching, not therapy. This distinction matters.

Life coaching focuses on the present and future: clarifying what matters to you, identifying concrete actions aligned with your values, building skills for navigating challenges, and supporting follow-through on commitments you've made to yourself. In my practice, I draw on Acceptance and Commitment Therapy (ACT) concepts—psychological flexibility, defusion, values clarification—as a framework for this work.

Psychological flexibility is essentially a life skill: the ability to be present, open to what you're experiencing, and able to act according to your values even when difficult thoughts and feelings show up. This isn't about fixing what's broken—it's about developing capacities that serve you in any circumstance. Many people find that building these skills during integration helps them navigate not just the post-journey period, but challenges that arise months or years later.

Coaching assumes a basically functional starting point. You might be stuck, uncertain, or struggling with a transition, but you're not in crisis and you're not working through trauma. Coaching helps you move toward what you want, not heal from what happened to you.

After a psilocybin journey, coaching-focused integration might involve questions like: What did this experience reveal about what matters to you? What patterns do you want to change? What's one concrete step you could take this week? How do you want to respond differently when that familiar thought shows up?

What Therapy Covers

Therapy goes places coaching doesn't. A licensed therapist can work with trauma, process difficult memories, address clinical conditions like depression or anxiety, and provide support during mental health crises. Therapy can go deep into your history, explore the origins of your patterns, and work with material that's destabilizing or overwhelming.

If your psilocybin journey surfaces traumatic memories, intense grief, or material that feels bigger than "how do I apply this insight," you need therapeutic support. If you have a diagnosed mental health condition, you should have a therapist involved in your care. If you're coming to psilocybin work hoping to address trauma, the journey should be embedded in a therapeutic relationship—not a substitute for one.

This isn't about what's "better." Coaching and therapy serve different functions. A good coach knows when someone needs a therapist; a good therapist knows when someone might also benefit from coaching. The question is what kind of support matches what you're actually working with.

When You Need Both

Many clients benefit from having both a therapist and integration coaching. This isn't redundant—the roles complement each other.

Your therapist brings clinical training, a longer-term relationship, knowledge of your history, and the capacity to work with whatever emerges—including material that's outside a coach's scope. They can process trauma, manage medication considerations, and provide support if the journey destabilizes you.

Integration coaching brings a framework specifically designed for post-journey work, focused attention on translating insights into action, and accountability for the concrete changes you want to make. Some therapists are experienced with psychedelic integration; many are not. Coaching can fill the gap.

When a client has both, I'm explicit about boundaries—with the client and with the therapist. My role is values clarification, committed action, psychological flexibility skills. The therapist handles trauma processing, clinical concerns, and deeper psychological work. If clinical material arises in our sessions, I acknowledge it and redirect: "This sounds important. I think this is something to bring to your therapist—it's more in their wheelhouse than mine."

Integration Options

My base facilitation package includes a morning-after integration session—a walk-and-talk for initial processing and check-in. This is a starting point, not comprehensive integration.

For clients who already have a therapist or other qualified professional providing integration support, the base package may be sufficient. Your therapist becomes your primary integration partner; I've done my part in preparing you and holding the container.

For clients without existing support, I offer an extended integration package: three additional coaching sessions over the two weeks following your journey. This provides structured support during the neuroplasticity window—the period when your brain is most capable of consolidating new patterns. If you don't have a therapist and aren't planning to get one, this extended support is strongly recommended.

For those who find the coaching relationship valuable, ongoing life coaching beyond the integration period is also available. Some clients continue monthly or as-needed sessions to support the changes they're making, work through new challenges as they arise, or deepen their psychological flexibility skills over time.

How Collaboration Works

When clients have an existing therapist, I offer collaboration regardless of which integration option they choose. Coordination helps ensure continuity of care.

Before the journey, I can connect with your therapist to share information about the protocol and discuss anything relevant to your preparation. This helps them understand what you're undertaking and prepare to support your integration.

After the journey, with your consent, I provide your therapist with a summary: the general character of the experience, themes or material that emerged, areas you want to explore in therapy, and any observations that might be useful for their work. This isn't a clinical assessment—it's a handoff, giving them context for what you'll be bringing to your sessions.

Some therapists are deeply familiar with psychedelic work and need minimal context. Others are curious but inexperienced. A few are skeptical. In all cases, clear communication about what happened and what you're working with helps them support you better.

How to Know What You Need

If you're uncertain what configuration of support makes sense for you, here are some questions to consider:

Do you have a diagnosed mental health condition? If yes, you should have a therapist involved in your care—ideally one who's informed about your psilocybin work, even if they're not directing it.

Are you coming to this work to address trauma? If yes, the psilocybin journey should be embedded in a therapeutic relationship. The journey may surface material that needs skilled clinical support to process. Coaching alone isn't sufficient.

Do you have a therapist you trust? If yes, keep them in the loop. They know your history and can provide support that I can't. I'm happy to collaborate with them.

Are you basically stable, seeking growth or clarity rather than healing from something specific? If yes, facilitation plus coaching may be sufficient. You'll still want to ensure you have support available if unexpected material surfaces—but you may not need ongoing therapy.

Are you unsure? That's fine. We can discuss it in the introductory session. Part of my job is helping you assess what support makes sense for your situation. Sometimes the answer is "let's proceed," sometimes it's "let's get a therapist involved first," and sometimes it's "this might not be the right time."

The Goal Is Good Outcomes

None of this is about gatekeeping or making the process complicated. It's about setting you up for the best possible outcome.

Psilocybin can open doors, but what happens after you walk through them depends on the support structure around you. Some people need a therapist. Some need a coach. Some need both. Some need neither—they have their own support systems and integration practices, and facilitation alone is enough.

My job is to help you figure out what configuration serves you, to provide the support that's within my scope, and to connect you with the right people for everything else. The goal isn't to fit everyone into the same model. The goal is to get you the support you actually need.

Michael Kelly is a licensed psilocybin facilitator in Oregon and founder of Mindstream Wellness. He offers facilitation services and life coaching for integration, and collaborates with therapists to support clients who need clinical care.