Read this article in Dutch here.
On May 8, 2026, the Amsterdam Healthcare Disciplinary Board ruled on a significant case in which the Health and Youth Care Inspectorate (IGJ) had filed a complaint against a clinical psychologist (CP). The psychologist was conditionally suspended for treating a patient who had consumed psilocybin-containing truffles prior to therapy sessions. The patient in question was satisfied with the treatment and had suffered no demonstrable harm.
This ruling brings to light tensions that have been simmering for years. Although approval of the first psychedelic medications in the U.S. is getting closer by the day—both the pharmaceutical companies Resilient Pharmaceuticals (formerly Lykos) and Compass Pathways have completed two Phase 3 studies—the question remains as to when Europe’s turn will come. To meet the growing need for this new form of treatment, both Germany and Czechia recently approved the therapeutic use of psilocybin for treatment-resistant depression, on a limited basis and under strict medical conditions. In Switzerland, LSD, MDMA, and psilocybin have long been available for prescription under a “limited medical use” model. In the Netherlands, the situation is different: with the exception of esketamine, psychedelic treatments are not yet available within mental health care. In contrast, psilocybin-containing truffles are legally available, and guided sessions are offered by all kinds of providers. Often without proper training, and sometimes explicitly targeting people with mental health issues.
Moreover, these developments are taking place within a mental health care system that is under enormous pressure: long waiting lists, and desperate patients who often don’t derive sufficient benefit from the available treatment options in psychiatry. Similarly, healthcare professionals also notice that they sometimes hit a dead end and that treatments stall. As a result, sometimes patients turn to the gray market, as do practitioners acting in good faith. It is within this broader context that the suspension of the aforementioned psychologist should be understood.
The Disciplinary Board’s Ruling
Through this case, the inspectorate sought answers to open questions that have long been discussed among experts:
- Is a licensed healthcare provider, such as a clinical psychologist or a psychiatrist, permitted to work as a coach using psilocybin-containing truffles?
- Are clinical psychologists, psychiatrists, or other licensed healthcare practioners allowed to treat patients with psilocybin-containing truffles?
The disciplinary board provided a clear answer to both questions. In the current situation, without recognized guidelines or treatment protocols, the use of truffles within standard mental health care treatment is not in line with professional standards, according to the ruling. Even outside a formal treatment relationship, the following applies: any licensed professional who offers or facilitates a psilocybin experience, and in doing so—explicitly or implicitly—relies on their own clinical expertise and registration, falls under the scope of disciplinary law. According to the board, the fact that one offers a retreat, experience, or program as a coach does not alter this. An important detail: the legality of psilocybin-containing truffles does not grant licensed professionals carte blanche, as the disciplinary board does not assess the legal status of the substance, but rather the professional conduct of the healthcare provider.
The disciplinary case
The case involved a clinical psychologist who had been in a therapeutic relationship for several years with a patient suffering from complex trauma symptoms and dissociative identity disorder. On two occasions, the patient took truffle tea at home of her own initiative prior to therapy sessions. The clinical psychologist agreed to this and allowed the sessions to proceed. For a third session, during which the patient wished to take a higher dose, the clinical psychologist undertook a short preparatory course — without her manager’s consent. The day after this third session, a crisis arose in which the clinical psychologist, without informing colleagues, made a home visit to address the patient’s suicidal ideation. A year later, as a coach, she offered a one-off truffle retreat, which she promoted on LinkedIn.
The disciplinary tribunal ruled that, by consenting to the patient’s use of truffles and deliberately allowing the sessions to proceed, the clinical psychologist bore full professional responsibility; regardless of the fact that the initiative lay with the patient. It also ruled that this intervention had not been sufficiently carefully considered, partly because there is no scientific evidence for the use of psilocybin in trauma-related complaints and DID, nor is it included in any clinical guidelines. Additional criticisms concerned the lack of consultation with colleagues, inadequate record-keeping, and the retreat during which the CP utilised her clinical expertise under the guise of coaching.
What this case illustrates is not primarily the failure of a single practitioner, but the structural context in which she operated: no guidelines, no treatment protocols, no legal framework within which transparent consultation with colleagues was possible. This makes the individual allegations understandable, but does not resolve the underlying problem.
