The Project New Day (PND) program Acceptance and Screening Procedures, as outlined below, provide guidelines for organizations intending to implement the PND program model. It is not the intention of Project New Day to provide rigid guidelines for exclusionary criteria. It is up to each organization to define its own unique criteria, based on its specific goals and purpose. For example, one organization may choose to exclude participants who have previously participated in a recovery program while another may not. Ultimately, the procedures, as written below, are templates; starting points for adopting organizations. It is up to each organization to comply with all pertinent legal statutes and professional guidelines and to do everything possible to ensure their participants have a meaningful experience in an environment that promotes safety and well-being.
At the time of this writing, Oregon is the only state offering psychedelic-assisted services. As a result, there are references to the Oregon Health Oregon Authority and Oregon Psilocybin Services on this page and its associated documents. All of these documents may be found on the Resources page:
To initially screen for major exclusionary criteria, an online questionnaire must be administered as the most preliminary phase of the acceptance and screening procedures, using the Initial Screening Survey. In this phase, specific responses to a series of questions will exclude any clients who are deemed unsuitable to partake in psychedelic services as outlined by the Oregon Health Authority.
Beyond serving as a screening measure, the Initial Screening Survey will provide life coaches with basic information regarding medical and mental health conditions that may exclude individuals from receiving services or require further explanation in subsequent screenings. While it is under the discretion of each organization to define its own exclusionary criteria, the OHA has stated that answers in the affirmative to the following questions will exclude individuals from partaking in psilocybin services at any licensed Oregon service center.
The Initial Screening Survey will also provide potential clients with the opportunity to provide open-ended responses to a short series of questions. These questions are aimed at creating a narrative for the client and facilitator to work with during later phases of the acceptance and screening procedure.
As part of the initial screening, a set of diagnostics will be presented within the Initial Screening Survey. These specific scales have been selected as they each work to provide information about both issues regarding substance abuse and the potential presence of stress disorders. These assessments are completed at the end of the Initial Screening Survey and results are kept confidential, only viewed by the assigned life coach and the staff responsible for handling acceptance and screening. During this phase of the screening procedure, embedded psychological questionnaires are used to further assess the client’s eligibility. To obtain measurable data regarding the mental well-being of potential clients, the following questionnaires and scales will be administered. Upon completing the following diagnostics, the client will then be scheduled for two Zoom interviews with two separate PND staff members. The diagnostics and their descriptions are listed below. Additional information regarding these tools can be found within the Initial Survey Exclusion Checklist and Diagnostics document.
The Kessler Psychological Distress Scale is a simple measure of psychological distress. The K10 includes 10 questions about emotional states, each with a five-level response scale to determine levels of distress. The measure can be used as a brief screen to identify levels of distress. A score of 20 or higher would indicate the likelihood of the presence of a stress disorder and would prompt further inquiry at a later stage, using the PSS-SR5 and ACE assessments. The score on the initial K10 would serve to identify the initial likelihood and intensity of a potential stress disorder using the associated scale, listed below.
K10 Score: Likelihood of having a mental disorder (psychological distress)
The Adverse Childhood Experiences Questionnaire tallies different types of abuse, neglect, and other adverse childhood experiences. A higher score indicates a higher risk for future violence, victimization, perpetration, and negative impacts on lifelong health and opportunity.
The DAST-10 yields a quantitative index of the degree of consequences related to drug abuse. This tool allows for the measuring of the potential presence of a substance abuse issue.
The CAGE questionnaire is a four-question screening tool that clinicians may use to help in the diagnosis of alcoholism and substance abuse disorders. CAGE is an acronym for the focus of the questions.
Provided that the client passes the initial screening, they will then be scheduled for their Zoom interviews. This phase consists of two conversations held via Zoom to be conducted by two separate staff members dedicated to handling the screening process. These members of the screening and acceptance team will evaluate answers provided by the client in the first phases of the acceptance and screening procedures prior to their conversations. This preliminary information will be used to further explore topics addressed in the initial online screening and diagnostics submission.
To direct and grade the interviews, staff members will use a script, interview response form, and grading rubric originated by PND. These materials serve to ensure the quality of both the interview itself and decisions regarding eligibility. If it is the professional opinion of both screening staff members that the potential client meets all criteria to participate in psychedelic services as outlined by the Oregon Health Authority and the specific PND criteria, the client would move into the third phase of acceptance and screening. If the first interviewer finds that the client is ineligible to receive services, a second interview will not be scheduled, and the client will be excluded at that point. Potential exclusionary criteria may include the following:
This phase will also provide the opportunity for staff members conducting the interview to answer any questions an individual may have regarding the nature, objectives, and procedures of the upcoming psilocybin session.
Project New Day would like to reiterate the importance of individual entities establishing their own researched criteria for inclusion and exclusion. It is not in our interest to establish criteria that are to be generalized across all organizations interested in offering services based on the PND program. Instead, we wish to provide well-researched and well-defined examples of what responsible screening may look like. In line with these efforts, please refer to the documents under Acceptance and Screening Forms on the Resources page.
It is the expectation, according to the PND model, that service centers hosting psilocybin sessions will oversee and administer psychiatric and physiological screenings before a licensed facilitator moves forward with psychedelic services. It is in the best interest of the client that these screenings are administered by a licensed medical doctor. While it is not currently the position of the Oregon Health Authority that specific mental or physical disorders would disqualify an individual from consuming psilocybin at a licensed service center, it is the position of the PND model that individuals with the following disorders would be excluded from participating in psilocybin services:
Exclusionary Psychiatric Disorders
Exclusionary Physiological Conditions
Individuals diagnosed with the above conditions will be excluded from participating in psilocybin-assisted services. More information regarding exclusionary criteria may be found in the Exclusion Criteria Explanation and References form.
The service center should also provide space for the client and facilitator to create any extra plans necessary to ensure the client’s safety during a future psilocybin session. Examples of additional safety measures as outlined by the Oregon Health Authority include but are not limited to:
Psilocybin is a naturally occurring psychedelic prodrug compound produced by more than 200 species of fungi. The drug is safe to consume but in order to avoid potentially dangerous and/or inhibiting drug-drug interactions, drug screening is a necessary part of the acceptance and screening procedures. While it is a priority and core feature of the PND Program Model to support individuals overcoming drug addiction, there are a number of prescription drugs that interfere with medicinal psilocybin doses, creating issues in intensity and overall experience during sessions. This list includes but is not limited to:
Certain medications, including medications used to treat anxiety and depression, may require the client to stop taking prescription medications for a short period of time in order to prepare for the therapeutic psilocybin dose. In the case of illegal narcotics, the client should abstain from using for at least six days prior to the session where psilocybin will be consumed. Below is a more detailed list of each drug and recommendations for abstinence prior to psilocybin therapy.
It is important to note that it is not possible to list all prescription medications that might be either contraindicated or inhibitory to the therapeutic psilocybin dose. It is important to achieve a comprehensive drug screening with each participant, conduct additional research, and ensure that the participant can safely consume psilocybin before proceeding any further. More information regarding contraindicated medications may be found in the Exclusion Criteria Explanation and References form.
Inquiry refers to a component of mindfulness-based interventions. This approach discourages coaches from providing participants with unsolicited advice and rather encourages an expression of genuine curiosity toward the participant’s experiences in an effort to understand their unique situation. Any interpretation of the participant’s experience or uninvited problem-solving is viewed as a hindrance to the participant’s authentic production of insights and overall intuitive process.
|
Area of Concern |
Inclusion Criteria |
Exclusion Criteria |
|
Need for Treatment |
Meets Moderate to Severe Substance Abuse or PTSD criteria. |
Meets Mild substance Abuse or PTSD criteria. Or Client is not currently struggling with addiction or PTSD |
|
Psychological Screening |
Has no background of Bipolar 1, Bipolar 2, schizophrenia, or severe personality disorders |
Has a diagnosis of Bipolar 1, Bipolar 2, schizophrenia, or severe personality disorder |
|
Physiological Screening |
Is not currently diagnosed with or being treated for any condition that a licensed medical professional deems unsuitable for participation in psilocybin services. |
Is currently diagnosed with or being treated for high blood pressure, heart condition, epilepsy, or any condition a licensed medical professional deems unsuitable for participation in psilocybin services. |
|
Drug Screening |
Is not currently prescribed and taking any drug that may negatively impact the beneficially therapeutic effects of psilocybin. Or Is currently prescribed a potentially exclusionary medication but is able to refrain from taking prescription medication for at least 48 hours prior to the psilocybin session. |
Is currently prescribed and taking any drug that might interfere with the effects of psilocybin. |
|
Client Interview |
Staff member assesses that the client meets the criteria for a general level of functioning that can be improved through PND services. |
Staff member assesses that the client does not meet the general criteria to receive PND services. (History of violent crime, homelessness, etc.) |
|
Consent |
Consents to receive a therapeutic dose of psilocybin under the supervision physician as detailed in the "Commitments from the Client" section above |
Does not consent to receive a therapeutic dose of psilocybin under the supervision of a physician as detailed in the "Commitments from the Client" section above |