A lack of guidelines
One of the most significant points in the ruling is how the disciplinary tribunal deals with the lack of official protocols. The defence argued that without a standard, it is not possible to breach that standard. The disciplinary board took a different view: it is precisely the absence of a recognised framework that means application outside scientific research does not meet professional standards. As long as safety, efficacy and long-term effects are still being investigated, there is no valid basis for clinical application outside a research context. This is a clear position from both a legal and disciplinary perspective. However, it does not resolve the underlying demand for psychedelic-assisted treatment, nor does it address the lack of clear legal, ethical and professional frameworks. The question is therefore not whether that need is being met, but by whom and under what conditions.
Preparation and responsibility
The CP took a one-week course in preparation for the third session. The course was not accredited in the Netherlands. The disciplinary board did not view this as a step in the right direction, but rather as an illustration of how the CP prioritized her own judgment over the applicable standard.
Regardless of the accreditation issue, it is unlikely that a one-week course would enable anyone to work responsibly with psychedelics and altered states of consciousness. ADEPT, the training program organized by OPEN, lasts two years and, in addition to covering pharmacological and neurobiological mechanisms of action, somatic and psychiatric screening, and potential medication interactions, also devotes significant attention to therapeutic assessment and repeated training in specific skills for guiding non-ordinary states of consciousness. This is combined with ethical competencies around boundary management and (counter)transference, guided self-experience as a form of learning therapy, and practical experience under the supervision of experienced clinicians. It is our view that competence does not arise from knowledge transfer alone; it requires repetition, reflection, and supervision over an extended period, all the more so when working with vulnerable populations.
The professional community faces the task of translating these requirements into best practices, with effective therapeutic skills and competency standards, before broader implementation in mental health care takes place (for more details, see also the Memorandum on Psychedelics in Psychiatry). There are now several training programs specifically for mental health professionals, including SÄPT in Switzerland, APT in Germany, and ADEPT in the Netherlands. Serious training programs also explicitly address the legal dimension. For example, prior to the training, ADEPT participants are thoroughly informed about the applicable legal frameworks, and they agree to only apply the knowledge and skills they acquire within legal boundaries.
Finally, high-quality training is necessary but not sufficient. As long as the legal and care-related framework is lacking, even well-trained practitioners will continue to operate in a gray area.
A systemic issue
What this ruling also reveals is a troubling asymmetry: on the one hand, a qualified mental health professional is subject to disciplinary action for actions she took out of genuine concern and with some preparation; on the other hand, various coaches, trip sitters, and pseudo-therapists sometimes also work with people experiencing mental health issues. Not because their actions carry fewer risks, but simply because they are not BIG-registered.
A healthcare provider who acted out of concern, who had known her patient for years and sought training, has been disciplined. The patient had not filed a complaint. There is no demonstrable harm. The fact that her actions violated professional standards simultaneously demonstrates that the appeal of psychedelic-assisted therapy is real and that both patients and practitioners are actively seeking better treatments. For a deeper dive, see the ZonMw Report – Therapeutic Applications of Psychedelics [in Dutch].
We believe this situation calls for regulation: treatment protocols, guidelines, safety frameworks, and accredited training programs. Curiosity and education are valuable: the field needs people who follow scientific developments, understand the ethical complexities, and are prepared for the role they may play in the future. But preparation alone is not enough as long as frameworks are not in place.
Without clear frameworks, vulnerable patients sometimes end up with unqualified providers in the gray market, and BIG-registered practitioners face disciplinary risks—sometimes without even realizing it. This calls for decisive action from policymakers, professional associations, and registration authorities. For psychedelics for which there is sufficient evidence of safety and effectiveness, conditional authorization deserves serious consideration: linked to systematic data collection on safety, efficacy, and side effects, for example through a naturalistic study, as recommended by the MDMA State Commission.
The question is not whether we can turn a blind eye to this reality. The question is whether we are willing to take it seriously.
Joost Breeksema, Daan Keiman, Renske Blom, Michiel van Elk, and Wim van den Brink. For more information about OPEN, see open-foundation.org. For the ADEPT training, see learnwithadept.com.
